Upper Extremity

Question 1

Elbow carrying angle

Answer 1

5-15

cubitus varus: 15

Question 2

Elbow flexion/extension

Answer 2

0-140-150

Question 3

Pronation/supination

Answer 3

supinate: (elbow) 80-85; 90
pronate: (elbow) 75-80; 80-90

Question 4

Tennis Elbow

Answer 4

make fist, pronate, extend wrist and fingers against resistance

pain at lateral epicondyle suggests lateral epicondylitis

Question 5

Golfer’s Elbow

Answer 5

supinate arm, extend wrist and elbow

pain at medial epicondyle suggests medial epicondylitis

Question 6

Elbow LCL/MCL instability test

Answer 6

25 flexion, apply varus/valgus stress

Question 7

Ulnar Nerve Entrapment Tests

Answer 7

Tinel’s Sign

Maxima elbow flexion for 3min

Question 8

Pinch grip

Answer 8

AIN (median nerve) pathology

Question 9

Wrist Flexion/Extension

Answer 9

Flexion: 80
Extension: 70

Question 10

Radial/Ulnar Deviation

Answer 10

Radial: 15-25
Ulnar: 30-45

Question 11

Durkan Carpal Compression

Answer 11

manual pressure on median nerve at carpal tunnel

most sensitive test

Question 12

Phalen Test

Answer 12

flex both wrists for 1 minute

Question 13

Finkelstein

Answer 13

flex thumb into palm, ulnarly deviate the wrist

pain in 1st dorsal compartment (APL/EPB)

De Quervain’s

Question 14

Piano Key Test

Answer 14

Stabilize ulna and translate radius dorsal volar

laxity or subluxation (click) indicates DRUJ instability

Question 15

Watson (Scaphoid Shift)

Answer 15

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)

Question 16

Allen Test

Answer 16

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

Question 17

Profundus Test

Answer 17

Stabilize PIPJ in extension, flex DIPJ only

FDP pathology

Question 18

Sublimus Test

Answer 18

Extend all fingers, flex a finger at PIPJ

FDS pathology

Question 19

Froment’s sign

Answer 19

hold paper with thumd and index finger, pull paper

if thumn IP flexion is positive, suggest adductor pollicis weakness and/or ulnar nerve palsy

Question 20

CMC grind test

Answer 20

axial compress and rotate CMC joint

pain indicates arthritis

Question 21

Finger instability test

Answer 21

stabilize proximal joint, apply varus and valgus stress

laxity indicates collateral ligament injury

Question 22

Thumb instability test

Answer 22

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

Question 23

Bunnell-Littler Test

Answer 23

Extend MCPJ, passively flex PIPJ

tight or inability to flex PIPJ, improved with MCPJ flexion indicates tight intrinsic muscles

Question 24

Elson Test

Answer 24

Flex PIPJ 90 over table edge, resist middle phalanx extension

DIPJ rigidly extending (via lateral bands) indicatres central slip injury (boutonniere)