Mod 8: Elbow, Forearm, Wrist & Hand

Question 1

what parts of the humerus articulate with the radius & ulna?

Answer 1

radius: capitulum
ulna: trochlea

Question 2

nerve that innervates triceps?
brachialis & biceps?
pronator teres & flexor carpi radialis?
flexor carpi ulnaris?

Answer 2

radial n.
musculocutaneous n.
median n
ulnar n.

Question 3

elbow ligament that provides stability against valgus stress?
with 3 bundles: ___

Answer 3

medial (ulnar) collateral lig.
anterior, transverse, posterior bundle

Question 4

elbow ligament that provides stability against varus stress?

Answer 4

lateral (radial) collateral lig.

Question 5

ligament providing stability to radial head

Answer 5

annular ligament

Question 6

proximal radioulnar glide:
convex __ on concave ___
anterior for?
posterior for?

Answer 6

radius, ulna
supination
pronation

Question 7

proximal humeroradial glide:
concave ___ on convex ___
anterior for?
posterior for?

Answer 7

humerus, radius
flexion
extension

Question 8

2 special tests for pain in lateral epicondyle or mm weakness

Answer 8

Cozen’s Test
Lateral Epicondylitis Test

Question 9

pos Tinel’s sign causes what?

Answer 9

tingling sensation in ulnar nerve distribution in ulnar groove to forearm, wrist, hand or fingers

Question 10

type of splint & brace for elbow/forearm

Answer 10

cock-up splint (carpal tunnel)
counter-force brace (dec. pressure in epicondylar region)

Question 11

where to work up/down chain from elbow?

Answer 11

cervical
wrist/hand

Question 12

examples of wrist/hand/elbow mm endurance exercises

Answer 12

hammer exercises
broom handle exercises
grip strength devices

Question 13

common elbow mm rupture (2)

Answer 13

biceps & triceps

Question 14

repetitive hyperext w/ pronation or flexion w/ stressful pronation/supination d/t heavy lifting/load

Answer 14

biceps tendonitis/osis

Question 15

s/s: tender olecranon, pain with resisted elbow ext or passive elbow flex/shoulder flex

Answer 15

triceps tendonitis/osis

Question 16

irritation/inflamm of mm from common extensor tendon :
(3 mm: ___)

Answer 16

lateral epicondylitis/tennis elbow
extensor carpi radialis brevis & longus, extensor digitorum

Question 17

2 special tests for lateral epicondylitis

Answer 17

Mill’s test
Maudsley’s Test

Question 18

irritation to mm originating from common flexor tendon:
(4 mm: ___)

Answer 18

medial epicondylitis
pronator teres, flexor carpi radialis & ulnaris, flexor digitorum superficialis

Question 19

s/s: medial elbow pain at ligament origin, valgus laxity; d/t ER forces

Answer 19

medial collateral ligament sprain

Question 20

name of surgery for MCL sprain:
-activity to avoid acutely ___
- use ____ ____ exercise once full ROM

Answer 20

Tommy John
shoulder ER
progressive resistive exercise

Question 21

entrapment of ulnar nerve in ___ tunnel

Answer 21

cubital tunnel syndrom

Question 22

entrapment of supinator mm d/t repetitive twisting of forearm
-dislocates ___
-causes ___ motion to occur
-causes dec. ____ sensation

Answer 22

radial nerve palsy
radial head
wrist drop
thumb

Question 23

median nerve palsy causes median nerve entrapment in which mm?

Answer 23

pronator teres

Question 24

4 locations of elbow fx

Answer 24

supracondylar fx
intercondylar fx
radial head fx
olecranon fx

Question 25

what activities are contraindicated after total elbow arthro?

