Elbow Lab Flashcards
Pt fell off their bike and hurt their elbow, they’re coming to you via direct access, what do you do first
Canadian C Spine followed by
Clearing C-Spine
for all trauma cases!!!
What should a pt’s dominant arm look like?
Stronger w/ greater muscle mass and lower shoulder
Should you treat strength or mobility first (for any joint)?
MOBILITY
up to how much hyperext in the elbow is considered normal
up to 10
When would you apply resisted isometrics to the fingers
if they have pain w gripping
Humero-ulnar distraction improves what?
all motions!
what is the correct way to apply humero-ulnar distraction mobs
Towel under elbow
Grip the distal forearm
Scoop down and distract
what position do we do humero-ulnar jt play
70 elbow flexion and 10 supination
what position do we do humero-rad jt play
full elbow ext and wrist supination
What position do we do radio-ulnar jt play
70 flexion and 35 supination
medial/lateral glide of the ulna on humerus improves what
flexion and extension, just do both, dr. arnold doesnt care
Dorsal glide of the radius on the humerus improves what
ext
Volar glide of the radius on the humerus improves what
flex
Dorsal glide of the radius on the ulna (hand goes into supination) improves what
Pronation
Volar glide of the radius on the ulna (hand goes into pronation) improves what
Supination
How many months is the prognosis for a tendinopathy?
2-3 months
Most important tool for diagnosis at elbow?
palpation
Pt has medial elbow pain w/ acute MOI, but negative valgus stress test, next we preform?
Moving valgus stress test
What is the difference between the valgus stress test and moving valgus stress test
Moving valgus detects smaller tears
The regular valgus stress test is only positive if its a massive tear or fully torn
Which way do we bring the arm during the moving valgus stress test
from flexion to ext with valgus stress and shoulder ER
From what position(s) do we preform the valgus stress test?
Extension and slight flexion
From what position(s) do we preform the varus stress test
from extension AND slight flexion (20-30)
positive moving valgus stress test
reproduction of pain between 120 to 70 degrees flexion
indicates UCL tear
How do you preform cozens test?
What condition is it for?
Pt preforms wrist ext + radial deviation w/ fingers in fist
you push towards wrist flexion + ulnar deviation
tests for lateral elbow tendinopathy
what special test(s) are for lateral elbow tendinopathy
cozens test and mills test
What is Mills test?
examiner palpates near lateral epicondyle
then PASSIVELY pronates forearm, flexes wrist, and extends elbow
FOR LATERAL TENDINOPATHY
How do you test for medial tendinopathy?
Golfer’s elbow test
examinder palpates the medial epicondyle with one hand
In supination, patient manually flexes wrist w/ fingers closed against resistance
Positive test = pain recreated
How many times do you tap (Tinel’s sign) to test for ulnar compression at the elbow
4-6 times
Besides tinels sign, what is another special test for ulnar neurological dysfunction at elbow
ELBOW FLEXION TEST
Pt w/ elbow flexion and wrist ext
hold 3-5 minutes
positive test: tingling and paresthesias of ulnar nerve distribution
What test, when posititve, could potentially indicate PLR Instability
Varus instability test (with a grade 3 sprain)
What is considered a positive varus/valgus instability test
Laxity or pain
What is this screening for: Do your hands or feet blanch, go blue, & then turn red when exposed to cold or emotional stress?
Raynauds
