Elbow and Wrist

Question 1

Radial Head TP Location

Answer 1

lateral part of AC fossa
just below crease
push A-P

Question 2

Radial Head TP Tx

Answer 2

Pt supine and ph seated on tx side

Elbow in full extension (on knee), forearm in marked supination and slight valgus force.

Question 3

Radial Head TP m

Answer 3

supinator or extensor carpi radialis longus

Question 4

Pronator TP Location

Answer 4

medial part of AC fossa
just below crease
push A-P

Question 5

Pronator TP Tx

Answer 5

Pt supine and ph seated on tx side
Elbow flex to 90°
pt dorm of hand to chest for marked pronation

Question 6

Pronator TP m

Answer 6

Pronator Teres

Question 7

Flexion Elbow TP Location

Answer 7

at the coronoid process of the ulna

midline of AC fossa

Question 8

Flexion Elbow TP Tx

Answer 8

Pt supine and ph seated on tx side
PRONATE the forearm
 The palm is facing anterior (waving)
 FLEX the elbow >90°
 ABDUCT the arm
UNMONITORED

Question 9

Extension Elbow TP Location

Answer 9

Posterior aspect of elbow

at the sides of the olecranon process of the ulna, near the triceps tendon

Question 10

Extension Elbow TP Tx

Answer 10

Patient lying on side opposite dysfunction with physician behind; or supine, with physician on side of dysfunction
Grasp the elbow with your caudad hand so that your thumb is on the tenderpoint and your hand is around the forearm
 HYPEREXTEND the elbow over the monitoring hand
 Fine tune with ABDUCTION or ADDUCTION


Question 11

Extension Wrist TP Location

Answer 11

2 points just proximal to wrist joint on posterior aspect

Question 12

Extension Wrist TP Tx

Answer 12

 EXTEND the wrist

 Fine tune with pronation or supination, and/or ulnar or radial deviation at the wrist

Question 13

Extension Wrist TP m

Answer 13

extensor digitorum

Question 14

Dorsal Carpometacarpal and Metacarpophalangeal TP Location

Answer 14

 Tenderpoint(s) is/are on the “opposite side” of the weak muscles
AT THE CMC OR MCP Joints

Question 15

Dorsal Carpometacarpal and Metacarpophalangeal TP Tx

Answer 15

 EXTEND the fingers and wrist, using your palm on the volar surface of the fingers and palm

Question 16

Abductor Pollicis Brevis TP Location

Answer 16

 The flexor thumb tenderpoint (“flext thumb”)

 Anteroradial aspect of the base of the first metacarpal bone

Question 17

Abductor Pollicis Brevis TP Tx

Answer 17

 FLEX the wrist

 Use your fingers to ABDUCT the thumb

Question 18

Palmar Thumb TP Location

Answer 18

deep in the palmar side of the head of the first metacarpal

 Press from the medial side toward the 1st carpometacarpal joint.

Question 19

Palmar Thumb TP Tx

Answer 19

 Pull the thumb across the palm toward the opposite side of the palm (opposition).
 Fine tune with slight internal rotation.

Question 20

Palmar Thumb TP m

Answer 20

flexor pollicis brevis

Question 21

Adductor Pollicis TP Location

Answer 21

 Location: in the web of the thumb.

Question 22

Adductor Pollicis TP Tx

Answer 22

 Push the thumb under the index and long fingers, into the palm.
 Compress with your hand.
UNMONITORED

Question 23

Interossei TP Location

Answer 23

over the interosseous muscles (palmar)

Most commonly involves the index or long fingers

Question 24

Interossei TP Tx

Answer 24

 marked FLEXON of the MCP joint

 slight abduction or adduction of the finger toward the tenderpoint side