Elbow

Question 1

Bony Palpation

Answer 1

1) Medial Epicondyle
2) Medial supracondylar line of the humerus
3) Groove of the ulnar nerve
4) Trochlear
5) Olecranon
6) Olecranon fossa
7) Lateral epicondyle
8) Lateral supracondylar line of the humerus
9) Radial head

Question 2

Soft Tissue Palpation

Answer 2

1) Ulnar Nerve
2) Wrist flexor muscles
- Pronator teres, Felxor Carpi Radialis, Palmaris longus, Felxor Carpi Ulnaris
3) Medial collateral ligament
4) Supracondylar lymph nodes
5) Brachial Artery
6) Triceps muscle
7) Lateral collateral ligament
8) Biceps
9) Olecranon bursa
10) Elbow flexor muscles
- Brachioradialis, Extensor carpi radialis longus and brevis

Question 3

Range of Motion

Answer 3

Elbow flexion: 150
Elbow extension: 0
Forearm supination: 80
Forearm pronation: 80

Question 4

Medial Collateral Ligament Test (Abduction Stress Test)

Answer 4

Instruct: Patient seated, examiner stabilizes the lateral aspect of the arm and places an adduction (valgus) pressure on the patient’s medial forearm
Positive:Excessive gapping & pain
Indicates: Medial collateral ligament instability

Question 5

Lateral Collateral Ligament Test (Adduction Stress Test)

Answer 5

Instruct: Patient seated, examiner stabilizes the medial aspect of the arm and places adduction (varus) pressure on the patient’s lateral forearm
Positive: Excessive gapping & pain
Indicates: Lateral collateral ligament instability

Question 6

Tinel Elbow Sign

Answer 6

Instruct: Patient seated, with a Taylor reflex hammer, examiner taps over the groove between the medial epicondyle and the olecranon process.
Positive: Pain and/or tenderness at the site being tapped and paresthesia in the ulnar nerve distribution area (fingers 4,5)
Indicates: Neuroma of the ulnar nerve

Question 7

Cozen test

Answer 7

Instruct: Patient seated, examiner instructs patient to make a fist and place wrist into extension. Examiner instructs patient to resist as examiner tries to push extended wrist into flexion
Positive: Pain over the lateral epicondyle
Indicates: Lateral epicondylitis (Tennis Elbow)

Question 8

Mills Test/Maneuver (Evans)

Answer 8

Instruct: Patient seated at rest with forearm supinated. In a smooth continuous motion the Dr. passively maximally flexes the patient’s fingers and wrist. While maintaining wrist and finger flexion, the Dr. passively extends the patient’s elbow (the forearm is now pronated)
Positive: Pain of the lateral epicondyle
Indicates: Lateral Epicondylitis (Tennis Elbow)

Question 9

Golfer Elbow Test

Answer 9

Instruct: Patient seated, examiner instructs patient to extend the elbow and supinate hand. Examiner instructs patient to flex the wrist against resistance.
Positive: Pain over the medial epicondyle
Indicates: Medial Epicondylitis