Elbow

Question 1

elbow extension vs elbow flexion test indication

Answer 1

ext = fracture

flex = cubital tunnel

Question 2

tests of ligamentous instability

Answer 2

varus/valgus stress test

Question 3

varus/valgus stress test
- protocol
- positive

Answer 3

arm supported and stabilized with elbow flexed to 20

valgus = UCL stress
varus = radial collateral ligament

(+) = laxity and pain

Question 4

moving valgus stress test
- protocol
- positive

Answer 4

Pt arm abducted and elbow flexed, maintain valgus stress as pt moves into flex/ext at elbow

pain at 70-120 degrees = UCL partial tear

Question 5

cluster for lateral tendinopathy

Answer 5

mills
maudsley’s
cozens

Question 6

cozen’s test
- protocol
- positive

Answer 6

make a fist, pronate FA and radially deviate
– pt extends against resistance

(+) = pain at lateral epicondyle

Question 7

mill’s test
- protocol
- positive

Answer 7

passive pronation, flexion of wrist and extension of elbow

(+) Lateral epicondyle pain

Question 8

mill’s test differential

Answer 8

can also stress radial nerve
– symptoms will be distal to condyle

Question 9

maudsley’s test
- protocol
- positive

Answer 9

resistance of middle finger extension

(+) = lat epi pain

Question 10

“popeye sign”

Answer 10

distal bunching of mm with loss of function

long head bicep rupture

Question 11

elbow flexion test
- protocol
- positive

Answer 11

cubital tunnel test

supine, done B
- shoulder ER, elbow actively held in max flexion with wrist extension
- 1 min

(+) = pain of medial aspect of elbow, n/tingling in ulnar distribution

Question 12

pinch grip test

Answer 12

AIN entrapment

pinch tips of index finger/thumbs

(+) - inability to pinch tip of finger to tip of finger

will go pad to pad

Question 13

common motion lost at elbow

Answer 13

flexion > extension
– can be due to loose body in joint, ligament sprain, and/or CRPS

Question 14

lateral epicondylitis characteristics

Answer 14

typically ECRB tendonitis at lateral epicondyle

gradual onset due to activity/occupations requiring repetitive wrist extension/strong grip

Question 15

medial epicondylitis characteristics

Answer 15

tendonitis of pronator teres / flexor carpi radialis at medial epicondyle

overuse injury
- pronation and hand grip

Question 16

outcome measures for elbow

Answer 16

DASH
PSFS

PRTEE - lateral epicondylitis

Question 17

interventions related to lateral epicondylitis

Answer 17

ther-ex
manual
multimodal
taping

Question 18

ther-ex intervention for lateral epicondylitis

Answer 18

= isotonic/isometric wrist extension (subacute/chronic)

Question 19

manual for lateral epicondylitis

Answer 19

local MT to elbow to reduce pain and improve grip strength

Question 20

taping interventions for lateral epicondylitis

Answer 20

taping for pain relief

can also dry needle

Question 21

distal humerus fx complications

Answer 21

loss of motion
myositis ossificans
malalignment
neurovascular compromise
ligament injury
CRPS

Question 22

supracondylar fracture
– precautions

Answer 22

need to assess neurovascular status
- radial nerve
- vascular structure impairment can lead to volkmann’s ischemia

Question 23

supracondylar fracture prognosis
- adolescents vs adults

Answer 23

adolescent = check for growth plate involvement

adults/adolescents = high rate of malunion

Question 24

lateral epicondyle fracture

Answer 24

more common in youth

• ORIF

Question 25

osteochondrosis of humeral capitellum characteristics / population

Answer 25

OC dissecans of central/lateral aspect of capitellum/radial head bone fragment forms loose body in joint due to repetitive compression force at radial head and capitellum 12-15 y/o

Question 26

panner's disease characteristics and population

Answer 26

localized AVN of capitellum - loss of subchondral bone with fissuring and softening of articular surfaces <10 y/o

Question 27

UCL injury characteristics

Answer 27

repetitive valgus stress to medial elbow with throwing pain along the medial elbow at distal ligament insertion -- can have paresthesia in ulnar distribution

Question 28

examination of UCL injury

Answer 28

moving and non-moving valgus stress MRI

Question 29

interventions related to UCL injury (non-op)

Answer 29

period of rest -- decrease pain/inflammation strengthen elbow flexors taping

Question 30

s/s of ulnar entrapment

Answer 30

medial elbow pain paresthesia in ulnar distribution (+) tinnels

Question 31

causes of ulnar nerve entrapment

Answer 31

direct trauma to cubital tunnel traction at medial aspect compression (thickened retinaculum/hypertrophy of FCU) sublux/dislocation DJD at elbow

Question 32

median nerve entrapment causes

Answer 32

pronator teres hypertrophy flexor digitorum superficialis hypertrophy

Question 33

s/s of median nerve entrapment

Answer 33

aching pain with forearm weakness (+) tinnels paresthesia in median nerve

Question 34

radial nerve entrapment causes

Answer 34

PIN = in radial tunnel as a result of OH and/or throwing activity

Question 35

s/s of radial nerve entraoment

Answer 35

lateral elbow pain pain over supinator mm (+) tinnels paresthesia in radial n distribution

Question 36

indication of neurodynamic mobilization

Answer 36

abnormal neurotension

Question 37

posterior elbow dislocation

Answer 37

most common - defined by position of olecranon relative to humerus

Question 38

most common posterior dislocation precautions associated with

Answer 38

posterolateral elbow hyperextension during FOOSH avulsion of medial epicondyle secondary to traction pull of medial collateral ligament

Question 39

commonality of anterior/radial head fx

Answer 39

1-2%

Question 40

complete dislocation of elbow results in

Answer 40

UCL rupture LCL rupture brachialis mm rupture wrist flexor mm rupture possible anterior capsule rupture

Question 41

s/s of elbow fracture

Answer 41

rapid swelling severe pain deformity of olecranon

Question 42

nursemaid's elbow - characteristics - population

Answer 42

longitudinal traction on extended elbow - slippage of annular ligament - radial nerve can be damaged pt will have arm at side with hand pronataed 2-3 y/o

Question 43

s/s of olecranon bursitis

Answer 43

swelling over posterior elbow

Question 44

AIN syndrome

Answer 44

weakness of FPL and FDP "playboy" sign

Question 45

myositis ossificans is most common in _________ due to ________

Answer 45

brachialis -- trauma and aggressive stretching

Question 46

brachialis strain s/s

Answer 46

anterior aspect of distal arm - tenderness in mm belly painful resisted elbow flexion w FA pronated