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Pt Assess II Final > Elbow Wrist Hand Lecture > Flashcards

Elbow Wrist Hand Lecture Flashcards

1
Q

What is the carrying angle of the elbow?

A
  • In anatomical position (palms up), slightly valgus

- 5 degrees in males, 10 in females

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2
Q

What does a carrying angle greater than 15 degrees indicate?

A

Possible history of a lateral epicondylar fracture and epiphyseal damage as a child

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3
Q

What does a decrease in the carrying angle or a varus angle indicate?

A

Supracondylar fx as a child w/epiphyseal injury

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4
Q

What is a gunstock deformity?

A

Varus carrying angle

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5
Q

Inspection of elbow:

A
  • Localized or diffuse swelling
  • Ecchymosis (traumatic injury)
  • Obvious deformity d/t fx or dislocation
  • Scars, burns, needle marks
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6
Q

Palpation of elbow (medial aspect)

A
  • Medial epicondyle (ME)
  • Ulnar groove (gently) b/w ME and olecranon
  • Flexor muscles
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7
Q

How is the hand affected by ulnar nerve compression?

A

Numbness and tingling in ring finger and pinky

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8
Q

Palpation of elbow (posterior aspect)

A
  • Olecranon (bursa should NOT be felt normally)

- Triceps

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9
Q

How can you make the triceps more prominent for palpation?

A

Have pt lean on table w/elbow slightly flexed

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10
Q

Palpation of elbow (lateral aspect)

A
  • Lateral epicondyle
  • Extensor muscles
  • Brachioradialis muscle
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11
Q

How to make brachioradialis more prominent for palpation?

A
  • Close fist, place it under edge of table

- Lift fist against table

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12
Q

Palpation of elbow (anterior aspect)

A
  • Biceps tendon in cubital fossa
  • Brachial artery
  • Median nerve
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13
Q

4 movements at elbow for both PROM and AROM?

A
  1. Flexion (135 degrees)
  2. Extension (0 to -5 degrees)
  3. Supination (90 degrees)
  4. Pronation (90 degrees)
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14
Q

How to test ligamentous instability in the elbow?

A
  • Pt slightly flex elbow w/forearm supinated
  • Face pt and cup posterior aspect just above elbow
  • Force elbow medially and then laterally (note any instability)
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15
Q

What is Tinel’s sign of the elbow?

A
  • Test for ulnar nerve compression
  • Tap in ulnar groove
  • Positive if pt feels numbness and tingling in ring and pinky fingers
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16
Q

What is the tennis elbow test?

A
  • Pt makes fist and dorsiflexes wrist
  • Apply resistance to dorsiflexed wrist
  • Pain at lateral epicondyle is positive
17
Q

Inspection of hand and wrist:

A
  • Fingers slightly flexed at rest (normal)
  • Joint swelling
  • Gouty tophi
  • Thickened palmar fascia
  • Bouchard’s or Heberden’s nodes
  • Mallet finger
18
Q

Bouchard’s nodes

A

PIP joint (sign of OA)

19
Q

Heberden’s nodes

A

DIP joint (sign of OA)

20
Q

What is trigger finger?

A

Painless nodule on palmar side near MC head - finger “pops” into extension w/extra effort or assistance

21
Q

What is felon?

A

Small closed space infection at distal pulp of finger

22
Q

When does atrophy of the thenar eminence occur?

A

Median nerve injury or carpal tunnel

23
Q

When does atrophy of the hypothenar eminence occur?

A

Ulnar nerve injury

24
Q

What is “no man’s land” of the hand?

A

From distal palmar crease to proximal interphalangeal crease

25
Q

What is the MC fractured carpal bone?

A

Scaphoid

26
Q

What is the largest carpal bone?

A

Capitate

27
Q

Tenderness over the anatomical snuffbox indicates:

A

Scaphoid fracture

28
Q

What makes the scaphoid easier to palpate?

A

Ulnar deviation

29
Q

What is Tinel’s sign of the wrist?

A
  • Percussion over carpal ligament

- Positive if numbness/tingling in first and second digits

30
Q

Dermatomes of the hand

A

C6: Thumb, index finger, radial side of palm
C7: central palm, middle finger
C8: ulnar side of palm, ring, pinky fingers

31
Q

Purest area of median nerve sensation in the hand:

A

Palmar tip of index finger

32
Q

Purest area of ulnar nerve sensation in the hand:

A

Volar surface of tip of pinky

33
Q

What is Phalen’s test?

A
  • Test for carpal tunnel
  • Pt hold wrists together in flexed position
  • Positive is numbness or tingling in median nerve distribution
34
Q

What is Finkelstein’s test?

A
  • Used to determine presence of DeQuervain’s disease (tenosynovitis of 1st dorsal compartment aka snuffbox)
  • Close fist w/thumb inside and ulnar deviate the wrist
  • Palpate snuffbox
  • Positive if painful

Pt Assess II Final (17 decks)

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