Elbow

Question 1

What does Varus/Valgus stress test

Answer 1

Valgus/abduction- md lig strain
Varus- adduction- lat

Question 2

Valgus stress test technique

Answer 2

Pt seated
1. applies valgus force with elbow fully extended
2. examiner applies valgus force with elbow flexed at 30 and forearm supinated

Question 3

Varus technique

Answer 3

Pt seated
1. varus force fully extended
2. varus force with elbow flexed 30 and forearm supinated

Question 4

+ve Varus/valgus

Answer 4

P oor excessive movement either side of elbow

Question 5

Varus/valgus clinical notes

Answer 5

Due to dynamic range of elbow Jt its important to test elbow ligament integrity in at least two positions

Question 6

What does Cozens test

Answer 6

Lateral elbow tendinopathy

Question 7

Cozens technique

Answer 7

Stabilise forearm- palpate lat epi
Pronate arm
Radially deviate
Ext wrist
Pt resist ext movement

Question 8

+ve Cozen

Answer 8

Weakness + lat elbow P

Question 9

Cozens clinical notes

Answer 9

P often described as sharp + shooting
May be reproduced with palpation over radial nerbe + common extensor tendon

Most commonly caused by extensor carpi radials longus/brevis- can muscle test these

Question 10

What does reverse Cozen test

Answer 10

Medial epicondylittis

Question 11

Reverse Cozen technique

Answer 11

Stabilise Pt forearm
Palpating med epi
Supinate arn
Ulnar deviate
Flex wrist
Resist flex

Question 12

+ve Reverse Cozen

Answer 12

Weakness + medial elbow P

Question 13

What does Mills test for

Answer 13

Lateral epicondylitis

Question 14

Mills technique

Answer 14

Palpate lat epi while pronating forearm
Flex wrist
Ext elbow
No resistance- stretch test

Tests the common extensor tendon

Question 15

Mills clinical notes

Answer 15

Can flex all fingers and apply pressure with thumb over common extensor tendon to inc sensitivity

Rx in ROM- arthritis, capsular adhesions, or tendon contracture

Can be used for treatment as it stretches the common extensor tendon

Question 16

+ve Mills

Answer 16

Lateral elbow P

Question 17

What does reverse Mills test

Answer 17

Medial epicondylitis

Question 18

Reverse Mills technique

Answer 18

Palpate med epi while supinating forearm
Ext wrist
Ext elbow

Question 19

+ve Reverse Mills

Answer 19

Medial elbow P

Question 20

Reverse mills and cozens clinic notes

Answer 20

Cozens- muscle testing common flexor tendon
Mills- stretching common flexor tendon

Question 21

What does Tinels test

Answer 21

Ulnar compressive neuropathy

Question 22

Tinels techniques

Answer 22

Pt seated
Examiner gently taps 4-6 times over cubital tunnel (groove between olecranon process and medial epi)

Question 23

+ve Tinels

Answer 23

Parasthesia from ulnar N (middle/little finger)

Question 24

Tinels at elbow clinic notes

Answer 24

Lots of false positives with asymptomatic side
Like hitting the funny bone

Question 25

Tinels for radial nerve

Answer 25

Tapping groove between lateral epicondyle and olecranon

Question 26

Pronator teres syndrome test

Answer 26

Pt seated Elbow flexed 90 Pt attempts to pronate forearm with elbow extension Examiner resists the pronation movement Can compress muscle to increase nerve compression and test sensitivity

Question 27

Pronator teres interpretation

Answer 27

Tingling or paraesthesia- median nerve compression at pronator teres muscle, pronator teres syndrome

Question 28

Pronator teres syndrome clinical notes

Answer 28

Median nerve runs between two heads of pronator teres muscle When pronation is resisted the inc compressive force from contracted muscle may result in distal neuro signs

Question 29

Pressure provocation test

Answer 29

Pt seated, supine or stnaidng Elbow flexed to 80 + forearm supinated Place finger over ulnar nerve just proximal to cubittal tunnel + hold pressure for 60s

Question 30

Pressure provocation interpretation

Answer 30

Numbness and tingling, paraesthesia in ulnar distribution= cubital tunnel syndrome

Question 31

Pressure provocation sens and spec

Answer 31

89 98