Elbow exam Flashcards
What is the carrying angle of men?
Varies from 5-15°
average is ~6.7°
What is the carrying angle of women?
Varies 10-25°
average is ~13.6°
Name the bursae in the elbow. Where in the elbow are they located?
- Deep (subtendinous) olecranon bursa
- between olecranon and triceps tendon - Intratendinous olecranon bursa
- sometimes present in triceps tendon - Superficial (subcutaneous) olecranon bursa
- located in subcutaneous connective tissue
Which muscles attach to the MEDIAL epicondyle?
- pronator teres
- flexors of the forearm
Which muscles attach to the LATERAL epicondyle?
- supinator
- common extensors of the elbow/wrist
Where do the radial and ulnar nerves run in the arm?
- Radial: trace along the back of the humerus
2. Ulnar: nerve runs behind the medial epicondyle
What are the different steps of examination of the elbow?
- introduction
- preparation
- look
- feel
- move
- special tests
- function
- summary + close
How should the patient be positioned for examination of the elbow?
can be sitting down, ask them to remove any clothing obscuring the arm/shoulder
When inspecting the elbow/arm what are you looking for?
- look anteriorly and posteriorly
- look for skeletal abnormalities (varus and valgus deformity)
- muscle bulk
- any swelling - oedema and bursae
- skin - scars, redness, psoriasis etc.
What is cubitus valgus and cubitus varus?
- Cubitus valgus = increased carrying angle
2. Cubitus varus = reduced carrying angle
What are you feeling for when you inspect the elbow?
- Temperature
- Joint line
- Swelling/effusion
- Tenderness over medial or lateral epicondyles
What movements do you perform when assessing the elbow? In what different ways should these movements be assessed?
- flexion, extension, supination, pronation for each of:
1. active
2. passive
3. resisted
What does active movement of a joint assess?
testing going, muscle and nerves
What does passive movement of a joint assess?
testing range of movement
What does resisted movement of a joint assess?
checking for pain at muscle/tendon attachments to bone
What special tests are there for the elbow?
- Resisted extension of the wrist
- Resisted flexion of the wrist
- Varus and valgus strain
How do you perform resisted extension of the wrist and what is this testing?
- stabilise patient’s wrist
- ask them to make a fist and cock back wrist
- place hand on back of hand and being to pull towards you
- ask patient to resist this movement
- ask patient to tell you if they experience pain
if patient experiences pain on wrist extension = lateral epicondylitis/tennis elbow
How do you perform resisted flexion of the wrist and what is this testing?
- stabilise patient’s wrist
- ask them to make a fist and hold it out straight
- place hand underneath fist and push up
- ask patient to resist this movement
- ask patient to tell you if they experience pain
if patient experiences pain on wrist flexion = medial epicondylitis/golfers elbow
How do you perform varus and valgus strain? What is this assessing?
- Medial collateral ligaments:
1. place hand on inside of patient’s elbow to stabilise
2. push wrist away from body - Lateral collateral ligaments:
1. place hand on outside of patient’s elbow to stabilise
2. push wrist towards the body
assessing laxity and give of ligaments
How should you assess the function of the elbow?
Ask patient to pretend to perform tasks/get them to perform tasks such as:
- writing
- doing up buttons
- upper limb eating + drinking