Answer 25

heavy lifting
racquet/throw sports
golf

Question 26

stress on arm’s growth plate causes inflamm/irritation in children
s/s: pain on cartilage/bone of medial elbow when throwing & dec. force production, regressed throwing ability/accuracy

Answer 26

LIttle Leaguer’s Elbow/ Medial Apophysitis

Question 27

inflamed cartilage/bone in joint d/t repetitive trauma to capitulum
-flap of cartilage dissects away from underlying subchondral attachment

Answer 27

capitellar osteochondritis dissecans

Question 28

contraindications to myositis ossificans (bone forms in muscle that’s been injured) - 3

Answer 28

massage, passive stretching, resistive exercise

Question 29

Bones of Hand (8): proximal row, distal row

Answer 29

scaphoid, lunate, triquetrum, pisiform
trapezium, trapezoid, capitate, hamate

Question 30

wrist ext mm (3)

Answer 30

extensor carpi radialis brevis,
ECR longus
EC ulnaris

Question 31

wrist flex mm (2)

Answer 31

flexor carpi radialis & FC ulnaris

Question 32

ulnar deviation mm (2)
radial deviation mm (4)

Answer 32

flexor carpi ulnaris & extensor carpi ulnaris
flexor carpi radialis & extensor carpi radialis, abductor pollicis longus & extensor pollicis brevis

Question 33

finger extension mm (3)

Answer 33

extensor digitorum
ext digiti minimi
ext indicis

Question 34

anatomical snuff box tendons (3)

Answer 34

ext pollicis longus
ext pollicis brevis
abductor pollicis longus

Question 35

distal radioulnar glides:
concave ___ on convex ___
anterior glide for?
posterior glide for?

Answer 35

radius on ulna
pronation
supination

Question 36

radiocarpal glide
convex ___ on concave ___
anterior glide for?
posterior glide for?

Answer 36

radius, on carpal unit
extension
flexion

Question 37

Allen’s Test for?

Answer 37

dec circulation in radial or ulnar 1/2 of hand

Question 38

Froment’s Sign for?

Answer 38

paralysis of adductor pollicis mm in thumb

Question 39

Phalen’s Test for?

Answer 39

tingling in median nerve distribution (reverse prayer)

Question 40

Finkelstein Test?

Answer 40

tenosynovitis in thumb
-abductor pollicis & ext pollicis brevis tendons

Question 41

floor & ceiling of the carpal tunnel

Answer 41

floor: distal carpals
ceiling: flexor retinaculum

Question 42

wrist/hand rehab: force couple relationships in these 3 areas

Answer 42

dexterity, grip & pinch/grasp

Question 43

Special tests for carpal tunnel syndrome (3)

Answer 43

Phalen’s
Reverse Phalen’s
Tinel’s Sign

Question 44

inflammation of tendon sheaths of abductor pollicis longus & extensor pollicis brevis
d/t repetitive ulnar deviations, texting, picking up child etc

Answer 44

DeQuervain’s Tenosynovitis

Question 45

Special Test for DeQuervain’s Tenosynovitis

Answer 45

Finkelstein’s Test

Question 46

thickening/shortening of palmar fascia causes flexion contracture of MCP, PIP or DIP
-bilateral or 1-3 fingers

Answer 46

Dupuytren contracture

Question 47

extensor tendon pathologies:
-central extensor tendon torn; PIP flexion & DIP hyperext
-deformity w/ PIP hyperextended & DIP flexion
-extensor digitorum tendon torn

Answer 47

1- Boutonniere deformity
2- swan neck deformity
3-mallet finger

Question 48

huge functional loss if damaged
risk of scar tissue formation
need surgical repair
-specific injury at distal phalanx?

Answer 48

flexor tendon rupture
Jersey Finger

Question 49

static isometric technique w/ minimal stress in which pt passively placed into position and hold 5 sec

Answer 49

place and hold

Question 50

tendon glide vs. tendon block

Answer 50

glide: neutral wrist, then progress to flexion, then extension; move flexor tendons over each jt in turn
block: actively flex each jt against gravity, blocking prox movement

Question 51

Colles vs Smith’s fx

Answer 51

C: distal radius fx w/ dorsal displacement (fall on extended hand)
S: distal radius fx w/ volar displacement (fall on flexed hand)

Question 52

Other common hand fx (3)

Answer 52

scaphoid- pain in anatomical snufbox
metacarpals- Boxer’s fx
phalangeal fx

Question 53

gamekeeper/skier/s/breakdancer’s thumb
d/t torsion/abduction or FOOSH

Answer 53

Ulnar Collateral Ligament Sprain of Thumb (MCP jt)

Question 54

disorders that occur after injury to a limb (distal)
s/s: sever burning pain, spasm, stiffness, change in skin color/temp, swelling etc

Answer 54

Complex Regional Pain Syndrome