Arm, Wrist And Hands

Question 1

Degree of Dupuytren’s contracture

Answer 1

To record flexion contractures found in dupuytren’s contracture.
Add together mip pip dip
Stage 1 mcp 0-45
Stage 2 pip45-90
Stage 3 dip 90-155
Stage4 total deformity greater than 135 Terminal becomes Hyperextended while other are flexed

Question 2

Phalen’s test

Answer 2

Asses presence of carpal tunnel syndrome or compression of median nerve
Back of hands together
Strongly compress back of hands together for 1 minute
This produce maximum compression
+‘tingling or pain report in thumb , index finger , middle finger , and lateral haft of ring finger

Question 3

Reverese phalen’s

Answer 3

Variation of phalen

Question 4

Cyriax’s variation on phalens test

Answer 4

To asses presence of cpt or compression of median nerve
Same position as Phalens after 1 full minute , instruct client to add sudden wrist extention
+ reproduction of symptom

Question 5

Finger flexion test

Answer 5

To asses active trigger point in Scalenes group
Seated
Metacarpophalangeal joint of affected side in full extention throughout the test
Intruct clt to flex interphalangesl joint try to touch palmar surface over mcp joint ( do not allow clt to make a fist)
+ if all finger tips cant touch mcp joint = scalens trps

Question 6

Finkelstein’s test

Answer 6

Presence of Dequervain’s tenosynovitis
Seated
Make a fist affected hand
Thumb firmly held in flexion inside flexed fingers
Staybilize prox to clt wrist , the other ulnarly deviate the wrist
+ pain along extensor pollicis brevis tendo positive for tenosynovtis
Variation - client active ulnarly deviate

Question 7

Froment’s sign

Answer 7

Ulna nerve lesion
Intruct to grasp a piece of paper btw the extended thumb and index finger
Try pull paper away
+ adductor pollicis weaken or paralysis allow terminal phalanx of client to flex

Question 8

Wrist Extension Ligamentous stress PR

Answer 8

Asses Sprain of the palmar wrist lig ir strain of wrist flexor mm
Seat , Affected hand pronate
Staybilize clients hand prox to wrist
Another passively move client wrist into extention with over pressure
+ hypermobile at joint for sprain of the palmar radiocapal lig
+ pain local flexor mm = strain mm spasm end feel may be subacute strain
+ pain with Dyesthesia= into palm from wrist prox along flexor = carpal
+ pain on PR wrist extension = dorsal surface of joint = extensor tenosynovitis

Question 9

Wrist flexion lig stress test PR

Answer 9

Wrist extensor
+ hypermobility- sprain
+ pain= strain

Question 10

Radial ligamentous stress test PR

Answer 10

Spain of ulnar collateral lig or strian or wrist adductor mm

Question 11

Ulnar ligametous stress test PR

Answer 11

Radial collateral lig wrist abductor mm

Question 12

Mills test

Answer 12

test for Tendinosis of common extensor tendon
Seated
Passively flex clients wrist with elbow extended
+ local pain common extensor tendon

Question 13

Reverse Mills test

Answer 13

Asses tendinosis of common flexor tendon
Seated
Extend wrist with elbow extension
+ cft pain

Question 14

Cozen Test ( extensor tendinosis test)

Answer 14

Seated 
Elbow extend 
Wrist pronate and slight extension
Hold this position 
Try to flex wrist 
 \+ pain CET n weakness = tendinosis 
Isolate Extensir carpi radialus brevis ='flex elbow rest the forearm on table and follow above

Question 15

Flexor tendinosis test

Answer 15

Elbow extend
Wrist supinate and slight flexion
Attempt to extend the wrist
+ pain = weak or tendinosis

Question 16

Abductor pollicis brevis Strength test AR

Answer 16

Affected arm supinated
Thump fully abduct 
Instruct hold this position 
Meet resistance trying to adduct it 
\+ weakness if unable