Elbow Flashcards
What does Varus/Valgus stress test
Valgus/abduction- md lig strain
Varus- adduction- lat
Valgus stress test technique
Pt seated
1. applies valgus force with elbow fully extended
2. examiner applies valgus force with elbow flexed at 30 and forearm supinated
Varus technique
Pt seated
1. varus force fully extended
2. varus force with elbow flexed 30 and forearm supinated
+ve Varus/valgus
P oor excessive movement either side of elbow
Varus/valgus clinical notes
Due to dynamic range of elbow Jt its important to test elbow ligament integrity in at least two positions
What does Cozens test
Lateral elbow tendinopathy
Cozens technique
Stabilise forearm- palpate lat epi
Pronate arm
Radially deviate
Ext wrist
Pt resist ext movement
+ve Cozen
Weakness + lat elbow P
Cozens clinical notes
P often described as sharp + shooting
May be reproduced with palpation over radial nerbe + common extensor tendon
Most commonly caused by extensor carpi radials longus/brevis- can muscle test these
What does reverse Cozen test
Medial epicondylittis
Reverse Cozen technique
Stabilise Pt forearm
Palpating med epi
Supinate arn
Ulnar deviate
Flex wrist
Resist flex
+ve Reverse Cozen
Weakness + medial elbow P
What does Mills test for
Lateral epicondylitis
Mills technique
Palpate lat epi while pronating forearm
Flex wrist
Ext elbow
No resistance- stretch test
Tests the common extensor tendon
Mills clinical notes
Can flex all fingers and apply pressure with thumb over common extensor tendon to inc sensitivity
Rx in ROM- arthritis, capsular adhesions, or tendon contracture
Can be used for treatment as it stretches the common extensor tendon
+ve Mills
Lateral elbow P
What does reverse Mills test
Medial epicondylitis
Reverse Mills technique
Palpate med epi while supinating forearm
Ext wrist
Ext elbow
+ve Reverse Mills
Medial elbow P
Reverse mills and cozens clinic notes
Cozens- muscle testing common flexor tendon
Mills- stretching common flexor tendon
What does Tinels test
Ulnar compressive neuropathy
Tinels techniques
Pt seated
Examiner gently taps 4-6 times over cubital tunnel (groove between olecranon process and medial epi)
+ve Tinels
Parasthesia from ulnar N (middle/little finger)
Tinels at elbow clinic notes
Lots of false positives with asymptomatic side
Like hitting the funny bone
Tinels for radial nerve
Tapping groove between lateral epicondyle and olecranon
Pronator teres syndrome test
Pt seated
Elbow flexed 90
Pt attempts to pronate forearm with elbow extension
Examiner resists the pronation movement
Can compress muscle to increase nerve compression and test sensitivity
Pronator teres interpretation
Tingling or paraesthesia- median nerve compression at pronator teres muscle, pronator teres syndrome
Pronator teres syndrome clinical notes
Median nerve runs between two heads of pronator teres muscle
When pronation is resisted the inc compressive force from contracted muscle may result in distal neuro signs
Pressure provocation test
Pt seated, supine or stnaidng
Elbow flexed to 80 + forearm supinated
Place finger over ulnar nerve just proximal to cubittal tunnel + hold pressure for 60s
Pressure provocation interpretation
Numbness and tingling, paraesthesia in ulnar distribution= cubital tunnel syndrome
Pressure provocation sens and spec
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