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Management of MS Disorders > Elbow > Flashcards

Elbow Flashcards

1
Q

Which test was found to have good to very good reliability with ICCs?

a. isometric MMT
b. dynamometry
c. grip strength testing
d. ROM

A

grip strength testing

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2
Q

MMT for the elbow should be done in what position?

a. end range
b. mid range
c. it doesn’t matter
d. none of the above

A

mid range between elbow flexion and extension

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3
Q

Carrying angle normal range for males is between

a. 0-5 degrees
b. 5-10 degrees
c. 10-15 degrees
d. 15-20 degrees

A

5-10 degrees

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4
Q

Carrying angle normal range for females is between

a. 0-5 degrees
b. 5-10 degrees
c. 10-15 degrees
d. 15-20 degrees

A

10-15 degrees

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5
Q

Males have a greater carrying angle than females (true/false)

A

false

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6
Q

Tissue texture is irrelevant to elbow assesement (true/false)

A

false

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7
Q

Tissue texture of coarseness, leathery skin, dry/flakey is symptoms of which system?

a. musculoskeletal system
b. cardiovascular system
c. parasympathetic nervous system
d. sympathetic nervous system

A

sympathetic nervous system

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8
Q

Tissue texture of coarseness, leathery skin, dry/flakey is symptoms of which system?

a. musculoskeletal system
b. cardiovascular system
c. parasympathetic nervous system
d. sympathetic nervous system

A

sympathetic nervous system

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9
Q

Normal ROM for elbow flexion is usually

a. 100-110
b. 110-120
c. 130-140
d. 140-150

A

140-150

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10
Q

Normal ROM for elbow extension is usually

a. 0-5
b. 0-10
c. 0-15
d. -5-0

A

0-10

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11
Q

Normal ROM for forearm supination is usually

a. 70
b. 75
c. 80
d. 90

A

90

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12
Q

Normal ROM for forearm pronation

a. 75-80
b. 85-90
c. 80-85
d. 80-90

A

80-90

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13
Q

Reliability for ROM for both intra-examiner and inter-examiner of the elbow is

a. poor
b. average
c. good to very good
d. weak to average

A

good to very good

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14
Q

Which of the following is the end feel for elbow flexion?

a. soft tissue approximation
b. tissue stretch
c. bone-to-bone
d. none of the above

A

soft tissue approximation

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15
Q

Which of the following is the end feel for elbow extension?

a. soft tissue approximation
b. tissue stretch
c. bone-to-bone
d. none of the above

A

bone-to-bone

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16
Q

Which of the following is the end feel for forearm supination?

a. soft tissue approximation
b. tissue stretch
c. bone-to-bone
d. none of the above

A

tissue stretch

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17
Q

Which of the following is the end feel for forearm pronation?

a. soft tissue approximation
b. tissue stretch
c. bone-to-bone
d. none of the above

A

tissue stretch

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18
Q

The deep tendon reflex for the bicep tests which nerve root?

a. C7, C8
b. C5, C8
c. C6, C8
d. C5, C6

A

C5, C6

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19
Q

The deep tendon reflex for the triceps tests which nerve root?

a. C8
b. C7, C8
c. C5, C6
d. C6, C7

A

C7, C8

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20
Q

The deep tendon reflex for the finger flexors tests which nerve root?

a. C5, C6
b. C6, C7
c. C7
d. C8

A

C8

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21
Q

To test the DTR of the finger flexors, the therapist does which of the following?

a. taps the patients fingers in a supinated position
b. taps the patients fingers in a pronated position
c. taps their own fingers while holding the patients fingers in a pronated and curled position
d. taps their own fingers while holding the patients fingers in a supinated and curled position

A

taps their own fingers while holding the patients fingers in a pronated and curled position

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22
Q

A DTR of the elbow is used to assess the possibility of an

a. cervical root involvement
b. thoracic root involvement
c. lumbar root involvement
d. LMN lesion

A

cervical root involvement

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23
Q

A patient presents with pain over the lateral elbow during gripping activities, what is the initial hypothesis?

a. possible medial epicondylitis
b. possible cubital tunnel syndrome
c. possible pronator syndrome
d. possible lateral epicondylitis

