Elbow, Forearm, Wrist and Hand Examination Flashcards

1
Q

INTRO AND VISUAL INSPECTION

A

INTRO AND VISUAL INSPECTION

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2
Q

Screening questions done during the patient interview?

A
  • UE Trauma; specify mechanism
  • Hx neck pain/trauma
  • Hx shoulder pain/trauma
  • UE paresthesia, anesthesia, weakness
  • Screening for other non-musculoskeletal health conditions or MSK conditions where referral is indicated
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3
Q

Common functional limitations present present during the patient interview?

A
  • Gripping/lifting
  • Eating
  • Pushing/pulling
  • Typing
  • Catching/throwing
  • w/b through UE
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4
Q

Outcome measures used for UE during patient interview?

A
  • PSFS

- QuickDASH

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5
Q

What do we look for during our visual inspection?

A
  • Gross abnormalities (local swelling/redness, deformity, atrophy)
  • Integumentary
  • Resting posture vs ability to correct
  • Posture assessment
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6
Q

With posture visual inspection we are looking at what structures?

A
  • Head on neck
  • Mandible on cranium
  • Neck on trunk
  • Scapulae on thorax
  • Upper arms on scapulae (rotation)
  • Carrying angle
  • Resting flexion angle of elbow
  • Resting position of supination/pronation at the forearm
  • Resting position of hand
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7
Q

Systems review purpose?

A

Identify things we need to look into further.

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8
Q

ELIMINATION TESTS

A

ELIMINATION TESTS

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9
Q

What are the parts of eliminations tests?

A
  • UQS
  • Neuro Screening Tests (light touch, pin prick, myotome, DTRs, Long Track Signs)
  • Special Tests
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10
Q

With our elimination tests, we should think about tests that could ____ _____ more proximal contributors.

A

rule out

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11
Q

What are some conditions that we can apply elimination tests to at the elbow/forearm?

A
  • Cubital Tunnel Syndrome
  • Fracture at Elbow
  • Biceps Tear
  • Elbow Instability
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12
Q

What test(s) are used to rule out Cubital Tunnel Syndrome?

A

Pressure Provocation Test

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13
Q

What test(s) are used to rule out Fracture at the Elbow?

A

-Elbow Extension, Flexion, Supination, Pronation Tests

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14
Q

What test(s) are used to rule out Biceps Tear?

A

Biceps Squeeze Test

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15
Q

What test(s) are used to rule out Elbow Instability?

A
  • Moving Valgus Stress Test
  • Varus Stress Test (LCL)
  • Valgus Stress Test (MCL)
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16
Q

What are some conditions that we can apply elimination tests to at the wrist/hand?

A
  • Thumb Instability
  • DeQuervain’s Tenosynovitis
  • Scaphoid Fracture
17
Q

What test(s) are used to rule out Thumb Instability?

A

Ulnar Collateral Ligament Test

18
Q

What test(s) are used to rule out DeQuervain’s Tenosynovitis?

A

Finkelstein’s Test

19
Q

What test(s) are used to rule out Scaphoid Fracture?

A

Anatomical Snuffbox Tenderness

20
Q

Neurodynamic Tension Testing:

  • What is done prior to the test?
  • What indicated a positive test?
A

Prior to test:

  • check base-line symptoms
  • demonstrate desired active sensitization motions
  • clear instructions

Positive test:

  • concordant symptom reproduction
  • response altered by movement of distant body part
  • test difference with laterality
21
Q

What is the order of the Median Nerve Bias Neurodynamic Tension Testing components?

A
  • Scapular depression
  • Shoulder adduction to 110 degrees
  • Forearm supination
  • Wrist/hand extension
  • Shoulder ER
  • Elbow Extension
  • Sensitization maneuver
22
Q

What is the order of the Radial Nerve Bias Neurodynamic Tension Testing components?

A
  • Scapular depression
  • Forearm pronation
  • Elbow extension
  • Wrist and finger flexion
  • Shoulder IR
  • Shoulder slight extension
  • Shoulder abduction
  • Sensitization maneuver
23
Q

What is the order of the Ulnar Nerve Bias Neurodynamic Tension Testing components?

A
  • Scapular depression
  • Shoulder abduction to 110 degrees
  • Shoulder ER
  • Elbow flexed
  • Forearm pronation
  • Wrist/hand extension
  • Sensitization maneuver
24
Q

STRUCTURAL STRESS TESTING

A

STRUCTURAL STRESS TESTING

25
Q

Structural Stress Testing involves what 3 components?

A
  • AROM
  • PROM
  • Resistive Testing
26
Q

What movements do we want to assess during our Structural Stress Testing?

A
  • Elbow Flexion/Extension
  • Elbow Supination/Pronation
  • Wrist Flexion/Extension
  • Wrist Abduction/Adduction
  • MCP Flexion/Extension
  • IP Flexion/Extension
  • CMC Flexion/Extension/ABD/ADD/Opposition/Reposition
27
Q

PALPATION AND JOINT MOBILITY TESTING

A

PALPATION AND JOINT MOBILITY TESTING

28
Q

What joint mobility can be performed at the Humero-Ulnar Joint?

A

Posterior

29
Q

What joint mobility can be performed at the Humero-Radial Joint?

A
  • Anterior

- Posterior

30
Q

What joint mobility can be performed at the Proximal Radio-Ulnar Joint?

A
  • Anterior

- Posterior

31
Q

What joint mobility can be performed at the Distal Radio-Ulnar Joint?

A
  • Anterior

- Posterior

32
Q

What joint mobility can be performed at the Radiocarpal Joint?

A
  • Ventral
  • Dorsal
  • Radial
  • Ulnar
33
Q

What joint mobility can be performed at the CMC?

A
  • Palmar
  • Dorsal
  • Radial
  • Ulnar
34
Q

What joint mobility can be performed at the MCP, PIP, DIP?

A
  • Palmar

- Dorsal

35
Q

CONFIRMATION TESTS

A

CONFIRMATION TESTS

36
Q

What confirmation test(s) can be used to rule in Cubital Tunnel Syndrome?

A
  • Elbow Flexion Test

- Tinel’s Sign

37
Q

What confirmation test(s) can be used to rule in Lateral Epicondylopathy?

A
  • Cozen’s Test
  • Resisted Tennis Elbow Test
  • Passive Tennis Elbow Test
38
Q

What confirmation test(s) can be used to rule in Carpal Tunnel Syndrome?

A
  • Phalen’s Test
  • Tinel’s Test
  • Median Nerve Compression Test
39
Q

What is a good performance measure for grip strength?

A

Jamar Hand Dynamometer