PCM Competency 2

Question 1

1/2 Verbalize extremity exam for elbow; inspect and carrying angle

Answer 1

I’m going to be performing an extremity exam for the elbow, it is okay if i give it a look? Okay I do not notice any swelling, erythema, no scars or abrasions. Is there any pain with touch or motion? Women: 10-15 Men: 5

Question 2

4. AROM for elbow

Answer 2

Flexion: 140-150 Extension: 0 to -5 Supination: 90 Pronation: 90

Question 3

5. Strength bilaterally for elbow

Answer 3

+5/5

Question 4

6, Reflexes to perform for elbow:

Answer 4

triceps Biceps Brachioradialis

Question 5

3. What do I palpate on the elbow exam?

Answer 5

Palpate medial and lateral epicondyle

Question 6

7. Dermatome for elbow

Answer 6

C6 On the medial epicondyle of the elbow

Question 7

8. Valgus stress test

Answer 7

looks at the medial collateral ligament i. Slightly flex the elbow ii. Supinate and add an abduction force at the distal forearm while pushing on the elbow 1. Positive test: pain or tenderness 2. Indication: Sprained medial collateral ligament

Question 8

8. Varus stress

Answer 8

b. Varus stress test: looks at the lateral collateral ligament i. Slightly flex the elbow ii. Supinate and adds a adduction force on the distal forearm while pulling on the elbow. 1. Positive test: pain or tenderness 2. Indication: Sprained lateral collateral ligament

Question 9

8. Golfer elbow test

Answer 9

i. Flex elbow to 90 with palms facing up. ii. Place one arm under proximal forearm and other over the patients wrist iii. Tell pt to FLEX wrist. 1. Positive test: Pain around medial epicondyle 2. +: Medial epicondylitis

Question 10

9. Tennis elbow test

Answer 10

i. Flex elbow to 90 with palms facing down. ii. Place one arm under proximal forearm and other over the patients wrist iii. Tell pt to extend wrist. 1. Positive test: Pain around lateral epicondyle 2. +: Lateraly epicondylitis

Question 11

10. Tinels test for ulnar nerve entrapment (on the elbow)

Answer 11

i. Slightly flex at the elbow ii. Tap between the olecranon and medial epidondyle. 1. Positive test: Tingling down the forearm 2. Indication: Ulnar nerve entrapment

Question 12

100. Verbalize extremity exam for wrist and hand; inspect bilateral fingers, wrist or fingers and palm or top of hand

Answer 12

I’m going to be performing an extremity exam for the ________ INSPECT: Okay I do not notice any swelling, erythema, no scars or abrasions. Is there any pain with touch or motion?

Question 13

101. What do I palpate?

Answer 13

1. Carpal bones 2. Anatomic snuffbox 3. DIP and PIP joints 4. Radial artery

Question 14

102. AROM of wrist

Answer 14

a. Flexion: 80-90 b. Extension: 70 c. Adduction: 30-40 d. Abduction: 20-30

Question 15

103. AROM for finger

Answer 15

Question 16

104. AROM of thumb

Answer 16

Question 17

105. How do we access grip strength for wrist and hand

Answer 17

Have pt sqeeze docs 2nd and 3rd finger

Question 18

106. ROM against resistance for wrists

Answer 18

Resistance against

1. flexion
2. Extension
3. Abduction
4. Adduction

Question 19

107. Finkelstein test for DeQuervain’s

Answer 19

1. Make a fist, trapping your thumb
2. Stretch it down
   
   1. Positive sign: Pain on the lateral side of the wrist
   2. Indication: DeQuervain’s tenosynovitis

Question 20

107. Phalen’s for CTS

Answer 20

1. Tell patient to put the dorsal parts of their hands together and force into wrist flexion
2. Hold for 60 seconds
   
   1. Positive sign: numbness or tingling of thumb, index and middle finger
   2. Indication: Carpal Tunnel

Question 21

107. Tinels for CTS

Answer 21

1. Tap over transverse carpal ligament with reflex hammer while that patients wrist is extended
   
   1. Positive sign: numbess or tingling to thumb, index and middle finger
   2. Indication: Carpal Tunnel

Question 22

107. Palpation for tenderness in anatomical snuff box (scaphoid fx)

Answer 22

1. Positive sign: tenderness in anatomical snuffbox
2. Inidication: Scaphoid fx