Comp Eval: Elbow/Hand/Wrist Flashcards
6-91 Web distal/humerus, forearm grasp pull; long axis distraction
-PP: Seated; elbow in slight flexion
-DP: Standing facing pt
-CH: Grasp distal forearm
-IH: Web contact on distal humerus
-VEC: LAD *Can also be applied with pronation and supination
6-92 Calcaneal/proximal ulna, forearm stabilization; medial to lateral glide
-PP: Seated; affected arm flexed at shoulder
-DP: Standing facing patient on medial side of affected arm
-CH: Calcaneus with inside hand on proximal ulna -IH: Outside hand on lateral aspect of forearm with your arm stabilizing pt arm against your body
-VEC: M-L impulse while slightly distracting with IH
6-93 Calcaneal/proximal radius, forearm stabilization; lateral to medial glide
-PP: Seated with arm flexed at shoulder
-DP: Standing on lateral side of affected arm
-CH: Outside hand calcaneal contact on proximal radius
-IH: Inside hand grasps proximal forearm holding affected arm against your body
-VEC: L-M impulse while slightly distracting with IH
6-94 Reinforced hypothenar/proximal radial pull; anterior to posterior glide
-PP: Seated at edge of table sitting on palm of hand of affected arm; ask patient to hold edge of table -DP: Sit on edge of table or straddling table facing pt on affected side
-CH: Inside hand hypothenar to proximal radius/radial head
-IH: reinforces CH with outside hand
-VEC: A-P impuls
6-95 Thumb/radius push, distal forearm grasp; posterior to anterior glide in pronation
-PP: Seated; affected arm slightly flexed at elbow in pronation
-DP: Stand on affected side
-CH: Outside hand thumb contact on radial head
-IH: grasp distal forearm
-VEC: P-A very shallow impulse; IH moves elbow into a slightly extended and pronated position
6-96 Mid-hypothenar (knife-edge) /proximal ulna, elbow flexion; anterior to posterior glide
-PP: Seated; shoulder and elbow flexed
-DP: Stand facing pt
-CH: Inside hand hypothenar/knife edge on proximal ulna in antecubital fossa
-IH: Grasp proximal forearm with outside hand
-VEC: A-P; using IH flex pt elbow over contact delivering A-P thrust with contact hand
6-97 Hypothenar/radius push, ulnar stabilization; posterior to anterior glide in supination
-PP: Seated on table edge while sitting on palm of affected side
-DP: Seated facing patient on table or straddle table -CH: Pisiform of inside hand on posterior radial head -IH: Grasp proximal ulna with posterior hand
-VEC: P-A shallow impulse
6-98 Thumb index/olecranon ; posterior to anterior glide in full extension
-PP: Seated with affected arm extended at elbow; flexed at shoulder
-DP: Standing on lateral side of affected arm
-CH: Form a ring with thumb and index finger
-IH: Grasp distal anterior forearm
-VEC: P-A shallow impulse on olecranon; IH applies light downward pressure on distal forearm
6-99 Bimanual grasp/distal humerus with knee extension; long axis distraction
-PP: Supine with affected arm slightly abducted
-DP: Bunny hop position; knees grasping distal forearm
-CH: Bimanual grasp on distal humerus
-VEC: LAD with slight knee extension
6-100 Web/proximal ulna push with knee extension; medial to lateral glide
-PP: Supine with affected arm slightly abducted
-DP: Bunny hop position; knees grasping distal forearm
-CH: Inside hand web contact on proximal ulna
-IH: Outside hand on lateral forearm just distal to CH -VEC: M-L shallow impulse with CH while distracting with knees
6-101 Web/proximal radius push with knee extension; lateral to medial glide
-PP: Supine with affected arm slightly abducted
-DP: Bunny hop position; knees grasping distal forearm
-CH: Outside hand web contact on proximal radius -IH: Inside hand on medial forearm just distal to CH -VEC: L-M shallow impulse with CH while distracting with knees
Cozen’s Test
• Pain in the
lateral
epicondyle
indicates
Lateral
Epicondylitis
Mill’s Test
• Pain in the
lateral
epicondyle is a
positive test
indicative of
lateral
epicondylitis
Stress Test of the Elbow
• Pain or
increased
movement
indicates
damage to the
supporting
ligaments of the
elbow
Pinch Grip Test
• Inability to keep the
thumb flexed
pinching tip to tip is
indicative of
impingement of the
anterior interossei
branch of the
median nerve
Medial Epicondylitis Test
• Pain in the medial
aspect of the
