Comp Eval: Elbow/Hand/Wrist Flashcards

(35 cards)

1
Q

6-91 Web distal/humerus, forearm grasp pull; long axis distraction

A

-PP: Seated; elbow in slight flexion
-DP: Standing facing pt
-CH: Grasp distal forearm
-IH: Web contact on distal humerus
-VEC: LAD *Can also be applied with pronation and supination

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2
Q

6-92 Calcaneal/proximal ulna, forearm stabilization; medial to lateral glide

A

-PP: Seated; affected arm flexed at shoulder
-DP: Standing facing patient on medial side of affected arm
-CH: Calcaneus with inside hand on proximal ulna -IH: Outside hand on lateral aspect of forearm with your arm stabilizing pt arm against your body
-VEC: M-L impulse while slightly distracting with IH

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3
Q

6-93 Calcaneal/proximal radius, forearm stabilization; lateral to medial glide

A

-PP: Seated with arm flexed at shoulder
-DP: Standing on lateral side of affected arm
-CH: Outside hand calcaneal contact on proximal radius
-IH: Inside hand grasps proximal forearm holding affected arm against your body
-VEC: L-M impulse while slightly distracting with IH

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4
Q

6-94 Reinforced hypothenar/proximal radial pull; anterior to posterior glide

A

-PP: Seated at edge of table sitting on palm of hand of affected arm; ask patient to hold edge of table -DP: Sit on edge of table or straddling table facing pt on affected side
-CH: Inside hand hypothenar to proximal radius/radial head
-IH: reinforces CH with outside hand
-VEC: A-P impuls

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5
Q

6-95 Thumb/radius push, distal forearm grasp; posterior to anterior glide in pronation

A

-PP: Seated; affected arm slightly flexed at elbow in pronation
-DP: Stand on affected side
-CH: Outside hand thumb contact on radial head
-IH: grasp distal forearm
-VEC: P-A very shallow impulse; IH moves elbow into a slightly extended and pronated position

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6
Q

6-96 Mid-hypothenar (knife-edge) /proximal ulna, elbow flexion; anterior to posterior glide

A

-PP: Seated; shoulder and elbow flexed
-DP: Stand facing pt
-CH: Inside hand hypothenar/knife edge on proximal ulna in antecubital fossa
-IH: Grasp proximal forearm with outside hand
-VEC: A-P; using IH flex pt elbow over contact delivering A-P thrust with contact hand

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7
Q

6-97 Hypothenar/radius push, ulnar stabilization; posterior to anterior glide in supination

A

-PP: Seated on table edge while sitting on palm of affected side
-DP: Seated facing patient on table or straddle table -CH: Pisiform of inside hand on posterior radial head -IH: Grasp proximal ulna with posterior hand
-VEC: P-A shallow impulse

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8
Q

6-98 Thumb index/olecranon ; posterior to anterior glide in full extension

A

-PP: Seated with affected arm extended at elbow; flexed at shoulder
-DP: Standing on lateral side of affected arm
-CH: Form a ring with thumb and index finger
-IH: Grasp distal anterior forearm
-VEC: P-A shallow impulse on olecranon; IH applies light downward pressure on distal forearm

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9
Q

6-99 Bimanual grasp/distal humerus with knee extension; long axis distraction

A

-PP: Supine with affected arm slightly abducted
-DP: Bunny hop position; knees grasping distal forearm
-CH: Bimanual grasp on distal humerus
-VEC: LAD with slight knee extension

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10
Q

6-100 Web/proximal ulna push with knee extension; medial to lateral glide

A

-PP: Supine with affected arm slightly abducted
-DP: Bunny hop position; knees grasping distal forearm
-CH: Inside hand web contact on proximal ulna
-IH: Outside hand on lateral forearm just distal to CH -VEC: M-L shallow impulse with CH while distracting with knees

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11
Q

6-101 Web/proximal radius push with knee extension; lateral to medial glide

A

-PP: Supine with affected arm slightly abducted
-DP: Bunny hop position; knees grasping distal forearm
-CH: Outside hand web contact on proximal radius -IH: Inside hand on medial forearm just distal to CH -VEC: L-M shallow impulse with CH while distracting with knees

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12
Q

Cozen’s Test

A

• Pain in the
lateral
epicondyle
indicates
Lateral
Epicondylitis

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13
Q

Mill’s Test

A

• Pain in the
lateral
epicondyle is a
positive test
indicative of
lateral
epicondylitis

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14
Q

Stress Test of the Elbow

A

• Pain or
increased
movement
indicates
damage to the
supporting
ligaments of the
elbow

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15
Q

Pinch Grip Test

A

• Inability to keep the
thumb flexed
pinching tip to tip is
indicative of
impingement of the
anterior interossei
branch of the
median nerve

