EXAMS ONLY Upper limb exam special tests

Question 1

What are the 2 special tests for the elbow?

Answer 1

Lateral epicondylitis test (Mill’s test)
Medial epicondylitis test

Question 2

What causes lateral epicondylitis
What is its colloquial name?

Answer 2

Overuse of muscles whose tendons attach to lateral epicondyle - wrist EXTENSORS
Tennis elbow - as tennis often involves extending the wrists

Question 3

How do you conduct the test for lateral epicondylitis (Mill’s test)? Cheats way of remembering?
What are the positive and negative signs?

Answer 3

Think - LaGay
Flex the elbow 90*
You want to stretch the extensor tendons. So flex the wrist. Also pronate the arm
Fully extend the arm
Positive sign: pain

Question 4

What causes medial epicondylitis?
What is its colloquial name?

Answer 4

Overuse of muscles whose tendons attach to medial epicondyle - wrist FLEXORS
Tennis elbow - as you use wrist flexors here

Question 5

How do you conduct the test for medial epicondylitis?
What are the positive and negative signs?

Answer 5

Flex the elbow 90*
You want to stretch the flexor endons. So, extend the wrist (and supinate arm)
Then flex the elbow
Positive sign: pain

Question 6

What are the 2 special tests for wrist?
What do these tests look for?

Answer 6

Phalen’s test, Tinel’s sign
Carpal tunnel syndrome

Question 7

How to conduct Phalen’s test?
Positive sign?

Answer 7

Get patient to hold hands in prayer for 30 seconds
Positive sign: pain/pins and needles

Question 8

How to conduct Tinel’s sign?
Positive sign?

Answer 8

Tap on the wrist over the median nerve
Positive sign: pain/pins and needles

Question 9

What are the 4 special tests for hands?

Answer 9

Grip strength
Key grip (pull apart 1 and 2)
Opposition strength (pull apart 1 and 5)
Practical test