Book contents
- Frontmatter
- Dedication
- Contents
- List of contributors
- Introduction
- Acknowledgments
- List of abbreviations
- Section 1 Principles of surgery
- Section 2 General surgery
- Section 3 Breast surgery
- Section 4 Pelvis and perineum
- Section 5 Orthopaedic surgery
- 14 Generic joint examination
- 15 Examination of gait
- 16 Examination of the cervical and thoracic spine
- 17 Cervical spine injury: assessment in trauma
- 18 Examination of the shoulder
- 19 Examination of the elbow
- 20 Examination of the lumbar spine and sacroiliac joint
- 21 Examination of the hip
- 22 Examination of the knee
- 23 Examination of the ankle
- Section 6 Vascular surgery
- Section 7 Heart and thorax
- Section 8 Head and neck surgery
- Section 9 Neurosurgery
- Section 10 Plastic surgery
- Section 11 Surgical radiology
- Section 12 Airway, trauma and critical care
- Index
19 - Examination of the elbow
from Section 5 - Orthopaedic surgery
Published online by Cambridge University Press: 05 July 2015
- Frontmatter
- Dedication
- Contents
- List of contributors
- Introduction
- Acknowledgments
- List of abbreviations
- Section 1 Principles of surgery
- Section 2 General surgery
- Section 3 Breast surgery
- Section 4 Pelvis and perineum
- Section 5 Orthopaedic surgery
- 14 Generic joint examination
- 15 Examination of gait
- 16 Examination of the cervical and thoracic spine
- 17 Cervical spine injury: assessment in trauma
- 18 Examination of the shoulder
- 19 Examination of the elbow
- 20 Examination of the lumbar spine and sacroiliac joint
- 21 Examination of the hip
- 22 Examination of the knee
- 23 Examination of the ankle
- Section 6 Vascular surgery
- Section 7 Heart and thorax
- Section 8 Head and neck surgery
- Section 9 Neurosurgery
- Section 10 Plastic surgery
- Section 11 Surgical radiology
- Section 12 Airway, trauma and critical care
- Index
Summary
Checklist
WIPER
• Patient standing in shorts or underwear with thorax exposed.
Physiological parameters
Look
• Skin: erythema, scars, carrying angle
• Soft tissues: biceps and triceps brachii mass, swelling or wasting; common flexor and extensor origins
• Bone: asymmetry, epicondyles, valgus/varus deformity
Feel
• Skin: temperature, capillary refill time, tenderness, sensation
• Soft tissues: pulses, tendons, common flexor and extensor origins, biceps brachii, triceps tendon
• Bone: bone and joint contours, epicondyles, radial head, olecranon
Move
• Active
• flexion/extension
• supination/pronation
• Passive
• flexion/extension
• supination/pronation
• Resisted
• flexion tests biceps brachii muscle and C5/C6 myotome
• extension tests triceps brachii muscle and C7 myotome
• supination tests biceps and supinator muscles
• pronation tests pronator teres and pronator quadratus muscles
Special tests
• Common flexor origin tendinopathy (medial epicondyle – golfer's elbow):
• resisted wrist flexion with the elbow extended and hand in a supinated position
• Common extensor origin (lateral epicondyle – tennis elbow):
• resisted middle finger extension with elbow pronated and flexed at 90° tests extensor carpi radialis brevis
• resisted index finger extension with elbow pronated and flexed at 90° tests extensor carpi radialis longus
• Valgus and varus testing to stress collateral ligaments
To complete the examination…
• Examine the joint above (shoulder) and the joint below (wrist).
• Check full neurovascular status of the upper limb.
• Order appropriate radiographs and further imaging.
- Type
- Chapter
- Information
- Physical Examination for SurgeonsAn Aid to the MRCS OSCE, pp. 152 - 153Publisher: Cambridge University PressPrint publication year: 2015