Week 8 Workbook questions

Study Guide Questions: 8.4

The questions for this week will focus on knowledge of orthopaedic tests and
SMR assessment for the following conditions. Complete the table below with
the appropriate tests, clinical picture and SMR examination findings. Hint:
(Souza and Magee will be good texts to refer to answer this question)

Lateral epicondylitis verses Medial Epicondylitis

Elbow Bursitis vs Elbow Tendinitis
Wrist fracture from a fall on an outstretched hand (FOOSH) vs Carpal Tunnel
Syndrome

Lateral Epicondylitis: Medial Epicondylitis:

OT’s: Cozen’s test +ve, Mill’s test +ve and Lift OT’s: Medial Epicondylitis test +ve and Lift
(polk) test +ve (forearm pronated)
(polk) test +ve (forearm supinated)

Cl presentation: localised pain and burning Cl presentation: Localised pain and

over lateral-posterior aspect of proximal tenderness of medial-anterior aspect of
forearm/elbow region.
proximal forearm/elbow region.

SMR: Wrist extensor (C6) weakness. SMR: Wrist flexor (C7/8) weakness.

Elbow bursitis: E.g. Olecranon brusa Elbow Tendinitis: E.g. Triceps tendinitis

OT’s: Elbow Extension Test +ve.

OT’s: Lift (polk) test +ve for either
Cl presentation: local swelling, signs of (depending which tendons) and

inflammation at region of bursa (posterior Cl presentation: local pain and

elbow).
tenderness in region of tendon (e.g. triceps
SMR: attachment).

SMR: Elbow extension (C7) weakness/

Triceps weakness.

Wrist fracture (FOOSH) injury: Carpal Tunnel Syndrome:

OT’s: Sitting press test +ve and Watson’s +ve.

OT’s: Tinel’s sign +ve, Phalen’s test +ve

Cl presentation: Pin-point tenderness in Cl presentation: Paraesthesia, pain and

region of suspected fracture, lack of mobility intermittent numbness (worse at night) into
with motion palpation and ROM assessment. thumb and 2-3rd fingertips and atrophy of
Swelling, crepitus and deformity may be thumb adductors.

observed depending on the tissues involved SMR: Sensory/dermatome changes to

and MOI.
median nerve path (C7) and possible
SMR: Sensory/dermatome changes to radial or thumb adductor weakness (C8/T1).
median (C6-T1).

Please note: I wasn’t sure which bursa or tendon you were referring to differentiate
between with the elbow, so I used two examples which are commonly associated with
one another: the triceps Tendon and the olecranon bursa.
 Cozen’s Soft tissue - tendons and muscles.
Test
Mill’s Test Soft tissue - tendons and muscles.

At times, presentation of capsular/joint

tissues may also be tested.
Froment’s Neural tissues - ulnar nerve
Test
Polk Lift Soft tissues - tendons and muscles.
Test
Finkelstei Soft tissues - muscles and tendons.
n’sTest
TFCC Test Soft tissues - capsular and joint tissues.
Phalen’s Neural tissues - median nerve/CTS
Test
Bunnel Soft tissues - capsular/joint tissues and
Littler’s intrinsic hand muscles.
Test
Tinel’s Neural tissues - median nerve/CTS and
Wrist Test differentiating form ulnar nerve.
Kirk Soft tissues - capsular and joint tissues.
Watson
Test

Test INTERPRETATION/WHAT TISSUE STRUCTURE DOES

THIS TEST LOAD? For you to complete