Elbow Flashcards
Which test was found to have good to very good reliability with ICCs?
a. isometric MMT
b. dynamometry
c. grip strength testing
d. ROM
grip strength testing
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
mid range between elbow flexion and extension
Carrying angle normal range for males is between
a. 0-5 degrees
b. 5-10 degrees
c. 10-15 degrees
d. 15-20 degrees
5-10 degrees
Carrying angle normal range for females is between
a. 0-5 degrees
b. 5-10 degrees
c. 10-15 degrees
d. 15-20 degrees
10-15 degrees
Males have a greater carrying angle than females (true/false)
false
Tissue texture is irrelevant to elbow assesement (true/false)
false
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
sympathetic nervous system
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
sympathetic nervous system
Normal ROM for elbow flexion is usually
a. 100-110
b. 110-120
c. 130-140
d. 140-150
140-150
Normal ROM for elbow extension is usually
a. 0-5
b. 0-10
c. 0-15
d. -5-0
0-10
Normal ROM for forearm supination is usually
a. 70
b. 75
c. 80
d. 90
90
Normal ROM for forearm pronation
a. 75-80
b. 85-90
c. 80-85
d. 80-90
80-90
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
good to very good
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
soft tissue approximation
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
bone-to-bone
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
tissue stretch
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
tissue stretch
The deep tendon reflex for the bicep tests which nerve root?
a. C7, C8
b. C5, C8
c. C6, C8
d. C5, C6
C5, C6
The deep tendon reflex for the triceps tests which nerve root?
a. C8
b. C7, C8
c. C5, C6
d. C6, C7
C7, C8
The deep tendon reflex for the finger flexors tests which nerve root?
a. C5, C6
b. C6, C7
c. C7
d. C8
C8
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
taps their own fingers while holding the patients fingers in a pronated and curled position
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
cervical root involvement
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
possible lateral epicondylitis
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
possible medial epicondylitis
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
possible radial tunnel syndrome
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
possible cubital tunnel syndrome
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
possible pronator syndrome
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
rotatory instability
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
valgus extension overload syndrome
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
cubital tunnel syndrome
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
immobilization
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
ligament laxity
recurrent dislocation/subluxation
flipping of the nerve out of the groove
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
thenar wasting
another symptom is hypothenar wasting
What are ways to manage cubital tunnel syndrome?
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
With Cubital Tunnel Syndrome treat by increasing _ of forearm muscles
flexibility
How is surgery done to treat Cubital Tunnel Syndrome?
epicondyle is shaved off and they let the nerve come up anteriorly or it is reattached to the muscle
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
treat regionally
Post Immobilization Capsular Tightness is caused by all of the following except
a. casting
b. surgery
c. immobilization
d. fracture
fracture
What is the biggest finding with Post Immobilization Capsular Tightness?
a. limited flexibility
b. limited nerve mobility
c. limited motion
d. limited resistance
limited motion
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
the capsule OR the musculature
What physiological changes occur with immobilization?
lose sarcomeres in a shortened position
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
ROM, modalities, mobilization, stretching and splinting
What joint mobilizations are appropriate for Post Immobilization Capsular Tightness?
humeroradial
humeroulnar
radial head
proximal radial/ulnar
Pain related to medial or lateral epicondylalgia is usually
a. insidious
b. trauma related
c. gradual onset
d. none of the above
gradual onset
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
repetitive wrist or gripping activities
Point tenderness over the medial epicondyle or lateral epicondyle is common (true/false)
true
Pain with tenderness due to medial or lateral epicondylalgia is regional (true/false)
false
usually localized
PROM with medial or lateral epicondylalgia is
a. painful
b. pain free
pain free
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
UNLT3
Which nerve has a sensory component and innervates everything except the thenar eminence?
a. Radial
b. Medial
c. Ulnar
d. None of the above
Ulnar
What is the clinical differentiator for ULNT3?
a. Scapular depression
b. Elbow flexion
c. side head bend
d. wrist and finger extension
side head bend
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
cubital tunnel on the medial side
Which motion is key for completing the ULNT3 correctly?
a. Pronation
b. Finger extension
c. Scapular depression
d. Elbow flexion
elbow flexion
Which test is used to test ulnar nerve entrapment?
