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Musculoskeletal > Elbow, Wrist and Hand Special Tests > Flashcards

Elbow, Wrist and Hand Special Tests Flashcards

1
Q

Tinel Sign

A

Sp. 0.99

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2
Q

Elbow Flexion Test

A

Sp. 0.99

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3
Q

Moving Valgus Stress Test

A

Backside of patient. Just shy of 90 abduction. Fully flex elbow. Apply valgus force while extending the elbow. Positive if painful arc between 120 to 70 flexion.

Sn 1.0

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4
Q

Anterior Band Valgus Test

A
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5
Q

Milking maneuver

A
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6
Q

BCI

A

+ is greater than 6 cm. If injured side over uninjured side is greater than 1.2. Rupture.

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7
Q

Passive Forearm Pronation

A
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8
Q

Hook Test

A
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9
Q

Mill’s Test

A
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10
Q

Maudsley’s Test

A
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11
Q

Cozen’s Test

A
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12
Q

Radiohumeral Anterior Glide

A

Patient supine; distal humerus stabilized, anterior glide of radius.

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13
Q

Radiohumeral Posterior Glide

A

Patient supine; distal humerus stabilized, Posterior glide of radius.

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14
Q

Humeroulnar distraction

A
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15
Q

If you suspect lateral epicondylalgia, what tests can you perform?

A

Cozen’s
Maudsley’s
Mill’s

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16
Q

If you suspect Biceps involvement what tests can you perform?

A

Hook test
Passive pronation
BCI

17
Q

If you suspect MCL involvement, what tests can you perform?

A

Anterior band stress test: 20-30 flexion, valgus force applied while palpating MCL.

Milking maneuver: Over 55 flexion; thumb pulled into ER.

Moving valgus stress test (Sn 1.0): Behind patient. Arm abducted just shy of 90. Full flexion. Extend with valgus force. Pain 120-70 is positive for partial tear of MCL

18
Q

If you suspect an ulnar nerve pathology, what test can you perform?

A

Elbow flexion test (Sp 0.99)- tingling/paresthesia in ulnar distribution is positive. 30-60 second hold.

ULNT3

Tinel Sign (Sp 0.99) - Tingling in ulnar distribution when tapped.

19
Q

List the carpal bones in consecutive/bordering order.

A

Scaphoid, trapezium, trapezoid, capitate, hamate, triquetrum pisiform, lunate

20
Q

Finkelstein’s Test

A

Wrap thumb and go into ulnar deviation. Positive is pain along radial side of wrist/forearm.

Tests for tenosynovitis (tendon)

21
Q

Phalen’s Test

A

Maximum wrist flexion hold over 60s
Positive is tingling in median nerve distribution
Does reverse Phalen’s alleviate?
Sp varies, but one source gave 0.89.

Tests CTS

22
Q

Flick Test

A

Ask patient how they get rid of symptoms when they come on. If wrist flick, positive.
Sp: 0.92

“tests” CTS

23
Q

Watson’s test

A

Thumb on scaphoid. Patient ulnar deviates. Pressure applied on dorsum of wrist. Patient radially deviates. Positive if pain is felt

Indicates ligamentous instability between scaphoid and lunate.

24
Q

Figure 8 Test

A

Tests for swelling/effusion/edema

25
Q

Median nerve Tinels

26
Q

Median nerve compression test

A

Thumb by thumb over the CT. Pressure for 30s. Numbness onset is positive.
Sn 0.87 Sp 0.90

Tests CTS

27
Q

Ulnocarpal stress test

A

90 degree elbow and shoulder flexion
Ulnar deviation
Pronate and supinate while applying longitudinal pressure
Reproduction of symptoms (clicking) is positive

Tests instability of TFCC

28
Q

If you suspect CTS, what tests can you perform?

A

Phalens/reverse
ask about flick test
Median nerve compression test
Median nerve Tinels

29
Q

If you suspect tenosynovitis what test can you perform?

A

Finkelstein’s

30
Q

If you suspect ligamentous instability of the wrist, what test can you perform?

A

Watson’s

31
Q

If you suspect instability of the TFCC what test can you perform?

A

Ulnocarpal stress test

32
Q

If you suspect radial nerve pathology what tests can you perform?

A

ULNT2

Tinels probably

33
Q

If you suspect median nerve pathology what tests can you perform?

A

All CTS tests I would think, especially Tinel’s

ULNT1

34
Q

ULNT1

A

Do active motion first

Active:
Standing, arm at side, elbow 90 flexion.
Straighten elbow
Bring arm out to side, above shoulder height
Palm up, bend wrist and fingers back
Tip head away

Passive:
Supine
add gentle shoulder depression
Abduct to 110
Extend wrist and fingies (approximate 1-3 with your own)
Supinate forearm
Shoulder ER
Elbow extension
Cervical lateral flexion away

35
Q

ULNT2

A

Do active motion first:

Active:
Standing, arm at side
Flex wrist
Turn palm so can look at it over shoulder
Push wrist toward floor
Tip head away

Passive:
Supine, shoulder slight abduction, elbow flexed across chest
Depress shoulder girdle
Extend elbow
IR entire UE
Flex wrist

36
Q

ULNT3

A

Do active first

Active:
Sit or stand, arm at side, elbow flexed 90
Bring arm up and out as if holding a tray of drinks on palm
ALTERNATE: Mask position

Passive:Supine, shoulder slight abduction and flexion, elbow slight flexion
Extend wrist and fingers, thumb between web space. Index on ring, Mid on mid.

Pronate forearm
Flex elbow
ER shoulder
Depress shoulder girdle
Abduct shoulder

Musculoskeletal (11 decks)

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