elbow is indicative
of medial
epicondylitis
Tinel’s Sign of the Elbow
• Pain, referred
pain or tingling
indicates damage
to the ulnar nerve
6-126 Bimanual thumb index/radius and ulna shear; anterior to posterior or posterior to anterior glide
-PP: Seated or supine
-DP: Stand facing pt on involved side
-CH: Thumb/Index on distal radius and ulna
-VEC: Apply A-P and P-A shearing bilaterally
6-127 Reinforced hypothenar/radius; medial to lateral compression
-PP: Seated on adjusting table, affected arm on headrest radius facing up
-DP: Stand at head of table facing pt
-CH: Pisiform contact with cephalad hand to distal radius
-IH: Caudal hand reinforces snuff box
-VEC: Compressive M-L approximation impulse thrust
6-128 Hand-grasp pull with forearm stabilization; long axis distraction
-PP: Seated with affected arm in flexion
-DP: Stand facing pt
-CH: Inside hand grasps pt hand
-IH: Outside hand grasps distal forearm
-VEC: LAD; shallow quick pul
6-129 Bimanual palmar grasp/hand with arm axillary stabilization; long axis distraction
-PP: Seated with affected arm slightly flexed at shoulder and elbow
-DP: Seated or standing on affected side
-CH: Inside arm rests in pts antecubital fossa with palmar contact placed proximal to pt thenar
-IH: Outside hand palmar contact over pt’s metacarpals/dorsal hand
-VEC: LAD; squeeze hands together while flexing pt’s elbow
6-130 Bimanual grasp/distal forearm hand; medial to lateral or lateral to medial glide; medial to lateral or lateral to medial tilt
-PP: Seated with affected arm in flexion
-DP: Stand on affected side facing lateral aspect of pt’s arm
-CH: Proximal hand grasp distal radius/ulna
-IH: Distal hand grasps pt’s distal wrist
-VEC: Shearing type stress either M-L or L -M or creating radial and ulnar deviation stress
6-131 Bimanual grasp/distal forearm hand; anterior to posterior or posterior to anterior glide
-PP: Seated with affected arm flexed
-DP: Stand on affected side
-CH: Proximal hand grasps distal radius/ulna
-IH: Distal hand grasps pt’s distal wrist over metacarpal-carpal joints
-VEC: A-P or P-A impulse thrust
6-132 Reinforced thumbs/carpal; anterior to posterior glide
-PP: Seated with affected arm raised in flexion
-DP: Standing facing pt
-CH: Reinforced thumb on affected carpal
-VEC: A-P or P-A impulse; remove articular slack (flex or extend wrist)
6-133 Bimanual thumbs digits/metacarpals; anterior to posterior or posterior to anterior
-PP: Seated with affected arm in forward flexion, elbow flexed
-DP: Stand facing pt CH/IH: Thumbs on palmar surface of metacarpals
-VEC: A-P or P-A, creating a shearing force between metacarpals
6-134 Thumb index grasp/metacarpophalangeal (or interphalangeal) with hand stabilization; long axis distraction; internal or external rotation; anterior to posterior or posterior to anterior glide; lateral to medial or medial to lateral glide
PP: Seated DP: Stand facing patient CH: Grasp distal to joint being adjusted IH: Grasp proximally to the joint being adjusted
VEC: LAD; A-P; P-A, L-M, M-L or internal/external rotation
-PP: Seated DP: Stand facing patient
-CH: Grasp distal to joint being adjusted
-IH: Grasp proximally to the joint being adjusted
-VEC: LAD; A-P; P-A, L-M, M-L or internal/external rotation
Tinel’s of the Wrist
• Pain or tingling in
the distribution
of the median
nerve distal to
the wrist
indicates medial
nerve
compression in
the carpal tunnel
Phalen’s
• Pain or tingling
in the hand
along the
distribution of
the median
nerve. Indicates
carpal tunnel
compression of
the median
nerve
Reverse Phalen’s
• Pain or tingling in
the hand along
the distribution
of the median
nerve indicates
carpal tunnel
compression of
the median
nerve
Finkelstein’s
• Sharp pain in tunnel 1
indicates DeQervain’s or
stenosing tenosynovitis
Bracelet Test
• Acute pain in the
wrist forearm and
hand indicates
Rheumatoid
Arthritis
Stress Test of the Wrist
• Pain or increased
movement
indicates damage
to the supporting
ligaments or
problems with the
tunnel
Carpal Lift Test
• This indicates carpal fracture or sprain
Froment’s Sign
• Positive is a
weakness in the
ability to keep the
digits together
indicating ulnar
nerve palsy
Finsterer’s Sign
• Pain in the center of
the wrist indicates
Keinbock’s disease (
lunate avascular
necrosis)
