Elbow Examination

Question 1

in observation of the elbow, what is looked at generally

Answer 1

bony alignment
posture
edema

Question 2

within bony alignment, what specifically is looked at

Answer 2

carrying angle
triangle formed by medial/lateral epicondyle and olecranon

Question 3

male and female carrying angle values

Answer 3

male = 5-10°
female = 10-15°

Question 4

cubital valgus vs varus would lead to what in terms of carrying angle

Answer 4

valgus = more of a carrying angle
varus = less of a carrying angle

Question 5

what is a gun stock deformity

Answer 5

excessive cubital varus

Question 6

where can edema pit in the elbow

Answer 6

interarticular space
= triangular space at elbow
olecranon process
= olecranon bursa

Question 7

general range of motions associated with elbow

Answer 7

flex = 150°
extension = 0°
pro/sup = 80°

Question 8

at what joint(s) does flexion/extension occur

Answer 8

humeroradial
humeroulnar

Question 9

at what joint(s) does pronation/supination occur

Answer 9

radioulnar

Question 10

where to stabilize when resistive testing triceps and biceps

Answer 10

shoulder

Question 11

where to stabilize when resistive testing pronation/supination

Answer 11

elbow

Question 12

what creates the radial tunnel

Answer 12

gap under the supinator

Question 13

how is radial tunnel entrapment differentiated from lateral epicondylitis

Answer 13

radial tunnel palpation / tinnels or tension testing

pain above condyle possibly because of extensor attachment point

Question 14

how to assess mobility at the humeroulnar joint

Answer 14

distraction

Question 15

which directions can humeroradial jt motion be assessed in

Answer 15

anterior
posterior

Question 16

in what motions can proximal radial ulnar joint motion be assessed

Answer 16

posterior
anterior

Question 17

explain the roll and slide of the proximal vs distal radioulnar joint

Answer 17

proximal = opposite direction
distal = same direction

Question 18

what does “3 peat” help with

Answer 18

cheat sheet for remembering roll and slide at proximal radioulnar joint

proximal
pronation (roll anterior)
(slide) posterior

Question 19

position for triceps muscle length testing

Answer 19

seated
shoulder max flexion / ER
elbow flexed with shoulder stabilized

Question 20

abnormal end feel for triceps length test

Answer 20

flexion at elbow is limited or muscle stretch

Question 21

explain patient positioning for biceps muscle length testing

Answer 21

supine
shoulder max extension
elbow flexed and supinated
- passively extended elbow

Question 22

abnormal biceps length test

Answer 22

elbow extension is limited
biceps stretch, no bony end feel

Question 23

goal of special tests at the elbow

Answer 23

either
– stress UCL in cocking phase
– stress muscle tendon junction at lateral elbow

Question 24

explain positioning of moving valgus stress test

Answer 24

patient seated
shoulder and elbow 90°/90°
stabilize elbow and add valgus force
move elbow through 70-120° of flexion

Question 25

explain positioning of cozen's test

Answer 25

seated elbow in slight flexion forearm in pronation wrist in radial deviation (in a fist) -- asked to resist extension

Question 26

explain the positioning of maudsley's test

Answer 26

basically just resistance testing middle finger extension elbow in slight flexion forearm pronated wrist extended middle finger extended

Question 27

explain positioning of mill's test

Answer 27

shoulder in 70° of abduction elbow at 90° thumb tucked into fist wrist flexed and ulnar deviation maintaining wrist position, slowly extend the elbow

Question 28

which band of the UCL typically tears? in what position?

Answer 28

anterior bundle late cocking phase of throwing

Question 29

explain how elbow position affects stress applied to the UCL

Answer 29

extension of elbow allows for greater bony articulation and less stress on the UCL 90° of flexion forces UCL to resist most stress

Question 30

what does the evidence say about special testing on medial/lateral epicondylitis

Answer 30

nothin... there is literally no testing data on any of it

Question 31

performance based measures that can be applied in most populations facing lateral epicondylitis? any for a more advanced population?

Answer 31

hand to mouth turning door knob grip strength wall push ups closed kinetic chain stability

Question 32

explain the weight and status relationship of hand to mouth functional testing

Answer 32

functional = 5-6 lbs functionally fair = 3-4 lbs functionally poor = 1-2 lbs nonfunctional = 0

Question 33

explain the reps and status relationship of wall pushup testing

Answer 33

functional = 5-6 reps functionally fair = 3-4 reps functionally poor = 1-2 reps nonfunctional = 0 reps

Question 34

what are red flags of the elbow in the: - MSK system - Neuro system - Cardio system - other systems

Answer 34

msk = fx neuro = CRPS CVD = compartment syndrome via trauma other = local infection

Question 35

what non-msk conditions could refer pain to elbow

Answer 35

acute MI pancoast tumor esophageal motor disorders