A

possible lateral epicondylitis

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24
Q

A patient presents with pain over the medial elbow during wrist flexion and pronation?

a. possible radial tunnel syndrome
b. possible medial epicondylitis
c. possible cubital tunnel syndrome
d. possible pronator syndrome

A

possible medial epicondylitis

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25
Q

A patient presents with pain over the lateral elbow during gripping activities, what is the initial hypothesis?

a. possible medial epicondylitis
b. possible cubital tunnel syndrome
c. possible pronator syndrome
d. possible radial tunnel syndrome

A

possible radial tunnel syndrome

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26
Q

A patient reports of numbness and tingling in the ulnar nerve distribution distal to the elbow, what is the initial hypothesis?

a. possible radial tunnel syndrome
b. possible cubital tunnel syndrome
c. possible carpal tunnel
d. possible lateral epicondylitis

A

possible cubital tunnel syndrome

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27
Q

A patient reports of pain in the anterior aspect of the elbow and forearm that is exacerbated by wrist flexion combined with elbow flexion and forearm pronation, what is your initial hypothesis?

a. possible valgus extension overload syndrome
b. possible supinator syndrome
c. possible pronator syndrome
d. possible rotary instability

A

possible pronator syndrome

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28
Q

A patient reports pain during movement with sensations of catching or instability, what is your initial hypothesis?

a. lateral epicondylitis
b. medial epicondylitis
c. cuntal tunnel syndrome
d. rotatory instability

A

rotatory instability

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29
Q

A patient complains of posterior elbow pain during elbow hyperextension, what is the most appropriate initial hypothesis?

a. rotatory instability
b. pronator syndrome
c. valgus extension overload syndrome
d. varus extension overload syndrome

A

valgus extension overload syndrome

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30
Q

Which type of elbow lesion is described as having pain with any prolonged flexion of the elbow and is common with throwers?

a. carpal tunnel syndrome
b. radial tunnel syndrome
c. cubital tunnel syndrome
d. rotatory instability

A

cubital tunnel syndrome

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31
Q

Cubital Tunnel Syndrome can be caused by any of the following EXCEPT

a. trauma
b. excessive leaning on the elbow
c. immobilization
d. ulnar collateral ligament laxity

A

immobilization

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32
Q

Cubital Tunnel Syndrome can be caused by irritation to the ulnar collateral ligament by

a. ligament laxity
b. recurrent dislocation/subluxation
c. flipping of the nerve out of the groove
d. all of the above

A

ligament laxity
recurrent dislocation/subluxation
flipping of the nerve out of the groove

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33
Q

Symptoms of cubital tunnel syndrome include all of the following EXCEPT

a. sensory in ulnar nerve distribution distal to the tunnel
b. weakness
c. hypersthesia
d. clumsiness
e. thenar wasting

A

thenar wasting

another symptom is hypothenar wasting

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34
Q

What are ways to manage cubital tunnel syndrome?

A 
soft elbow pad at night during sleep 
ROM - avoid painful ranges 
increase the flexibility of the forearm 
postural muscle stretching and strengthening 
mobilization, manipulation, traction
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35
Q

With Cubital Tunnel Syndrome treat by increasing _ of forearm muscles

A

flexibility

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36
Q

How is surgery done to treat Cubital Tunnel Syndrome?

A

epicondyle is shaved off and they let the nerve come up anteriorly or it is reattached to the muscle

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37
Q

Which of the following is important to treat with Cubital Tunnel Syndrome?

a. treat the median nerve
b. treat regionally
c. treat the ulnar nerve
d. treat only the radial nerve

A

treat regionally

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38
Q

Post Immobilization Capsular Tightness is caused by all of the following except

a. casting
b. surgery
c. immobilization
d. fracture

39
Q

What is the biggest finding with Post Immobilization Capsular Tightness?

a. limited flexibility
b. limited nerve mobility
c. limited motion
d. limited resistance

A

limited motion

40
Q

ROM restriction due to Post Immobilization Capsular Tightness can be the result of

a. the capsule
b. the musculature
c. the nerves
d. a and b

A

the capsule OR the musculature

41
Q

What physiological changes occur with immobilization?