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16
Q

Medial Epicondylitis Test

A

• Pain in the medial
aspect of the
elbow is indicative
of medial
epicondylitis

17
Q

Tinel’s Sign of the Elbow

A

• Pain, referred
pain or tingling
indicates damage
to the ulnar nerve

18
Q

6-126 Bimanual thumb index/radius and ulna shear; anterior to posterior or posterior to anterior glide

A

-PP: Seated or supine
-DP: Stand facing pt on involved side
-CH: Thumb/Index on distal radius and ulna
-VEC: Apply A-P and P-A shearing bilaterally

19
Q

6-127 Reinforced hypothenar/radius; medial to lateral compression

A

-PP: Seated on adjusting table, affected arm on headrest radius facing up
-DP: Stand at head of table facing pt
-CH: Pisiform contact with cephalad hand to distal radius
-IH: Caudal hand reinforces snuff box
-VEC: Compressive M-L approximation impulse thrust

20
Q

6-128 Hand-grasp pull with forearm stabilization; long axis distraction

A

-PP: Seated with affected arm in flexion
-DP: Stand facing pt
-CH: Inside hand grasps pt hand
-IH: Outside hand grasps distal forearm
-VEC: LAD; shallow quick pul

21
Q

6-129 Bimanual palmar grasp/hand with arm axillary stabilization; long axis distraction

A

-PP: Seated with affected arm slightly flexed at shoulder and elbow
-DP: Seated or standing on affected side
-CH: Inside arm rests in pts antecubital fossa with palmar contact placed proximal to pt thenar
-IH: Outside hand palmar contact over pt’s metacarpals/dorsal hand
-VEC: LAD; squeeze hands together while flexing pt’s elbow

22
Q

6-130 Bimanual grasp/distal forearm hand; medial to lateral or lateral to medial glide; medial to lateral or lateral to medial tilt

A

-PP: Seated with affected arm in flexion
-DP: Stand on affected side facing lateral aspect of pt’s arm
-CH: Proximal hand grasp distal radius/ulna
-IH: Distal hand grasps pt’s distal wrist
-VEC: Shearing type stress either M-L or L -M or creating radial and ulnar deviation stress

23
Q

6-131 Bimanual grasp/distal forearm hand; anterior to posterior or posterior to anterior glide

A

-PP: Seated with affected arm flexed
-DP: Stand on affected side
-CH: Proximal hand grasps distal radius/ulna
-IH: Distal hand grasps pt’s distal wrist over metacarpal-carpal joints
-VEC: A-P or P-A impulse thrust

24
Q

6-132 Reinforced thumbs/carpal; anterior to posterior glide

A

-PP: Seated with affected arm raised in flexion
-DP: Standing facing pt
-CH: Reinforced thumb on affected carpal
-VEC: A-P or P-A impulse; remove articular slack (flex or extend wrist)

25
6-133 Bimanual thumbs digits/metacarpals; anterior to posterior or posterior to anterior
-PP: Seated with affected arm in forward flexion, elbow flexed -DP: Stand facing pt CH/IH: Thumbs on palmar surface of metacarpals -VEC: A-P or P-A, creating a shearing force between metacarpals
26
6-134 Thumb index grasp/metacarpophalangeal (or interphalangeal) with hand stabilization; long axis distraction; internal or external rotation; anterior to posterior or posterior to anterior glide; lateral to medial or medial to lateral glide PP: Seated DP: Stand facing patient CH: Grasp distal to joint being adjusted IH: Grasp proximally to the joint being adjusted VEC: LAD; A-P; P-A, L-M, M-L or internal/external rotation
-PP: Seated DP: Stand facing patient -CH: Grasp distal to joint being adjusted -IH: Grasp proximally to the joint being adjusted -VEC: LAD; A-P; P-A, L-M, M-L or internal/external rotation
27
Tinel’s of the Wrist
• Pain or tingling in the distribution of the median nerve distal to the wrist indicates medial nerve compression in the carpal tunnel
28
Phalen’s
• Pain or tingling in the hand along the distribution of the median nerve. Indicates carpal tunnel compression of the median nerve
29
Reverse Phalen’s
• Pain or tingling in the hand along the distribution of the median nerve indicates carpal tunnel compression of the median nerve
30
Finkelstein’s
• Sharp pain in tunnel 1 indicates DeQervain’s or stenosing tenosynovitis
31
Bracelet Test
• Acute pain in the wrist forearm and hand indicates Rheumatoid Arthritis
32
Stress Test of the Wrist
• Pain or increased movement indicates damage to the supporting ligaments or problems with the tunnel
33
Carpal Lift Test
• This indicates carpal fracture or sprain
34
Froment’s Sign
• Positive is a weakness in the ability to keep the digits together indicating ulnar nerve palsy
35
Finsterer’s Sign
• Pain in the center of the wrist indicates Keinbock’s disease ( lunate avascular necrosis)