Elbow Wrist and Hand Evaluation

Question 1

carry angle

normal, cubitus varus and cubitus valgus

Answer 1

5-15
cubitus varus <5
cubitus calgus >15

Question 2

flexion ROM

Answer 2

140-150

Question 3

extension ROM

Answer 3

0- -5

Question 4

supination and pronation ROM

Answer 4

90

Question 5

nerve root tested for biceps reflex test

Answer 5

C5

Question 6

nerve root tested for with brachioradialis reflex test

Answer 6

C6

Question 7

nerve root tested for with triceps reflex test

Answer 7

C7

Question 8

valgus stress test assesses

Answer 8

medial (ulnar) collateral ligament

arm slightly abducted and externally rotated
forearm supinated and flexed to 30
slight medial valgus stress to elbow joint

+ with pain/tenderness and laxity

Question 9

varus stress test assesses

Answer 9

lateral (radial) collateral ligament

arm slightly abducted and internally rotated. elbow flexed to 15
varus stress applied to elbow joint

Question 10

tinel test assesses

Answer 10

ulnar nerve entrapment/cubital tunnel syndrome

tap between olecranon and medial epicondyle in ulnar groove

+ test = tingling sensation down forearm within ulnar n distribution

Question 11

golfers elbow test assesses

Answer 11

medial epicondylitis

anterior forearm/flexor compartment

Question 12

golfers elbow test

Answer 12

elbow flexed to 90 and forearm placed in supination with wrist neutral and palm facing up
stabilize proximal forearm and resist flexion

+ = pain/tenderness around medial epicondyle

Question 13

cozen’s test assesses

Answer 13

tennis elbow test

lateral epicondylitis

Question 14

cozen’s test

Answer 14

flex elbow to 90 and pronate forearm
stabilize proximal forearm and have patient extend wrist

+ = pain/tenderness around lateral epicondyle

Question 15

olecranon bursitis can result from

Answer 15

overuse (students elbow)
occupational (miners elbow)
athletic injury

region is often painless and ROM is normal

Question 16

Little league elbow refers to

Answer 16

a group of problems related to stress of throwing in young adults

Question 17

medial apophysitis occurs during

Answer 17

childhood

Question 18

medial epicondyle avulsion fractures typically happen during

Answer 18

adolescence

Question 19

medial collateral ligament tears typically occur during

Answer 19

young adulthood

Question 20

little league elbow characteristics

Answer 20

pain over medial epicondyle after throwing (repetitive valgus distraction force) progresses to persistent pain

most common elbow injury during childhood as growth plates are not fused
bone development changes characteristic of little league elbow

Question 21

nursemaids elbow
tear of ______ ligament
_____ is typically _______ displacement

Answer 21

annular ligament tear and/or radial head subluxation from annular ligament
pain with palpation of radial head with anterior displacement
restriction to posterior glide

Question 22

Coupled motions at elbow

Answer 22

ulnar adduction and radial head anterior glide with supination and vice versa

Question 23

wrist ROM

Answer 23

flexion 80-90
extension 70
ulnar deviation 30-40
radial deviation 20-30

Question 24

compression of the ulnar n is typically due to

Answer 24

flexor carpi ulnaris

Question 25

ok sign test assesses

Answer 25

anterior interosseous nerve - motor branch of median n

innervates flexor pollicis longus, deep flexors of digit 2 and 3, pronator quadratus

Question 26

carpal tunnel syndrome

Answer 26

entrapment of median n at the wrist in the carpal tunnel produces pain and parasthesias
chronic use may develop atrophy of intrinsic muscles of hand

Question 27

tinel’s sign assesses

Answer 27

entrapment of median n or carpal tunnel syndrome

Question 28

tinel’s sign test

Answer 28

tap transverse carpal ligament between thenar and hypothenar eminences
with patients hand held in extension

+ = parasthesias/numbness/tingling/pain radiating to thumb, index and middle finger (median n distribution)

Question 29

phalen’s sign test assesses

Answer 29

carpal tunnel syndrome

Question 30

phalen’s sign test

Answer 30

force patients hands into flexion and press the dorsal aspects together

+ = any reproduction of symptoms/parasthesias in the distribution of the median n

indicates carpal tunnel syndrome

Question 31

allen test assesses

Answer 31

lack of dual blood supply to the hand

Question 32

allen test

Answer 32

evaluates functioning of radial and ulnar arteries

occlude both arteries while patient makes a fist - have patient open/close fist (palm will be pale)

release pressure on ulnar artery and observe color return - repeat with radial a

no color return would indicate a lack of dual blood supply to the hand

Question 33

Dequervain’s tenosynovitis

Answer 33

pain and inflammation from reptitive overuse of tendons in first dorsal compartment
dorso-lateral wrist and thumb pain, might radiate into lateral hand and thumb

possible inflammation of tendon sheaths
abductor pollicis longus
extensor pollicis brevis

Question 34

Finkelstein test assesses for

Answer 34

dequervain’s tenosynovitis

Question 35

finkelstein test

Answer 35

patient makes fist enclosing thumb and performs ulnar deviation

+ = increased pain in first dorsal compartment/lateral wrist

Question 36

scaphoid fracture

Answer 36

most common carpal bone fracture
FOOSH
dull achiness deep in radial aspect of wrist after fall
decreased ROM, grip strength, tender snuff box
risk of avascular necrosis

Question 37

colle’s fracture

Answer 37

fracture of distal radius in forearm with dorsal (posterior) and radial displacement of the wrist and hand

Question 38

Monteggia fracture

Answer 38

fracture of proximal ulna

dislocation of radial head

Question 39

galeazzi fracture

Answer 39

fracture of distal radius

dislocation of ulna

Question 40

nightstick facture

Answer 40

isolated fracture of the mid shaft of the ulna from a direct blow