elbow wrist assessment

• extensor carpi radialis longus:

  origin: lateral condyle of humerus and common extensor origin

  insertion: base of 2nd MC

  extensor carpi radialis brevis:

  origin: common extensor origin

  insertion: base of 3rd MC

  extensor digitorum:

  origin: common extensor origin

  insertion: distal phalanges of finger 1-4
• mills test:

  • test lateral epicondylitis (tennis elbow=tendon inflammation)
  • palpate lateral epicondyle
  • pronate forearm, flex wrist
  • extend patient elbow

  
• cozens test:

  • test lateral epicondylitis
  • palpate lateral epicondyle
  • flex elbow, pronate forearm, radial deviation wrist
  • resist patient extension

  
• maudsley test

  • test lateral epicondylitis
  • palpate lateral epicondyle
  • pronate forearm
  • resist 3rd digit extension

  
• Flexor carpi ulnaris:

  origin: common flexor origin, medial olecranon

  insertion: piriform, hamate, palm base of 5th MC

  
  

  Flexor carpi radialis:

  origin: common flexor origin

  insertion: palmar base 2nd MC

  
  

  Palmar longus:

  origin: common flexor origin

  insertion: flexor retinaculum and palmar aponeurosis

  
  

  Pronator teres:

  origin: common flexor origin, coronoid process of ulna

  insertion: mid shaft of radius

  Flexor digitorum superficialis:

  origin: common flexor origin and shaft of radius

  insertion: palmar base of 2nd MC
• test for medial epicondylitis

  • palpae medial epicondyle
  • flex elbow, wrist supination
  • extend patient wrist and elbow

  
• varus stress test

  • test lateral collateral ligament (below lateral epicondyle)
  • humerus external rotation, elbow flex 30 degree
  • exert varus force to forearm

  valgus stress test

  • test medial collateral ligament
  • humerus external rotation, elbow flex 30 degree
  • exert valgus force to forearm

  
• carpal tunnel pathology(inflammation oedema press on median nerve in carpal tunnel)

  • tinel sign: tap on carpal tunnel 1234 finger tingling
  • phalen test: hold 1 min experience tingling in 1234 finger

  
• tenosynovitis(inflammation of tendon around thumb EPB/APL)

  dequervains finklestein test:

  • make fist wrapping thumb, ulnar deviation