Determine 6: activity, MOI, location of pain, type of pain, severity of pain, onset of pain, unusual sounds/ sensations, actions that increase & decrease pain, S/S, change in S/S over time, prior injury/ surgery, family history & general medical health
Inspection 1,6:
General: swelling, discoloration, deformity, muscle symmetry/atrophy, symmetry of head and arm while standing & walking
Skin: discoloration, open wounds, scars & skin infections
Anterior View: carrying angle & cubital fossa
Lateral View: lateral epicondyle, alignment, cubital recurvatum, extension lag & extensor muscle mass
Medial View: medial epicondyle & flexor muscle mass
Posterior View: bony alignment, olecranon process & olecranon bursa
Elbow Palpation Rollover: using internet explorer rollover the images to trace some anatomy of the elbow
Bony Palpation 1: medial epicondyle, medial supracondylar line of humerus, olecranon, ulnar border, olecranon fossa, lateral epicondyle, lateral supracondylar line of humerus & radial head
Soft Tissue Palpation 1:
Zone 1 (Medial Aspect): ulnar nerve, wrist flexor–pronator muscle group (pronator teres, flexor carpi radialis, palmaris longus & flexor carpi ulnaris), medial collateral ligament, supracondylar lymph nodes
Zone 2 (Posterior Aspect): olecranon bursa, triceps
Zone 3 (Lateral Aspect): wrist extensors "mobile wad of three" (brachioradialis, extensor carpi radialis longus & extensor carpi radialis brevis), lateral collateral ligament & annular ligament
Zone 4 (Anterior Aspect): cubital fossa ( biceps tendon, brachial artery, median nerve & musculocutaneous nerve)
Range of Motion 1,5:
AROM: extension (0–5°), flexion (135°+), supination (90°) & pronation (90°)
PROM: extension, flexion, supination & pronation
RROM: extension, flexion, supination & pronation
Upper Extrstrongity Neurologic & Circulatory Examination 1,5:
Dermatomes: test sensation over the sensory distribution of each nerve root, this is done by having the patient close their eyes & distinguish a sharp stimulus from a dull stimilus
Myotomes:
Reflex Testing:
Peripheral Nerve Distributions:
Circulation:
Biceps Brachii, Brachialis, Triceps Brachii, Anconeus, Palmaris Longus, Extensor Digitorum, Flexor Digitorum Superficialis, Flexor Digitorum Profundus, Flexor Carpi Radialis, Flexor Capri Ulnaris, Extensor Carpi Radialis Longus, Extensor Carpi Radialis Brevis, Extensor Carpi Ulnaris, Pronator Teres, Pronator Quadratus, Supinator, Brachioradialis
Lateral Epicondylitis/Resistive Tennis Elbow/Cozen's, Lateral Epicondylitis/Resistive Tennis Elbow, Lateral Epicondylitis/Passive Tennis Elbow, Medial Epicondylitis/Golfer's Elbow, Elbow Flexion, Varus Stress, Valgus Stress, Tinel's Sign, Pinch Grip, Pronator Teres Syndrome
Identifies examiner's impression of injury & potientally complicating factors based on subjective & objective information
Explains examiner's goals as well as how the examiner intends on meeting these goals through initial managstrongent, treatment, rehabilitation
