OSCE: Elbow, Wrist, and Hand Flashcards
What is the elbow carrying angle for males and females?
Males: 5o
Females: 10-15o
What is the normal ROM for elbow flexion?
What muscles are involved?
140-150o
Biceps Brachii, Brachialis, Brachioradialis, Coracobrachialis
What is the normal ROM for elbow extension?
What muscles are involved?
0 - (-5o)
Triceps Brachii, Anconeus
What is the normal ROM for elbow supination?
What muscles are involved?
90o
Supinator, Biceps Brachii
What is the normal ROM for elbow pronation?
What muscles are involved?
90o
Pronator Teres and Pronator Quadratus
What is the normal ROM for elbow abduction and adduction?
5o
What is the normal ROM for wrist flexion?
What muscles are involved?
80-90o
Flexor Carpi Radialis, Flexor Carpi Ulnaris, Palmaris Longus
Coupled with posterior carpal glide
What is the normal ROM for wrist extension?
What muscles are involved?
70o
Extensor Carpi Radialis Longus and Brevis, Extensor Carpi Ulnaris
Coupled with Anterior Carpal Glide
What is the normal ROM for wrist adduction?
What muscles are involved?
30-40o
Flexor Carpi Ulnaris and Extensor Carpi Ulnaris
Coupled with Ulnar Abduction
What is the normal ROM for wrist abduction?
What muscles are involved?
20-30o
Flexor Carpi Radialis, Extensor Carpi Radialis Longus and Brevis
Coupled with Ulnar Adduction
What does the C5 deep tendon reflex test?
Biceps Brachii
What does the C6 deep tendon reflex test?
Brachioradialis
What does the C7 deep tendon reflex test?
Triceps Brachii
What dermatome tests the lateral arm?
C5
What dermatome tests the lateral forearm and thumb?
C6
What dermatome tests the middle finger?
C7
What dermatome tests the medial forearm and little finger?
C8
What dermatome tests the medial arm?
T1
Valgus Stress Test
How do you peform this test?
What does a positive test indicate?
- Arm slightly abducted and externally rotated.
- Forearm supinated and flexed to approx. 30º.
Elbow toward body and forearm goes away
Positive test (pain/laxity/tenderness) indicates Sprained Medial (Ulnar) Collateral Ligament
Varus Stress Test
How do you peform this test?
What does a positive test indicate?
- Arm slightly abducted and internally rotated.
- Elbow flexed to approximately 15º.
Elbow away from body and forearm goes toward
Positive test (pain/laxity/tenderness) indicates Sprained Lateral (Radial) Collateral Ligament
Tinel Test
How do you peform this test?
What does a positive test indicate?
- Tap between olecranon and medial epicondyle in
ulnar groove
Elbow away from body and forearm goes toward
Positive test (tingling sensation in forearm) indicates Ulnar Nerve Entrapment/Cubital Tunnel Syndrome
Medial Epicondylitis
How do you peform this test?
What does a positive test indicate?
- Place eblow in full extension
- Have patient resist wrist flexion
Positive test (pain/tenderness around medial epicondyle) indicates Golfer’s Elbow/Medial Epicondylitis.
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Lateral Epicondylitis
How do you peform this test?
What does a positive test indicate?
- Place eblow in full extension
- Have patient resist wrist extension
Positive test (pain/tenderness around lateral epicondyle) indicates Tennis Elbow/Lateral Epicondylitis.
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Tinel Sign
How do you peform this test?
What does a positive test indicate?
- Tap over the transverse carpal ligament/flexor
retinaculum
Positive test (pain/tingling sensation in lateral side of hand) indicates Carpal Tunnel Syndrome
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Phalen’s Sign
How do you peform this test?
What does a positive test indicate?
- Place dorsal aspects of patient’s hands together and force into wrist flexion.
- Hold for 60 seconds.
Positive test (paresthesia in lateral side of hand) indicates Carpal Tunnel Syndrome
DeQuervain’s Tenosynovitis
How do you peform this test?
What does a positive test indicate?
Finkelstein Test
- Examiner asks patient to make a fist encompassing their thumb
- Ulnar deviate the wrist.
Positive test (increased pain in lateral wrist) indicates DeQuervain’s Tenosynovitis.