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PCM I > ELbow, WRist, Hand Exam Tests > Flashcards

ELbow, WRist, Hand Exam Tests Flashcards

1
Q

What is carrying angle?

A

-normally 5-15 degrees

  • cubitus varus= less then 5
  • cubitus valgus= greater than 15
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2
Q

Elbow ROM

A
  • flexion= 140-150
  • extension= 0- -5
  • supination adn pronation= 90
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3
Q

What are the 3 muscle reflexes you test in the arm?

A
  • biceps= C5
  • brachioradialis= C6
  • triceps= C7
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4
Q

What test do you persofrm for ligamentous stability at the elbow?

A

-valgus and varus stress tests for ulnar and radial collateral ligaments

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5
Q

What is valgus stress test of the elbow?

A
  • arm slightly abducted and externally rotated
  • forarm supinated and flexed about 30 and slight medial valgus stress applied (pushing on lateral side elbow–>medial)
  • positive test= pain/tenderness with palpation, increased laxity
  • indicates= injury to ulnar collateral ligament
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6
Q

What is a varus stress test for the elbow?

A
  • arm slightly abducted and internally rotated
  • elbow flexed about 15 degrees and slight varus stress applied on medial side of elbow (push medial–>lateral)
  • positive test= pain or increase laxity
  • indicates= injury to radial collateral ligament
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7
Q

What is tinsel test for ulnar nerve entrapment?

A
  • tap between olecranon and medial epicondyle in ULNAR GROOVE
  • positive test= tingling sensation down forearm with ulnar nerve disruption
  • indicates= ulnar nerve entrapment, cubital tunnel symdrome
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8
Q

What is the golfers elbow test?

A
  • for medial epicondylitis
  • anterior forearm/flexor compartment
  • pt elbow flexed to 90 and forearm placed in supination with wrist neutral and palm up
  • place one hand under proximal forarm to stabilize and other over the wrist to resist movement
  • pt flexes wrist against resistance
  • positive test= pain/tenderness around ME
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9
Q

What is the tennis elbow test? Aka Cozens test

A
  • for lateral epicondylitis
  • posterior forearm/extensor compartment
  • pt elbow flexed 90 degrees, forearm placed pronation with wrist neutral palm down
  • 1 Hand under proximal forarm to stabilize and other hand over pt hand to resist movement
  • pt extend wrist against resistance
  • positive test= pain/tenderness around LE
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10
Q

What is olecranon bursitis?

A
  • region painless and ROM normal
  • soft tissue inflammation
  • olecranon bursa lies superficial to posterior elbow joint
  • students elbow= posterior elbow distension/discomfort from overuse
  • miners elbow= due to occupational injury
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11
Q

What is little league elbow?

A
  • group of problems related to stress of throwing in young athletes
  • pain over ME initially after throwing (repetative valgus distraction force) progresses to persistent pain
  • most common elbow injury during childhood b/c growth plate not fused
  • as bone development matures most common injury seen evolved MCL (UCL) tear
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12
Q

What are teh 3 phases of little league elbow based on age?

A
  1. Apophysitis
  2. Avulsion
  3. Ligamentous injury
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13
Q

What is radial head instability?

A
  • nursemaids elbow
  • annular ligament tear and/or radial head subluxation from annular ligament
  • pain with palpation of radial head w/anterior displacement of radial head and restriction to posterior glide
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14
Q

What is ulnar abduction and ulnar adduction motion coupled with?

A

Ulnar abduction= pronation
Ulnar adduction= supination

Radial head anterior glide= supination
Radial head posterior glide= pronation

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15
Q

ROM of the wrist/hand

A
  • flexion= 80-90 coupled with posterior carpal glide
  • extension= 70 coupled with anterior carpal glide
  • adduction= 30-40 coupled with ulnar abduction
  • abduction= 20-30 coupled with ulnar adduction
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16
Q

What muscles contribute to flexion adn extension at the wrist?

A
  • flexion= flexor carpi radialis and palmaris longus

- extension= extensor carpi radialis longus and brevis

17
Q

What does teh OK sign test for?

A
  • motor branch of median n- inervating FPL, pronator quadratus, FDP digits 2/3
  • on exam if neuropathy present pt cannot make an O with thumb and forefingers
18
Q

What is carpel tunnel syndrome and what are tests for it?

A
  • entrapment of the median n at the wrist in the carpel tunnel
  • pain/paresthesias
  • atrophy of hand muscles
  • tests:
    1. Tinels sign
    2. Phalens sign
19
Q

What is tinels sign?

A
  • indicates entrapment of median n or carpal tunnel syndrome
  • elicited by tapping over the transverse carpal ligament with finger or reflex hammer with patient wrist in extension
  • positive test= paresthesias/numbness/tingling/pain radiates to thumb index middle finger
  • indicates= CTS
20
Q

What is phalens sign?

A
  • dorsal aspect of patients hands together and force into wrist flexion
  • hold for 60 sec
  • positive test= any reproduction of sx/parasthesias in distribution of median N
  • indicates= CTS
21
Q

What is allens test for?

A
  • evaluates functioning of radial and ulnar a
  • occlude both arteries while patient makes a fist
  • have patient open and close fist (palm should be pale)
  • release pressure on Ulnar a and observe color return within 5-10 sec
  • then repeat and release radial a. And observe color return
22
Q

What is dequervains tenosynovitis

A
  • get careful history about REPETATIVE activites
  • pain/inflammation from repetative overuse of tendons in 1st dorsal compartment
  • patient complain of dorsal-lateral wrist and thumb pain (w/radiation to hand and thumb)
  • positive finkelstein test
  • possible inflammation sites= AbPL or EPB (snuff box)
23
Q

What is the finkelstein test?

A
  • assess tenosynovitis of 1st dorsal compartment (used to test for dequervians syndrome)
  • patient make a fist encompassing their thumb and ulnar deviate the wrist
  • positive test= increase pain in the first dorsal compartment/lateral wrist
  • indicates= dequervains
24
Q

What is a scaphoid fracture?

A
  • most common carpal bone fracture due to falling foward or backward on outstretched hand (FOOSH)
  • patient complains dull achiness deep in radial aspect of wrist after fall
  • decrease ROM, decrease grip strength, tenderness in snuff box
  • immediate radiographyic evidence not always visible/may repeat image (confirm with CT or MRI)
  • important to treat due to risk of avascular necrosis
25
Q

What is a colles fracture?

A

-fracture of distal radius in forearm with posterior and radial displacement of the wrist and hand

26
Q

What is mallet finger?

A
  • Jammed finger
  • forced flexion
  • distal extensor disruption at DIP
27
Q

What is trigger finger?

A

-flexor tendon restriction

28
Q

What is jersey finger?

A
  • forced extension of DIP

- flexor tendon rupture-FDP

29
Q

Where is a boxers fracture?

A

-shaft of 5th metatarsal

30
Q

What is skiers thumb?

A
  • tear of ulnar collateral ligament

- aka gamekeepers thumb

31
Q

Where is ulnar nerve entrapment?

A
  • guyons canal

- between hook of hamate adn pisiform

PCM I (9 decks)

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