Elbow, wrist, hand Practical Setups

Question 1

elbow traction

Answer 1

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

Question 2

radius P

Answer 2

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

Question 3

ulna P

Answer 3

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

Question 4

ulna PM

Answer 4

tissue pull lateral to medial, same as ulna P otherwise

Question 5

wrist traction longitudinal

Answer 5

traction wrist by grabbing distal forearm and hand

hold traction while flexing and extending wrist

Question 6

wrist traction transverse

Answer 6

grab wrist, push fingers up into wrist while thumbs stretch from midline out

Question 7

lunate, capitate Dth

Answer 7

have the patient hold their arm

traction wrist, then give a slight thrust at the end if it does’t move before that

Question 8

scaphoid, trapezium, trapezoid Dth

Answer 8

have patient hold their arm

traction and radial deviate the wrist, give a small thrust if it hasn’t moved before that

Question 9

triquetrum, hamate Dth

Answer 9

have patient hold their arm

traction and ulnar deviate the wrist and give a small thrust if it hasn’t moved before that

Question 10

lunate, capitate Sth

Answer 10

hold the opposite row of carpals
place thumb on affected carpal
traction and extend wrist

Question 11

triquetrum, hamate Sth

Answer 11

hold the opposite row of carpals with one hand, place thumb on affected carpal, extend and ulnar deviate wrist

Question 12

navicular, trapezium, trapezoid Sth

Answer 12

hold opposite row of carpals, place thumb on affected carpal and extend and radially deviate

Question 13

MCP traction

Answer 13

pinch distal part of the metacarpal and the proximal part of the phalange
traction the joint

Question 14

IP traction

Answer 14

pinch distal part of the phalange and proximal part of phalange around the joint in question
traction the joint

Question 15

CMC 1st

Answer 15

have patient grab their arm
grab thumb with both hands
place both thumbs at base of 1st metacarpal
traction and extend the metacarpal

Question 16

CMC 2-5

Answer 16

grab the carpals
place other thumb at the base of the metacarpal in question
traction and extend

Question 17

Mill’s test

Answer 17

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

Question 18

cozen’s test

Answer 18

patient extends wrist against resistance
positive: lateral epicondylitis
posteiror radius will also cause this to be positive

Question 19

lift test

Answer 19

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

Question 20

allen’s test

Answer 20

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)

Question 21

eden’s test

Answer 21

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

Question 22

wright’s test

Answer 22

palpate pulse
lift their arm until their pulse is no longer palpable
unilateral positive: hyperabduction syndrome

Question 23

adson’s test

Answer 23

palpate pulse
have patient look up and toward you and hold their breath
positive: decrease in volume of pulse, scalenus anticus or cervical rib

Question 24

tinel tap

Answer 24

tap over the median nerve for 10 seconds

positive: pain, carpal tunnel syndrome

Question 25

phalen’s

Answer 25

have patient touch back of hands together

positive: pain, carpal tunnel syndrome

Question 26

english

Answer 26

compress forearm proximal to the wrist
have patient make a fist 6-8 times
positive: numbness and paresthesia, indicates carpal tunnel syndrome