A

lose sarcomeres in a shortened position

42
Q

Which of the following is an appropriate treatment for Post Immobilization Capsular Tightness?

a. ROM, modalities, and joint mobilization
b. only ROM is allowed
c. joint mobilization and stretching
d. ROM, modalities, mobilization, stretching and splinting

A

ROM, modalities, mobilization, stretching and splinting

43
Q

What joint mobilizations are appropriate for Post Immobilization Capsular Tightness?

A

humeroradial
humeroulnar
radial head
proximal radial/ulnar

44
Q

Pain related to medial or lateral epicondylalgia is usually

a. insidious
b. trauma related
c. gradual onset
d. none of the above

A

gradual onset

45
Q

Medial and Lateral Epicondyalgia is related to

a. immobilization
b. repetitive flexing of the elbow
c. repetitive wrist or gripping activities
d. repetitive wrist extension

A

repetitive wrist or gripping activities

46
Q

Point tenderness over the medial epicondyle or lateral epicondyle is common (true/false)

47
Q

Pain with tenderness due to medial or lateral epicondylalgia is regional (true/false)

A

false

usually localized

48
Q

PROM with medial or lateral epicondylalgia is

a. painful
b. pain free

49
Q

Which type of neurodynamic test would you use to determine if a patient has an ulnar nerve injury?

a. ULNT1
b. ULNT2a
c. ULNT2b
d. ULNT3

50
Q

Which nerve has a sensory component and innervates everything except the thenar eminence?

a. Radial
b. Medial
c. Ulnar
d. None of the above

51
Q

What is the clinical differentiator for ULNT3?

a. Scapular depression
b. Elbow flexion
c. side head bend
d. wrist and finger extension

A

side head bend

52
Q

Where can the ulnar nerve be palpated?

a. the snuff box
b. thenar eminence
c. cubital tunnel on the medial side
d. it is too deep to be palpated

A

cubital tunnel on the medial side

53
Q

Which motion is key for completing the ULNT3 correctly?

a. Pronation
b. Finger extension
c. Scapular depression
d. Elbow flexion

A

elbow flexion

54
Q

Which test is used to test ulnar nerve entrapment?

a. Moving valgus test
b. Cozens test
c. Elbow flexion test
d. Varus stress test

A

Elbow flexion test

55
Q

Ulnar nerve entrapment testing is used to diagnose:

a. Carpal tunnel
b. Cubital tunnel syndrome
c. Lateral epicondylitis
d. all of the above

A

Cubital Tunnel Syndrome

56
Q

The moving valgus stress test is used to assess the

a. RCL
b. Ulnar nerve
c. UCL
d. Radial nerve

57
Q

Which of the following is an indicator of a positive elbow flexion test?

a. they are unable to flex their elbows
b. they experience pain with elbow flexion
c. they experience a tingling sensation

A

they experience a tingling sensation

58
Q

Which of the following is used to test for Cubital Tunnel Syndrome?

a. elbow flexion test
b. pressure provocation test
c. Tinels Sign
d. all of the above

A

all of the above

59
Q

To complete a pressure provocation test, the therapist will place their fingers over the _ _ and palpate the _ nerve in _ degrees of elbow _ and forearm _

A

place fingers over the cubital tunnel and palpate the ulnar nerve
arm is in 20 degrees of elbow flexion and forearm supination

60
Q

A positive pressure provocation test is positive when

a. the patient feels pain
b. it feels tender
c. symptoms are reproduced

A

symptoms are reproduced

61
Q

Tinels Sign is testing the _ nerve and involves _ on the nerve

A

ulnar

tap on the nerve

62
Q

Which elbow motions can be tested for a fracture?

A

elbow extension
elbow flexion
elbow pronation
elbow supination

63
Q

How do you test for an elbow fracture?

