Elbow Hand and Wrist Notes

Describe the Press test for Ulnar sided wrist pain

Patient sits and then pushes up with body weight, if painful it is a positive test

Describe the Ulno-carpal stress test?

For ulnar pain

One hand under the elbow on the table

Other hand moves from full extension to full flexion with ulnar deviation

DRUJ Stability Test Describe?

DIstal Radius is stabilized and then we move the ulnar posteriorly and anteriorly

Describe the Ulnar Foveal test

For ulnar pain

Put the forearm in supination and apply pressure with the thumb onto the ulner fovea so bwetween the FCU and ulnar styloid.

Describe the ECU test

We put finger around the third and thumb

Palpate the ECU with the other hand

Describe the watsons test

Looks for scapholunate instability

Take one hand wrap around the radial wrist area

Hand in a fist with thumb tucked in

Using other hand pull down ulnar deviation

Describe the Lunotriquetral Instability

Grab the triquetrium with one hand

Grab the lunate with the other

Moves lunate up and down looking for laxity

Describe the WHAT test for Dequervains

Wrist is flexed and then the thumb is abducted in full finger extension

Then apply adduction force to the abduction and we look for pain

Describe the finklesteins test for de quervains

Hand at the edge of the table slightly ulnarly deviated and then push down on the thumb

DEscribe the Eichoffs test

Thumb inside of their hand

clench with other fingers

Passible abduct wrist to the ulnar side

Phalens test for carpal tunnel

Fully flex the wrist for 30 seconds

Durkans test Describe it

It is for carpal tunnel

applies direct pressure to carpal tunnel for 30 seconds

Pain shows a positive test

Phdurkens test

Wrists flexed and pressure on carpal tunnel area look for pain

60 seconds

Allens test for vessels

Have them clench and open first mutliple times and then hold pressure down on the arteries.

Let go and see it if fills up immediately

UCL stress test

Stabilize the MC with one hand and then hold proximal phalanx with the other

applies a valgus stress to the phalanx

Positive test is laxity or pain

What are some manual therapies can we do for the ulna?

AP and PA glides

Describe Epicondylar Tendinopathy

It is a tendon damage, degradation can be medial or lateral. De

Describe a pediatric pulled elbow?

Pulling of the arm

subluxation occurs

Manage with flexion and hypersupination

Describe a pediatric supracondylar fracture?

Often occurs during FOOSH

if its displaced we must do surgery

non displaces we do a cast

DEscribe a Monteggia lesion

Ulna fracture occurs

radial head may dislocate from the elbow

2 most common types of stiffness with elbow fractures and how do we prevent it

DO neurological stimulation

Loss of elbow extension and supination

Techniques to help with Lateral Epicondylalgia?

Gripping MWM

Flexion Extension MWM

Wrist extension MWM

Describe the Cozens Test

Arm flexed at 90 degrees

Palpate lateral epicondyle

Patient makes a fist and turns palm down (max pronation)

radially deviate wrist

Wrist extension against resistance

Describe the Mills Test

Arm flexed and supported at 90 degrees

support elbow and then wrist is flexed hold the wrist

extend the elbow holding the hand

Laterla Elbow Tendinopathy

Describe the Maudsleys Test

Lateral elbow tendinopathy

common extensor tendon

Support elbow flexed at 90 degrees and full pronation

Palpate lateral epicondyle

extend middle finger, examiner provides resistance to PIPJ

Describe the reverse cozens

For the medial epicondyle

ELbow flexed to 90 and supported

palpate medial epicondyle

patient moves into flexion and ulnar deviation against resistance

UCL/MCL Elbow stress test

ELbow flexed to 20-30 degrees

Palaptes lateral epicondyle and supports it

apply a valgus stress look for pain

Radial/Lateral collateral ligaments

Support the elbow at various flex and extensions and then apply a varus force

How do we check for radiohumeral and ulnarhumeral joint dysfunction?

AP glide to radial head

PA glide to the radial head

ELbow flexed to about 30 degrees, forearm supinated

Find the distal biceps tendon and side your thumb lateral to that area pushing the muscle bulk