Upper Extremity Flashcards
Elbow carrying angle
5-15
cubitus varus: 15
Elbow flexion/extension
0-140-150
Pronation/supination
supinate: (elbow) 80-85; 90
pronate: (elbow) 75-80; 80-90
Tennis Elbow
make fist, pronate, extend wrist and fingers against resistance
pain at lateral epicondyle suggests lateral epicondylitis
Golfer’s Elbow
supinate arm, extend wrist and elbow
pain at medial epicondyle suggests medial epicondylitis
Elbow LCL/MCL instability test
25 flexion, apply varus/valgus stress
Ulnar Nerve Entrapment Tests
Tinel’s Sign
Maxima elbow flexion for 3min
Pinch grip
AIN (median nerve) pathology
Wrist Flexion/Extension
Flexion: 80
Extension: 70
Radial/Ulnar Deviation
Radial: 15-25
Ulnar: 30-45
Durkan Carpal Compression
manual pressure on median nerve at carpal tunnel
most sensitive test
Phalen Test
flex both wrists for 1 minute
Finkelstein
flex thumb into palm, ulnarly deviate the wrist
pain in 1st dorsal compartment (APL/EPB)
De Quervain’s
Piano Key Test
Stabilize ulna and translate radius dorsal volar
laxity or subluxation (click) indicates DRUJ instability
Watson (Scaphoid Shift)
push dorsally on distal pole of scaphoid, bring wrist from ulnar to radial deviation
A click or clunk (scaphoid subluxating dorsally over rim of distal radius) is positive for carpal instability (scapholunate dissiciation)
Allen Test
occlude both radial and ulnar arteries manually, pump fist, then release one artery only
delay or absence of “pinking up” of the palm and fingers suggests compromise of the artery released
Profundus Test
Stabilize PIPJ in extension, flex DIPJ only
FDP pathology
Sublimus Test
Extend all fingers, flex a finger at PIPJ
FDS pathology
Froment’s sign
hold paper with thumd and index finger, pull paper
if thumn IP flexion is positive, suggest adductor pollicis weakness and/or ulnar nerve palsy
CMC grind test
axial compress and rotate CMC joint
pain indicates arthritis
Finger instability test
stabilize proximal joint, apply varus and valgus stress
laxity indicates collateral ligament injury
Thumb instability test
stabilize MCP, apply valgus stress in extension and 30 degrees of flexion
Laxity at 30: ulnar collateral ligament
Laxity in extension: accessory collateral ligament and/or volar plate injury
Bunnell-Littler Test
Extend MCPJ, passively flex PIPJ
tight or inability to flex PIPJ, improved with MCPJ flexion indicates tight intrinsic muscles
Elson Test
Flex PIPJ 90 over table edge, resist middle phalanx extension
DIPJ rigidly extending (via lateral bands) indicatres central slip injury (boutonniere)
