week 6 - elbow, wrist and hand

Question 1

what are some subjective questions for the elbow, wrist and hand?

Answer 1

aggs/eases
-gripping, pushing, pulling, twisting
-occupation
-physical activity
-hobbies
onset
-insidious
-trauma
neurological symptoms
cervical symptoms

Question 2

What observations should you make of the elbow, wrist and hand?

Answer 2

posture/positioning
muscle bulk
inflammatory signs
-redness
-swelling
-bruising
deformities
maladaptive patterns

Question 3

Which accessory movements are available at the elbow?

Answer 3

medial glide
lateral glide
longitudinal distraction

Question 4

What does Mill’s test test for?

Answer 4

lateral epicondylalgia (tennis elbow)

Question 5

How do you carry out Mill’s test?

Answer 5

palpate proximal common wrist extensor tendon
flex the wrist and extend the elbow

Question 6

What is a positive test for Mill’s test?

Answer 6

Reproduce lateral elbow pain

Question 7

What does Cozen’s test test for?

Answer 7

lateral epicondylalgia (tennis elbow)

Question 8

What is a positive result for Cozen’s test?

Answer 8

reproduce lateral elbow pain

Question 9

What does Phalen’s test test for?

Answer 9

carpel Tunnel syndrome

Question 10

What is a positive test for Phalen’s test?

Answer 10

Paraesthesia reproduced in the cutaneous distribution of the median nerve

Question 11

What does Tinel’s test test for?

Answer 11

Carpel tunnel syndrome

Question 12

What is a positive test for Tinel’s test?

Answer 12

Paraesthesia preproduced in the cutaneous distribution of the median nerve

Question 13

What does Finkelstein’s test test for?

Answer 13

DeQuervain’s Tenosynovitis

Question 14

How do you carry out Finkelstein’s test?

Answer 14

Patient in sitting or standing
actively flexes the thumb maximally and wrap fingers over thumb making a fist
place wrist into ulnar deviation to stretch APL and EPB

Question 15

What is a positive Finkelstein’s test?

Answer 15

Pain at APL and EPB

Question 16

Name some common signs and symptoms of lateral epicondylalgia

Answer 16

gradual onset - overloading
pain on lateral elbow
painful with gripping, wrist extension and pronation/supination
thickening of the proximal common extensor tendon
pain and reduced strength with gripping, wrist extension and pronation/supination
tender on palpation of lateral epicondyle and wrist extensors

Question 17

What are some common signs and symptoms of carpel tunnel syndrome?

Answer 17

pain, paraesthesia and/or anaesthesia on cutaneous distribution of the median nerve
symptoms often worse at night
difficulty gripping and weakness in hands
reduced grip strength
pain on wrist extension
positive Phalen’s test
Thennar atrophy/wastage

Question 18

Name some common signs and symptoms of DeQuervain’s Tenosynovitis

Answer 18

Gradual onset
aggravated by gripping and use of thumb with radial deviation
may be some swelling/thickening present
weakness and pain on active thumb extension and radial deviation of the wrist

Question 19

What movements occur at the elbow?

Answer 19

flexion
extension
pronation
supination

Question 20

What movements occur at the wrist?

Answer 20

flexion
extension
radial deviation
ulna deviation

Question 21

What movements occur at the hand?

Answer 21

finger flexion
finger extension
finger abduction
thumb opposition

Question 22

How do you carry out Cozan’s test?

Answer 22

patient in sitting or standing
place arm in elbow flexion and pronation
palpate proximal common wrist extensor tendon
ask the patient to extend their wrist against your resistance

Question 23

How do you carry out Phalen’s test?

Answer 23

patient in sitting or standing
flex the patient’s wrist and place both dorsal surfaces together
their position is held for 60 seconds or until symptoms are reproduced

Question 24

How do you carry out TInnel’s test?

Answer 24

patient in sitting or standing
lightly tap over the medial nerve within the carpal tunnel for 60 seconds or until symptoms are reproduced