a. Moving valgus test
b. Cozens test
c. Elbow flexion test
d. Varus stress test
Elbow flexion test
Ulnar nerve entrapment testing is used to diagnose:
a. Carpal tunnel
b. Cubital tunnel syndrome
c. Lateral epicondylitis
d. all of the above
Cubital Tunnel Syndrome
The moving valgus stress test is used to assess the
a. RCL
b. Ulnar nerve
c. UCL
d. Radial nerve
UCL
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
they experience a tingling sensation
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
all of the above
To complete a pressure provocation test, the therapist will place their fingers over the _ _ and palpate the _ nerve in _ degrees of elbow _ and forearm _
place fingers over the cubital tunnel and palpate the ulnar nerve
arm is in 20 degrees of elbow flexion and forearm supination
A positive pressure provocation test is positive when
a. the patient feels pain
b. it feels tender
c. symptoms are reproduced
symptoms are reproduced
Tinels Sign is testing the _ nerve and involves _ on the nerve
ulnar
tap on the nerve
Which elbow motions can be tested for a fracture?
elbow extension
elbow flexion
elbow pronation
elbow supination
How do you test for an elbow fracture?
ask them to do that elbow motion and if they cant do it or don’t want to it is a possible fracture
To complete the moving valgus stress test, the patient will _ their elbow and a _ force is applied then _ the elbow
flex their elbow to 120
valgus force is applied posteriorly
then extend the elbow
UCL injuries are common in
overhead athletes
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
elbow bent 20-30 degrees
The Valgus stress test is used to screen the
a. ulnar collateral ligament
b. radial collateral ligament
c. median nerve
d. ulnar nerve
ulnar collateral ligament
The Varus stress test is used to asses the
a. ulnar collateral ligament
b. medial collateral ligament
c. lateral collateral ligament
d. median nerve
lateral collateral ligament
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
Cozens test
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
resist extension and ulnar deviation
A positive Cozens test will be indicated by
a. tingling
b. numbness
c. weakness
d. pain
pain
A Maudsleys test is performed by resisting all fingers in extension (true/false)
true
Which type of treatment has been shown to be successful for lateral epicondylitis?
mobilization with movement
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
ULNT1 and ULNT2a
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
ULNT2b
When would it be appropriate to use ULNT2a instead of ULNT1?
when the patient cannot elevate their arm
ULNT1 loads only the medial nerve (true/false)
false
it loads all but specifically the medial
What is the most common outcome measure used for the treatment of the elbow?
DASH
What is the clinical differentiator for ULNT1?
a. side head bend
b. let off some depression
c. let off all depression
d. elbow extension
side head bend
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
let off some depression
What is the clinical differentiator for ULNT2b?
a. side head bend
b. let off some depression
c. let off all depression
d. elbow flexion
let off some depression
What 2 motions are tested with dynamometry of the elbow?
a. elbow pronation and supination
b. elbow flexion and extension
elbow flexion and extension
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
slight wrist extension
The wrist is in a _ or _ position for gripping activities which fires the _ connected to the lateral epicondyle
neutral or extended
extensors
Aggravating symptoms such as activities involving wrist extension/grasping will likely be diagnosed as
lateral epicondylitis
Aggravating symptoms such as activities involving wrist flexion will likely be diagnosed as
medial epicondylitis
Aggravating symptoms with a valgus stress of the elbow, throwing, and pitching will likely be diagnosed as
UCL ligament injury
Aggravating symptoms such as activities involving elbow and wrist extension will likely be diagnosed as
ulnar nerve entrapment
Aggravating symptoms such as activities involving full elbow extension or pronation of the forearm will likely be diagnosed as
median nerve entrapment
The radial lateral ligament resists a _ (valgus/varus) stress
varus
The ulnar medial ligament resists a _ (valgus/varus) stress
valgus
Where are three places the ulnar nerve can be palpated?
bottom 1/4 of the medial arm
cubital tunnel
guions tunnel
Where are the three places the radial nerve can be palpated?
the radial groove of the humerus
along the radius in the forearm
anatomical snuffbox
Compression of a nerve will cause pain (true/false)
false
it will cause paresthesia unless it has been compressed for a long time