Elbow, Wrist, and Hand Lab

Question 1

What does the OK sign test for?

Answer 1

anterior interosseous nerve - motor branch

pt cannot make an O with thumb and forefinger pinching together

Question 2

What does a varus test evaluate?

Answer 2

lateral/radial collateral L.

Question 3

What is nursemaid’s elbow or radial head instability?

Answer 3

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

Question 4

What is colle’s fracture?

Answer 4

fall with wrist extended –> fracture of distal radius w/ dinner fork deformity

Question 5

What is Smith fracture?

Answer 5

fall with wrist flexed –> ventral displacement of wrist

Question 6

What does a valgus test evaluate?

Answer 6

medial/ulnar collateral L.

Question 7

How do you do tennis elbow testing?

Answer 7

have pt extend wrist against resistance

pain = lateral epicondylitis

Question 8

How do you test for a scaphoid fracture?

Answer 8

physician extends pt’s wrist and applies pressure to snuff box –> tenderness = fracture
*good specificity

Question 9

What is dupuytren’s contracture?

Answer 9

abnormal connective tissue thickening in the palmar fascia

Question 10

What is little league elbow?

Answer 10

group of problems related to stress of throwing in young athletes:
pain over medial epicondyle, initially after throwing, progresses to persistent pain
apophysitis –> avulsion –> ligamentous injury

Question 11

What are some hallmarks of carpal tunnel syndrome?

Answer 11

pain and paresthesia on lateral 3 digits

grip weakness and weakness w/ thumb abduction

Question 12

What is a galeazzi fracture?

Answer 12

fracture of distal radius

dislocation of the ulna

Question 13

How do you perform Phalen’s sign?

Answer 13

have pt place dorsal aspects of hands together and force into wrist flexion –> hold for 60 sec
+ test = any reproduction of symptoms
Indication: carpal tunnel syndrome

Question 14

What do pts present with who have olecranon bursitis?

Answer 14

posterior elbow distention and discomfort due to overuse or occupation
region is often painless and range of motion is normal

Question 15

What are the possible inflammation sites for dequervain’s tenosynovitis?

Answer 15

tendon sheath
abductor pollicis longus
extensor pollicis brevis

Question 16

What is boxer’s fracture?

Answer 16

fracture of distal shaft of the 5th metacarpal

usually due to punching a solid surface

Question 17

What does triceps reflex test for?

Answer 17

C7 nerve root

Question 18

What is mallet finger?

Answer 18

extensor tendon injury at DIP

Question 19

What is monteggia fracture?

Answer 19

fracture of proximal ulna

dislocation of the radial head

Question 20

What is dequervain’s tenosynovitis?

Answer 20

pain and inflammation from repetitive overuse of tendons in first dorsal compartment
pt will complain of dorsolateral wrist and thumb pain, occasionally w/ radiation into lateral hand and thumb
grip weakness

Question 21

How do you perform a tinel’s test at elbow?

what does it evaluate?

Answer 21

tap on cubital tunnel (by medial epicondyle of elbow

pain/numbness = ulnar n entrapment

Question 22

What determines clubbed fingers?

Answer 22

angle btw nail and proximal nail fold > 180
proliferation of connective tissue btw nail matrix and distal phalanx along w/ vasodilation w/ increased blood flow to digits

Question 23

How do you do golfer’s elbow testing?

Answer 23

Have pt flex wrist against resistance

pain medial epicondylitis

Question 24

What is trigger finger?

Answer 24

inflammation and narrowing of flexor tendon sheath –> finger curled up

Question 25

How do you perform Finkelstein test?

Answer 25

have pt make a fist encompassing their thumb –> ulnar deviate wrist
+ test = increased pain in first dorsal compartment
indication: dequervain’s tenosynovitis

Question 26

Where are bouchard nodes?

What disease are they associated with?

Answer 26

proximal interphalangeal joints (PIP)

rheumatoid arthritis

Question 27

What is jersey finger?

Answer 27

avulsion fo flexor digitorum profundus from fingertip –> can’t bend finger affected

Question 28

What is a nightstick fracture?

Answer 28

isolated fracture of mid-shaft/distal ulna from a direct blow

Question 29

What is gamekeeper’s thumb/skier’s thumb?

Answer 29

tear of ulnar collateral L of the 1st MCP –> pain on medial aspect of MCP

Question 30

What are the landmarks to palpate on the elbow?

Answer 30

olecranon process
medial and lateral epicondyles
radial head

Question 31

What are symptoms of rheumatoid arthritis?

Answer 31

ulnar deviation of fingers
bouchard nodes (PIP)
Heberden nodes (DIP)
subcutaneous nodules along the extensor surface of the proximal ulna or around the olecranon bursa

Question 32

What is ulnar n entrapment/ handlebar palsy?

Answer 32

ulnar n gets entrapped in guyon’s canal = space btw hook of hamate and pisiform
irritation –> numbness, tingling, weakness/ pain in ulnar nerve distribution

Question 33

Where are heberden nodes?

What disease are they associated with?

Answer 33

DIPs

rheumatoid arthritis

Question 34

What does biceps reflex test for?

Answer 34

C5 nerve root

Question 35

What does brachioradialis reflex test for?

Answer 35

C6 nerve root