I always begin with the pulse, then I examine the hands, then I look at the nail beds, then I slide my hand up to the epitrochlear node, and I was into my ritual.

During this period, patients may remove the sling to practice passive pendulum Range of Motion (ROM) exercises to reduce atrophy in the elbow and shoulder, but they are minimized to 15 20 degrees off vertical.

Coudé Adding further optics to a Nasmyth style telescope to deliver the light (usually through the declination axis) to a fixed focus point that does not move as the telescope is reoriented gives a coudé focus (from the French word for elbow).

Sometimes the pulse cannot be taken at the wrist and is taken at the elbow (brachial artery), at the neck against the carotid artery (carotid pulse), behind the knee (popliteal artery), or in the foot dorsalis pedis or posterior tibial arteries.