Elbow, wrist, hand Practical Setups Flashcards
elbow traction
put your wrist in the bend of the patient’s elbow (thumb down) and press in until patient tolerance or until the joint opens up
radius P
find radial head with thumb, grab wrist with other hand
extend and pronate the elbow to end ROM, back off, then put a small thrust into it
ulna P
place knife-edge hand an inch down from the olecranon process, other hand supinates arm
bring arm to full tension, back off, then add a small thrust
ulna PM
tissue pull lateral to medial, same as ulna P otherwise
wrist traction longitudinal
traction wrist by grabbing distal forearm and hand
hold traction while flexing and extending wrist
wrist traction transverse
grab wrist, push fingers up into wrist while thumbs stretch from midline out
lunate, capitate Dth
have the patient hold their arm
traction wrist, then give a slight thrust at the end if it does’t move before that
scaphoid, trapezium, trapezoid Dth
have patient hold their arm
traction and radial deviate the wrist, give a small thrust if it hasn’t moved before that
triquetrum, hamate Dth
have patient hold their arm
traction and ulnar deviate the wrist and give a small thrust if it hasn’t moved before that
lunate, capitate Sth
hold the opposite row of carpals
place thumb on affected carpal
traction and extend wrist
triquetrum, hamate Sth
hold the opposite row of carpals with one hand, place thumb on affected carpal, extend and ulnar deviate wrist
navicular, trapezium, trapezoid Sth
hold opposite row of carpals, place thumb on affected carpal and extend and radially deviate
MCP traction
pinch distal part of the metacarpal and the proximal part of the phalange
traction the joint
IP traction
pinch distal part of the phalange and proximal part of phalange around the joint in question
traction the joint
CMC 1st
have patient grab their arm
grab thumb with both hands
place both thumbs at base of 1st metacarpal
traction and extend the metacarpal
CMC 2-5
grab the carpals
place other thumb at the base of the metacarpal in question
traction and extend
Mill’s test
show off bicep with fist facing them
have them turn their fist out and extend out
positive: lateral epicondylitis
posterior radius will also cause this to be positive
cozen’s test
patient extends wrist against resistance
positive: lateral epicondylitis
posteiror radius will also cause this to be positive
lift test
have patient lift in pronation (extensors) and supination (flexors)
positive pronation= lateral epicondylitis
positive supination= medial epicondylitis
posterior radius can cause this to be positive
allen’s test
have patient clench fists bilaterally, then hold a fist
occlude their arteries and have them open up their hands
positive is when the blood doesn’t return within 10 seconds (patency of artery)
eden’s test
palpate radial pulse
have them pull elbows into their sides and put their head down
a weakended or lost pulse means they have costoclavicular syndrome
wright’s test
palpate pulse
lift their arm until their pulse is no longer palpable
unilateral positive: hyperabduction syndrome
adson’s test
palpate pulse
have patient look up and toward you and hold their breath
positive: decrease in volume of pulse, scalenus anticus or cervical rib
tinel tap
tap over the median nerve for 10 seconds
positive: pain, carpal tunnel syndrome
phalen’s
have patient touch back of hands together
positive: pain, carpal tunnel syndrome
english
compress forearm proximal to the wrist
have patient make a fist 6-8 times
positive: numbness and paresthesia, indicates carpal tunnel syndrome
