Elbow Wrist Hand Lecture Flashcards Preview

Pt Assess II Final > Elbow Wrist Hand Lecture > Flashcards

Flashcards in Elbow Wrist Hand Lecture Deck (34)
1

What is the carrying angle of the elbow?

-In anatomical position (palms up), slightly valgus
-5 degrees in males, 10 in females

2

What does a carrying angle greater than 15 degrees indicate?

Possible history of a lateral epicondylar fracture and epiphyseal damage as a child

3

What does a decrease in the carrying angle or a varus angle indicate?

Supracondylar fx as a child w/epiphyseal injury

4

What is a gunstock deformity?

Varus carrying angle

5

Inspection of elbow:

-Localized or diffuse swelling
-Ecchymosis (traumatic injury)
-Obvious deformity d/t fx or dislocation
-Scars, burns, needle marks

6

Palpation of elbow (medial aspect)

-Medial epicondyle (ME)
-Ulnar groove (gently) b/w ME and olecranon
-Flexor muscles

7

How is the hand affected by ulnar nerve compression?

Numbness and tingling in ring finger and pinky

8

Palpation of elbow (posterior aspect)

-Olecranon (bursa should NOT be felt normally)
-Triceps

9

How can you make the triceps more prominent for palpation?

Have pt lean on table w/elbow slightly flexed

10

Palpation of elbow (lateral aspect)

-Lateral epicondyle
-Extensor muscles
-Brachioradialis muscle

11

How to make brachioradialis more prominent for palpation?

-Close fist, place it under edge of table
-Lift fist against table

12

Palpation of elbow (anterior aspect)

-Biceps tendon in cubital fossa
-Brachial artery
-Median nerve

13

4 movements at elbow for both PROM and AROM?

1. Flexion (135 degrees)
2. Extension (0 to -5 degrees)
3. Supination (90 degrees)
4. Pronation (90 degrees)

14

How to test ligamentous instability in the elbow?

-Pt slightly flex elbow w/forearm supinated
-Face pt and cup posterior aspect just above elbow
-Force elbow medially and then laterally (note any instability)

15

What is Tinel's sign of the elbow?

-Test for ulnar nerve compression
-Tap in ulnar groove
-Positive if pt feels numbness and tingling in ring and pinky fingers

16

What is the tennis elbow test?

-Pt makes fist and dorsiflexes wrist
-Apply resistance to dorsiflexed wrist
-Pain at lateral epicondyle is positive

17

Inspection of hand and wrist:

-Fingers slightly flexed at rest (normal)
-Joint swelling
-Gouty tophi
-Thickened palmar fascia
-Bouchard's or Heberden's nodes
-Mallet finger

18

Bouchard's nodes

PIP joint (sign of OA)

19

Heberden's nodes

DIP joint (sign of OA)

20

What is trigger finger?

Painless nodule on palmar side near MC head - finger "pops" into extension w/extra effort or assistance

21

What is felon?

Small closed space infection at distal pulp of finger

22

When does atrophy of the thenar eminence occur?

Median nerve injury or carpal tunnel

23

When does atrophy of the hypothenar eminence occur?

Ulnar nerve injury

24

What is "no man's land" of the hand?

From distal palmar crease to proximal interphalangeal crease

25

What is the MC fractured carpal bone?

Scaphoid

26

What is the largest carpal bone?

Capitate

27

Tenderness over the anatomical snuffbox indicates:

Scaphoid fracture

28

What makes the scaphoid easier to palpate?

Ulnar deviation

29

What is Tinel's sign of the wrist?

-Percussion over carpal ligament
-Positive if numbness/tingling in first and second digits

30

Dermatomes of the hand

C6: Thumb, index finger, radial side of palm
C7: central palm, middle finger
C8: ulnar side of palm, ring, pinky fingers

31

Purest area of median nerve sensation in the hand:

Palmar tip of index finger

32

Purest area of ulnar nerve sensation in the hand:

Volar surface of tip of pinky

33

What is Phalen's test?

-Test for carpal tunnel
-Pt hold wrists together in flexed position
-Positive is numbness or tingling in median nerve distribution

34

What is Finkelstein's test?

-Used to determine presence of DeQuervain's disease (tenosynovitis of 1st dorsal compartment aka snuffbox)
-Close fist w/thumb inside and ulnar deviate the wrist
-Palpate snuffbox
-Positive if painful