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BMS 150 Practical Final > Elbow and Wrist Tests > Flashcards

Elbow and Wrist Tests Flashcards

1
Q

what is the valgus stress test?

A
  1. Cup posterior aspect of the patient’s elbow in one hand
  2. Hold wrist in other hand
  3. Use hand on elbow as a fulcrum around which other hand will force
    the forearm laterally (valgus stress)
  4. Assess at 0 degrees, 30 degrees, 90 degrees

Positive => pain, increased medial joint gapping

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2
Q

what is the findings for valgus stress test

A

Sprain of medial collateral ligament

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3
Q

what is the varus stress test

A
  1. Cup posterior aspect of the patient’s elbow in one hand
  2. Hold wrist in other hand
  3. Use hand on elbow as a fulcrum around which other hand will force
    the forearm medially (varus stress)
  4. Assess at 0 degrees, 30 degrees, 90 degrees

Positive => pain or laxity in the lateral joint of the elbow

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4
Q

what are the findings for the varus stress test

A

lateral collateral ligament pathology

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5
Q

what is the mills test

A
  1. Place patient in position where their elbow is extended, wrist
    pronated, and flexed
  2. Examiner pushes on wrist while supporting elbow into flexion

Positive => pain at lateral epicondyle

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6
Q

what is the finding for Mill’s test?

A

lateral epicondyle ( tennis elbow)

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7
Q

what is the reverse mill’s test

A

Reverse Mill’s Test
1. Place patient in position where their elbow is extended, wrist
pronated, and extended
2. Examiner pushes on wrist while supporting the elbow in extension

Positive => pain at medial epicondyle

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8
Q

what is the finding for the reverse mill’s test

A

medial epicondylitis (golfer’s elbow)

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9
Q

what is the ulnar nerve instability test

A
  1. Examiner places patients arm in abduction and external rotation
  2. While palpating the ulnar nerve at the ulnar groove, flex and extend
    the patient’s arm repeatedly

Positive => examiner can palpate the nerve as it subluxes (partial
dislocation) out of the ulnar groove

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10
Q

what is the finding for ulnar nerve instability

A

ulnar nerve instability

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11
Q

what is the tinel sign

A
  1. Designed to elicit tenderness over a neuroma within the nerve
  2. Tap nerve between the olecranon and the medial epicondyle

Positive => tingling sensation down the forearm in the ulnar nerve
distribution

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12
Q

what are the findings for the tinel sign

A

A neuroma in the ulnar nerve

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13
Q

what is the cozen’s test

A
  1. Stabilize patient’s forearm
  2. Have patient make a fist and pronate, radially deviate, and extend the
    wrist
  3. Examiner forces wrist into flexion against patient’s resistance

Positive => sudden severe pain at thhme lateral epicondyle (common
extensor origin)

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14
Q

what is the findings for cozen’s test

A

lateral epicondylitis (tennis elbow)

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15
Q

what is the reverse cozen’s test

A
  1. Stabilize patient’s forearm
  2. Have patient make a fist, supinate, and flex the wrist
  3. Examiner forces wrist into extension against patient’s resistance

Positive => sudden severe pain at the medial epicondyle (common flexor origin)

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16
Q

what is the findings for reverse cozen’s test

A

medial epicondylitis (golfer’s elbow)

17
Q

what is the supination lift test

A
  1. Patient seated with elbow flexed to 90
  2. Forearms supinated, place the hands on the underside of a table
  3. Ask patient to try to lift the table

Positive => pain on the ulnar side of the wrist and difficulty applying force

18
Q

what is the finding for the supination lift test

A

Dorsal tear of the triangular fibrocartilage complex (TFCC)

19
Q

what is the triangular fibrocartilage complex (TFCC) load test?

A
  1. Examiner holds the patient’s forearm with one hand and the patient’s hand with the other hand
  2. Examiner then ulnar deviates the wrist and applies a stretch like pressure in the same direction, while moving hand dorsally and towards the palm

Positive => pain, clicking, or crepitus in the area of TFCC

20
Q

what is the finding for triangular fibrocartilage complex (TFCC) load test

A

TFCC tear/injury

21
Q

what is the Allen’s test

A
  1. Patient opens and closes their hand multiple times, then makes a fist
  2. Examiner holds down the radial and ulnar arteries with the thumb and index finger
  3. Let go of the artery being tested and the patient’s hand should go pink on the side of the artery just released
  4. Repeat same evaluation for the other artery

Positive => skin stays white, no apparent return of blood flow after decompression of the artery

22
Q

what is the finding for Allen’s test

A

Vascular compromise to radial or ulnar artery

23
Q

what is the Finkelstein’s test

A
  1. Patient makes a fist with thumb tucked in
  2. Examiner deviates wrist in the ulnar deviation

Positive => skin stays white, no apparent return of blood flow after decompression of the artery

24
Q

what is the finding for Finkelstein’s test

A

First dorsal compartment stenosing
tenosynovitis (abductor pollicis
longus and extensor pollicis brevis) = DeQuervain’s tenosynovitis

25
Q

what is the Phalen’s test

A
  1. Patient places the dorsal aspect of one hand against the dorsal aspect of the other, causing flexion of the wrists
  2. Position held for at least one minute while the patient reports changes in sensation or pain

Positive => reproduction of neurologic symptoms

26
Q

what is the findings for Phalen’s test

A

Carpal tunnel syndrome (CTS)

27
Q

what is the Tinel’s sign

A
  1. Patient sitting with both wrists facing up on their lap
  2. Examiner uses a reflex hammer on their re-enforced finger to tap the transverse carpal ligament on the volar aspect of the wrist

Positive => carpal tunnel syndrome (CTS)

28
Q

what is the findings for Tinel’s sign

A

Paresthesia in the median nerve distribution with percussion

29
Q

what is the pronator teres test

A
  1. Patient stands with elbow in 90 of flexion
  2. Examiner places one hand on the client’s elbow for stabilization and
    the other hand grasps the patient’s hand in a handshake position
  3. Patient holds this position as the practitioner attempts to supinate the
    patient’s forearm (forcing patient to contract the pronator muscles)
  4. While holding resistance against pronation, the clinician extends the
    patient’s elbow
  5. *Patient should keep the elbow relaxed during the test – holding
    elbow firmly in flexion will not allow for elbow extension

Positive => if the patient’s pain or discomfort is reproduced

30
Q

what is the findings for pronator teres test

A

Median nerve compression by pronator teres

31
Q

what are the special test for lateral epicondylitis?

A
  • Cozens
  • mills
  • varus stress test
  • tinels
32
Q

what are the special test for medial epicondylitis

A
  • reverse cozens
  • reverse mills
  • valgus stress test
  • tinel’s
33
Q

what are the special test for carpal tunnel syndrome

A
  • phalen’s
  • reverse Phalen’s
  • tinel’s
  • pronator teres test
  • allen’s test

BMS 150 Practical Final (17 decks)

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