A

ask them to do that elbow motion and if they cant do it or don’t want to it is a possible fracture

64
Q

To complete the moving valgus stress test, the patient will _ their elbow and a _ force is applied then _ the elbow

A

flex their elbow to 120
valgus force is applied posteriorly
then extend the elbow

65
Q

UCL injuries are common in

A

overhead athletes

66
Q

Which of the following is a specific way to test the radial/lateral collateral ligament using the varus stress test

a. elbow straight
b. elbow bent 10-20 degrees
c. elbow bent 20-30 degrees
d. elbow bent 120 degrees

A

elbow bent 20-30 degrees

67
Q

The Valgus stress test is used to screen the

a. ulnar collateral ligament
b. radial collateral ligament
c. median nerve
d. ulnar nerve

A

ulnar collateral ligament

68
Q

The Varus stress test is used to asses the

a. ulnar collateral ligament
b. medial collateral ligament
c. lateral collateral ligament
d. median nerve

A

lateral collateral ligament

69
Q

Which of the following tests is used to screen for lateral epicondylitis?

a. Valgus stress test
b. Varus stress test
c. elbow flexion
d. Cozens test

A

Cozens test

70
Q

To complete a Cozens test, the patient will pronate and extend the wrist then radially deviate, the therapist will

a. resist extension and radial deviation
b. resist flexion and ulnar deviation
c. resist ulnar deviation
d. resist extension and ulnar deviation

A

resist extension and ulnar deviation

71
Q

A positive Cozens test will be indicated by

a. tingling
b. numbness
c. weakness
d. pain

72
Q

A Maudsleys test is performed by resisting all fingers in extension (true/false)

73
Q

Which type of treatment has been shown to be successful for lateral epicondylitis?

A

mobilization with movement

74
Q

Which type of neurodynamic test would you use to determine if a patient has a medial nerve injury?

a. ULNT1
b. ULNT2a
c. ULNT2b
d. ULNT3

A

ULNT1 and ULNT2a

75
Q

Which type of neurodynamic test would you use to determine if a patient has a radial nerve injury?

a. ULNT1
b. ULNT2a
c. ULNT2b
d. ULNT3

76
Q

When would it be appropriate to use ULNT2a instead of ULNT1?

A

when the patient cannot elevate their arm

77
Q

ULNT1 loads only the medial nerve (true/false)

A

false

it loads all but specifically the medial

78
Q

What is the most common outcome measure used for the treatment of the elbow?

79
Q

What is the clinical differentiator for ULNT1?

a. side head bend
b. let off some depression
c. let off all depression
d. elbow extension

A

side head bend

80
Q

What is the clinical differentiator for ULNT2a?

a. side head bend
b. let off some depression
c. let off all depression
d. relax finger extension

A

let off some depression

81
Q

What is the clinical differentiator for ULNT2b?

a. side head bend
b. let off some depression
c. let off all depression
d. elbow flexion

A

let off some depression

82
Q

What 2 motions are tested with dynamometry of the elbow?

a. elbow pronation and supination
b. elbow flexion and extension

A

elbow flexion and extension

83
Q

For optimal finger gripping, the wrist will be in what position?

a. slight wrist flexion
b. slight wrist extension
c. slight radial deviation
d. slight ulnar deviation

A

slight wrist extension

84
Q

The wrist is in a _ or _ position for gripping activities which fires the _ connected to the lateral epicondyle

A

neutral or extended

extensors

85
Q

Aggravating symptoms such as activities involving wrist extension/grasping will likely be diagnosed as

A

lateral epicondylitis

86
Q

Aggravating symptoms such as activities involving wrist flexion will likely be diagnosed as

A

medial epicondylitis

87
Q

Aggravating symptoms with a valgus stress of the elbow, throwing, and pitching will likely be diagnosed as

A

UCL ligament injury

88
Q

Aggravating symptoms such as activities involving elbow and wrist extension will likely be diagnosed as

A

ulnar nerve entrapment

89
Q

Aggravating symptoms such as activities involving full elbow extension or pronation of the forearm will likely be diagnosed as

A

median nerve entrapment

90
Q

The radial lateral ligament resists a _ (valgus/varus) stress

91
Q

The ulnar medial ligament resists a _ (valgus/varus) stress

92
Q

Where are three places the ulnar nerve can be palpated?

A

bottom 1/4 of the medial arm
cubital tunnel
guions tunnel

93
Q

Where are the three places the radial nerve can be palpated?

A

the radial groove of the humerus
along the radius in the forearm
anatomical snuffbox

94
Q

Compression of a nerve will cause pain (true/false)

A

false

it will cause paresthesia unless it has been compressed for a long time

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