Elbow Examination Flashcards
in observation of the elbow, what is looked at generally
bony alignment
posture
edema
within bony alignment, what specifically is looked at
carrying angle
triangle formed by medial/lateral epicondyle and olecranon
male and female carrying angle values
male = 5-10°
female = 10-15°
cubital valgus vs varus would lead to what in terms of carrying angle
valgus = more of a carrying angle
varus = less of a carrying angle
what is a gun stock deformity
excessive cubital varus
where can edema pit in the elbow
interarticular space
= triangular space at elbow
olecranon process
= olecranon bursa
general range of motions associated with elbow
flex = 150°
extension = 0°
pro/sup = 80°
at what joint(s) does flexion/extension occur
humeroradial
humeroulnar
at what joint(s) does pronation/supination occur
radioulnar
where to stabilize when resistive testing triceps and biceps
shoulder
where to stabilize when resistive testing pronation/supination
elbow
what creates the radial tunnel
gap under the supinator
how is radial tunnel entrapment differentiated from lateral epicondylitis
radial tunnel palpation / tinnels or tension testing
pain above condyle possibly because of extensor attachment point
how to assess mobility at the humeroulnar joint
distraction
which directions can humeroradial jt motion be assessed in
anterior
posterior
in what motions can proximal radial ulnar joint motion be assessed
posterior
anterior
explain the roll and slide of the proximal vs distal radioulnar joint
proximal = opposite direction
distal = same direction
what does “3 peat” help with
cheat sheet for remembering roll and slide at proximal radioulnar joint
proximal
pronation (roll anterior)
(slide) posterior
position for triceps muscle length testing
seated
shoulder max flexion / ER
elbow flexed with shoulder stabilized
abnormal end feel for triceps length test
flexion at elbow is limited or muscle stretch
explain patient positioning for biceps muscle length testing
supine
shoulder max extension
elbow flexed and supinated
- passively extended elbow
abnormal biceps length test
elbow extension is limited
biceps stretch, no bony end feel
goal of special tests at the elbow
either
– stress UCL in cocking phase
– stress muscle tendon junction at lateral elbow
explain positioning of moving valgus stress test
patient seated
shoulder and elbow 90°/90°
stabilize elbow and add valgus force
move elbow through 70-120° of flexion
explain positioning of cozen’s test
seated
elbow in slight flexion
forearm in pronation
wrist in radial deviation (in a fist)
– asked to resist extension
explain the positioning of maudsley’s test
basically just resistance testing middle finger extension
elbow in slight flexion
forearm pronated
wrist extended
middle finger extended
explain positioning of mill’s test
shoulder in 70° of abduction
elbow at 90°
thumb tucked into fist
wrist flexed and ulnar deviation
maintaining wrist position, slowly extend the elbow
which band of the UCL typically tears? in what position?
anterior bundle
late cocking phase of throwing
explain how elbow position affects stress applied to the UCL
extension of elbow allows for greater bony articulation and less stress on the UCL
90° of flexion forces UCL to resist most stress
what does the evidence say about special testing on medial/lateral epicondylitis
nothin… there is literally no testing data on any of it
performance based measures that can be applied in most populations facing lateral epicondylitis? any for a more advanced population?
hand to mouth
turning door knob
grip strength
wall push ups
closed kinetic chain stability
explain the weight and status relationship of hand to mouth functional testing
functional = 5-6 lbs
functionally fair = 3-4 lbs
functionally poor = 1-2 lbs
nonfunctional = 0
explain the reps and status relationship of wall pushup testing
functional = 5-6 reps
functionally fair = 3-4 reps
functionally poor = 1-2 reps
nonfunctional = 0 reps
what are red flags of the elbow in the:
- MSK system
- Neuro system
- Cardio system
- other systems
msk = fx
neuro = CRPS
CVD = compartment syndrome via trauma
other = local infection
what non-msk conditions could refer pain to elbow
acute MI
pancoast tumor
esophageal motor disorders
