Special Tests

Question 1

Edema - ways to measure

Answer 1

Circumferential measurements

Volumetrics

Question 2

Explain volumetrics

Answer 2

Fill plastic apparatus until water pours out spicket and then have the patient stick arm into the containter and then use measuring cup to measure how much water pours out - 50mL difference is significant?
Need to do bilateral comparison

Question 3

Explain circumferential measurements

Answer 3

Olecranon
Epicondyles
Center, above and below
Need to do bilateral comparison

Question 4

Ligamentous instability tests

Answer 4

Valgus stress test
Varus stress test
Hyperextension test

Question 5

Valgus stress test

Answer 5

For the MCL
Place pt in 20-30 flex and full supination (can be sitting or supine)
Palpate MCL as apply valgus stress to elbow

Question 6

Varus stress test

Answer 6

For LCL
Place pt in 20-30 flex and full supination (can be sitting or supine)
Palpate LCL as apply varus stress to elbow

Question 7

Hyperextension test

Answer 7

Positive if 10 degrees of hyperextension

Needs to boney end feel with it

Question 8

Nerve impingement/entrapment tests

Answer 8

Tinels sign
Wartenbergs sign
Elbow flexion test
Pronator teres test
Pinch grip test
Neural tissue provocation test

Question 9

Tinels sign

Answer 9

Ulnar nerve
Therapist tap ulnar nerve at cubital tunnel
Positive if asymmetrical presentation of tingling and inc discomfort

Question 10

Wartenbergs sign

Answer 10

Ulnar nerve
Therapist passively spread patient fingers and ask patient to bring fingers together (they have arm pron on a surface)
Positive if can’t adduct 5th finger

Question 11

Elbow flexion test

Answer 11

Cubital tunnel
Patient in complete flexion of elbow and hold for 5 minutes
Positive if tingling in ulnar distribution
Can also be median nerve signs though because compression of carpal tunnel if they flex their wrists

Question 12

Pronator teres test

Answer 12

Median nerve
Patient sit with elbow flexed to 90 and pron
Therapist attempts to pull them into sup and ext as patient resists
Pos if tingling in median nerve distribution
NOT a muscle test

Question 13

Pinch grip test

Answer 13

Ant interosseous nerve - FPL and FDP
Pat makes the OK sign
Positive if cant tough their fingertips together

Question 14

Neural tissue provocation

Answer 14

Radial
Median
Ulnar

Question 15

Epicondylitis/Epicondyalgia

Answer 15

Lateral (Mills and Maudleys)

Medial

Question 16

Mills Test

Answer 16

Lateral epicondylitis or algia
Therapist palpate lat epicondyle while positioned in elbow ext, wrist flex, finger flexion, ulnar deviation, and pronation
Have them mimic you do it and can overpress too
Pos if pain/reproduction of patient symptoms over lateral epicondyle

Question 17

Maudleys Test

Answer 17

Lateral epicondylitis or algia
Therapist resists patient extension of middle finger distal to PIP joint (stressing ED)
If want to stress ECRB can resist at MC
Pos if pain/reproduction of pt sx

Question 18

Medial Epicondylitis

Answer 18

Therapist palpate epicondyle while supinating, ext elbow, wrist ext, radial deviation
Have them copy you do it and can overpress
Pos if pain/reproduction of pt sx

Question 19

Functional tests and measures

Answer 19

Questionnaires - DASH
ADLs
IADLs
Work simulation
Leisure/hobbies