Elbow

Question 1

4 movements of Elbow

Answer 1

FL
ET
Supination
Pronation

Question 2

Close Packed Position

Answer 2

Humeroulnar- EX (forearm in Supination)
Proximal Radioulnar - slight Supination
Capsul amd ligament are under max tension
Max contact of articular surfaces -cannot be separated with distraction

Question 3

Resting / Loose packed Position

Answer 3

Humeroulnar- 70 degree of FL with 10 degree of Supination
(Cast position)

Proximal radioulnar - 70 degree if elbow FL with 35 degree Supination
Joint Capsule is most relaxed

Question 4

Rule outs for Elbow

Answer 4

• ** Shoulder - FL & AB with overpressure
• ** Wrist - FL, EX, UL DV, RD DV

C- spine * neurological s/s , parasthesia AF + overpressure
(all movements except EX)

TOS * neurological s/s , parasthesia
Adson’s / Costoclavicular/ Wrights

Question 5

Active Resisted for Elbow

FL

Answer 5

FL:

1. Neutral - Brachioradialis
2. Supination - Biceps Brachii
3. Pronation - Brachialis

Question 6

AR- EX

Answer 6

EX : (PM- Triceps & anconeus)

1. Neutral

Question 7

AR- Supination

Answer 7

Supination: (PM- Supinator and Biceps)

1. Neutral
   * * Differentiate b/w supinator and biceps
   * ** a. Supination with elbow neutral
   b. Supination with Full EX

Elbow EX → Pain ↑ ー Supinator
→ Pain ↓ ー Biceps

Question 8

AR- Pronation

Answer 8

Pronation: (PM Pronator Quadratus & Pronator Teres)

1. Neutral
   * **Differentiate b/w two
2. Location of Pain
3. Test with elbow fully FL

Question 9

AR - Wrist EX ( Mms cross over wrist)

Answer 9

PM- EX Carpi Radialis Longus, Brevis, and EX Carpi Ulnaris

Elbow - FL to 90 Degree
Wrist - in neutral
Forearm - Pronation

Question 10

AR- Wrist FL

Answer 10

PM- FL Carpi radialis and Ulnaris

Elbow - FL 90 degree
Wrist- slightly FL
Forearm - Pronated???

Question 11

Varus Stress Test

Answer 11

Ligamentous Stability
Lateral Collateral Ligament

1. High seated
2. Shoulder and Elbow - both FL 20degree
3. Medial side pressure -away from body
   Lower hand - toward body

Positive

1. Pain at the lateral collateral lig
2. Joint opening

Question 12

Valgus Stress Test

Answer 12

Medial collateral Ligament & Jt capsule
***** Repeat this test at 50 degree of elbow FL
→ isolate lig from the joint capsule

1. High seated
2. Shoulder and elbow FL 20 degree & forearm Supinated
3. Th palpate Medial collateral Lig
4. 上→ toward body
   下→ away from body

Positive:

1. Pain at medial collateral lig
2. Joint opening

Question 13

Golfer’s Elbow

Answer 13

Medial Epicondylitis
Common Flexor tendinitis

Positive:
1. A sudden severe pain at common flexor tendon

1. forearm Supinated & wrist slightly FL
2. Th palpate medial epicondyle
3. Th RESISTS the Px attempt to FL the wrist

Question 14

Tennis Elbow test

Answer 14

Lateral Epicondylitis
Common Extensor tendinitis

Positive:
1. A sudden severe pain at common Extensor tendon

1. High seated with shoulder FL to 20 degree
2. Elbow FULLY EXTEND
3. Th palpate lateral epicondyle
4. Px make Fist (こぶし）
5. Px PRONATE forearm and slightly EX the wrist
6. Th RESISTS the Px attempt to EX the wrist

Question 15

Tinel’s sign at the elbow

Answer 15

Neurological Test

Positive:
Tingling sensation in ulnar distribution of the forearm and hand

1. Shoulder and elbow slightly FL
2. Tap ulnar nerve on the groove b/w ole ran on process and medial epicondyle

Question 16

Pinch Grip Test

Answer 16

Median Nerve Issue

Positive:
1. Compression of the anterior interosseous nerve
(Branch of median nn) b/w two heads of PRONATOR TERES

2. Nerve Pathology

Abnormal pinch- pulp to pulp （指のはらとはら）
Negative pinch - tip to tip (爪と爪）

Question 17

Pronator Teres Syndrome

Answer 17

Median Nerve issue

Positive:
Tingling or parasthesia in the median n distribution

1. Px seated with Elbow FL to 90 degree
2. Th RESISTS Pronation as Elbow EX

Question 18

Neurological Test for Elbow

Answer 18

C5- Biceps reflex (親指の上にハンマー）
C6 - Brachioradialis Reflex
C7- Triceps reflex