elbow special tests Flashcards

1
Q

valgus stress

A

purpose: test integrity of ulnar collateral ligament

pt. pos.: seated with arms in anatomical position

prac. pos.: standing in front of pt. supporting arm, one hand at lateral elbow and other is placed on medial distal arm near wrist

procedure: valus stress is applied to elbow at 0 and at 30 degrees of flexion

positive: increased valgus movement with a diminished or absent end point

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2
Q

varus stress

A

purpose: test integrity of radial collateral ligament

pt. pos.: seated with arms in anatomical position

prac. pos.: standing in front of pt. supporting arm, one hand at lateral elbow and other is placed on medial distal arm near wrist

procedure: varus stress is applied to elbow at 0 and at 30 degrees of flexion

positive: increased varus movement with a diminished or absent end point

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3
Q

cozen’s test

A

purpose: lateral epicondylitis

pt. pos.: seated next to table, wrist and hand hanging off the edge. hand in a fist, pronated and radial deviated

prac. pos.: seated opposite pt. one hand stabilizing arm, other on dorsal hand resisting movement

procedure: pt moves into extension, supination, and ulnar deviation against resistance

positive: pain along lateral epicondyle of humerus; general muscular weakness and discomfort in the lateral elbow

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4
Q

Mill’s test

A

purpose: lateral epicondylitis

pt. pos.: standing or sitting

prac. pos.: standing next to pt., one hand on the elbow and the other on the posterior hand

procedure: forearm is passively pronated, radially deviated and wrist flexed and the elbow is taken into extension

positive: pain over the lateral epicondyle

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5
Q

Maudley’s test

A

purpose: lateral epicondylitis

pt. pos.: seated with hand flat on table

prac. pos.: seated next to pt. wit one finger over the pt.’s middle finger

procedure: instruct pt to extend middle finger against resistance

positive: pain over lateral epicondyle

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6
Q

Kaplan’s sign

A

purpose: lateral epicondylitis

pt. pos.: standing or sitting, elbow slightly flexed, forearm neutral and wrist slightly extended

prac. pos.: standing in front of pt. two fingers in the pt. hand

procedure: have the pt. grasp your two fingers or a dynamometer, put a strap or have someone constrict the forearm 1-2 inches distal to the elbow and recheck grip

positive: a decreased in pain and/ or an increase in grip strength following the strap

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7
Q

milking sign

A

purpose: test the integrity of the ulnar collateral ligament

pt. pos.: shoulder and elbow flexion with thumb pointing down. (as if reaching behind the head)

prac. pos.: standing behind pt. holding pt. thumb

procedure: apply a downward force to pt.’s thumb

positive: pain on the medial joint line

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8
Q

Andrew’s UCL test

A

purpose: determine integrity and laxity of the ulnar collateral ligament

pt. pos.: seated, facing away from the prac. shoulder is abducted and externally rotated, elbow fully flexed

prac. pos.: standing behind pt. one hand on the elbow (thumb on UCL) and other on the wrist

procedure: PT. is instructed to extend the elbow while the prac. provides a valgus force at the elbow

positive: pain and/or laxity at any point in the ROM

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9
Q

Table top Test

A

purpose: determine integrity and laxity of the ulnar and radial collateral ligament

pt. pos.: standing facing away from the table. forearm is supinated and shoulder externally rotated. arm is placed flat against the table

prac. pos.: stading to the side of the table. both hands placed around the elbow

procedure: prac. takes elbow into both valgus and varus forces

positive:

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10
Q

golfer’s elbow (medial epicondylitis Test #1

A

purpose: medial epicondylitis

pt. pos.: forearm supinated with wrist and elbow in extension and hand hanging off the end of the table

prac. pos.: standing next to pt.

procedure: pt. is instructed to pronate and flex wrist against resistance. opposite of Mill’s test

positive: pain in medial epicondyle region of humerus

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11
Q

Golfer’s elbow (medial epicondylitis) Test #2

A

purpose: medial epicondylitis

pt. pos.: forearm supinated with wrist in extension

prac. pos.: standing next to pt. hand on maintaining supination and wrist flexion

procedure: pt. is instructed to extend the elbow with arm in supination and wrist flexion

positive: pain in medial epicondyle region of humerus

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12
Q

bicep squeeze test

A

purpose: potential bicep rupture

pt. pos.: seated with arm resting in lap at approx. 60-80 degrees of flexion and arm in pronation

prac. pos.: standing or seated next to pt. with one hand over the musculotendinous juncture of the bicep and the other on the belly of the muscle

procedure: squeezing with both hands along the bicep

positive: if the arm does not supinate= indicative of a bicep rupture

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13
Q

tinel’s sign

A

purpose: determine abnormal pathology of a nerve, particularly the ulnar nerve

pt. pos.: seated or standing with elbow in slight flexion

prac. pos.: standing next to pt. supporting distal arm

procedure: while supporting distal arm, tap the ulnar nerve on the ulnar notch with index finger

positive: tinging along ulnar nerve distribution in forearm, hand, or fingers

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14
Q

wartenberg sign

A

purpose: test for ulnar nerve problem

pt. pos.: sitting with hands on table

prac. pos.: sitting across from pt.

procedure: instruct pt. to abduct fingers then bring them back together

positive: inability to adduct little finger is indicative of a ulnar nerve pathology

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15
Q

elbow flexion

A

purpose: cubital tunnel syndrome

pt. pos.: standin or sitting, with elbows in flexion and wrists extended

prac. pos.: sitting across from pt.

procedure: instruct pt. to hold position of full elbow flexion and wrist extension for 3-5 minutes

positive: numbness, tingling indicative of cubital tunnel syndrome (typically last finger and 1/2)

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16
Q

ulnar nerve compression

A

purpose: test for involvement of ulnar nerve or cubital tunnel syndrome

pt. pos.: standing with arm in supination

prac. pos.: standing next to pt. with one finger just proximal to the cubital tunnel on the medial elbow

procedure: apply a force for 30 seconds and note any changes in sensation through the ulnar nerve distribution

positive: numbness and tingling or shooting pain through the ulnar nerve distribution

17
Q

pinch grip

A

purpose: nerve entrapment

pt. pos.: may be seated or standing

prac. pos.: standing or sitting next to pt.

procedure: instruct pt. to pinch the tips of fingers between thumb and fingers

positive: inability to touch tips of fingers and thumb together, touching pad to pad

18
Q

capillary refill

A

purpose: determine vascularity of upper extremity

pt. pos.: standing or sitting, fingers extended

prac. pos.: standing next to pt.

procedure: apply pressure to fingernail (nail should turn white)

positive: should return to pink color. whiteness or a slow return to pink are abnormal

19
Q

brachial pulse

A

purpose: determine vascularity of the upper extremity

pt. pos.: standing or sitting

prac. pos.: standing next to pt. fingers along medial humerus

procedure: pressure is applied to the brachial area, medially on the humerus, and a pulse is determined

positive: diminished or weak pulse as compared bilaterally

20
Q

isosceles triangle

A

purpose: fracture of the medial or lateral epicondyle or the olecranon process

pt. pos.: seated or standing

prac. pos.:standing across from pt .

procedure: fingers are placed on medial epicondyle, lateral epicondyle and olecranon process in full extension and then the elbow is flexed

positive: the three landmarks should form a straight line in extension and for an isosceles triangle in full flexion