Elbow Flashcards
Visualization of the elbow in the flexion? Abnormal?
Should be triangle
If not, olecranon fracture suspected
The median nerve runs between the heads of what muscle
Pronator teres
Elbow ROM
Flexion: 160
Extension: 0
Supination: 90
Pronation: 90
Mills test
+ = pain over lateral epicondyle
= lateral epicondylitis
Cozens
Wrists extended
Doc pushes down
+ pain over lateral epicondyle
= lateral epicondylitis
Lift test pronated
Lift weight with palm down (lift up)
+ pain over lateral epicondyle
Lateral epicondylitis
Lift test supinate
+ pain over medial epicondyle
Medial epicondylitis
Muscle test for radius
Triceps with wrist extended
Pt tries to extend elbow while doc pushes on it
Muscle test for ulna
Triceps with wrist flexed
DDx for painover lateral epicondyle
Lateral epicondylitis
Fracture
Radius P
Treatment for epicondylitis
Ice Rest Support PT Strengthen Check spine Daily activities- modify if possible
Elbow traction best for what
Ulna P
Good for: Ulna PM and Radius P
MC subluxation in the elbow
Radius posterior
Findings for Radius P
Pain over radial head
Decreased pronation (ROM)
Decreased extension and pronation (FM)
Decreased triceps with wrist extended
fluid motion, ROM and muscle findings for Ulna P and PM
Decreased fluid motion on extension and supination
Decreased ROM in extension (elbow)
Decreased triceps with wrist flexed
Pain point for ulna P
1-1.5 inches distal to medial epicondyle of humerus
Pain point for ulna PM
Olecranon fossa near the process
Nursemaids elbow
Dislocation of radial head from sudden pull on child’s arm
Unable to straighten
Treatment of nursemaid’s elbow
Hold radial head
Traction
Rotate the forearm to reposition (full supination)
Elbow traction
Docs thumb down in elbow crease and traction down while flexing forearm up.
LOOK at GH for movement
Best for ulna P
Radius posterior adjustment
MC subluxation of the elbow
Thumb on posterior radius with fingers behind. Inferior hand at distal wrist
Fully pronate and extend. Back off and thrust.
Ulna P procedure
Doc stand on lateral side of patient
Superior hand thumb web contact and inferior hand at distal wrist.
Extend and supinate; back off and thrust
(1-1.5inches distal to medial epicondyle)
Ulna PM procedure
Doc stand on medial side of arm
Use 7/8 and pull L-M till contact on ridge of ulna
Extend and supinate; back off and thrust
Ulna P and PM. ROM?
Decreased elbow extension
Ulna P and Ulna PM. Fluid motion
Decreased fluid motion with extension with arm supinated.
Radius P ROM
Decreased pronation
Radius P fluid motion
Decreased P-A at radial head
History common with wrist issues
FOOSH injuries
Wrist ROM
Flexion: 90
Extension: 70
Radial deviation: 20
Ulnar deviation: 55
Allens test
Pump blood, make a fist, doc occluded radial/ulnar artery. Lower and release
Refill in less than 5 seconds Normal
5+= occlusion of artery released
= TOS, cervical subluxation, Raynaud’s syndrome
TOS tests
Adson’s
Edens
Wrights
Adsons test
Palpate radial pulse. Turn head towards doc
eden’s test
palpate radial pulse and patient brings shoulders back and down
+=TOS
wrights test
indicates axillary artery or brachial plexus compression by pectoralis minor. 15 degrees difference = +
english test
hold wrist over radial and ulnar artery and pump fist. tingling, numbess over distribution of median nerve CTS
what is a common subluxation with CTS
anterior lunate –fix: strengthen extensors of hand
what is done specially with patients wtih CTS and wrist traction
no extension
what hand orthopedic tests are done
finklesteins and froment
finklesteins
bring thumb across to pinky and then wrap fingers around it and ulnar deviate.
+=pain
=stenosing tenosynovitis of dequervian
froments
hold paper between 1/2 finger with thumb straight and pull paper. + = pt flexes fingers
ulnar N palsy
history of C-MC
jammed, fell or hit hand, on crutches, cast removed
what is MC-P and I-P good for
fixation/subluxation, jammed finger, arthritis, DJD
