ch 17 skills

Question 1

Wrist MMT: flexion & radial deviation / flexion & ulnar deviation

Answer 1

elbow flexed to 90, forearm supinated, wrist is slightly flexed off the end of the table & ulnarly or radially deviated

Question 2

Wrist MMT: extension & radial deviation / extension & ulnar deviation

Answer 2

elbow flexed to 90, forearm pronated, wrist is slightly extended & radially deviated or ulnarly deviated with fingers relaxed

Question 3

wrist valgus stress test (UCL stress test)

Answer 3

elbow flexed to 90, forearm pronated, apply a valgus stress radially deviating the wrist

Question 4

wrist varus stress test (RCL stress test)

Answer 4

elbow flexed to 90, forearm pronated, apply a varus stress, ulnarly deviating the wrist

Question 5

IP joint valgus & varus stress test

Answer 5

valgus- ulnar collateral ligament
varus- radial collateral ligament
- positive test: increased gapping compared to opposite hand

Question 6

thumb UCL stress test (laxity of thumb MCP collateral ligaments)

Answer 6

valgus & varus stress applied to MCP joint to determine integrity of ulnar collateral and radial collateral ligaments
- positive test: ulnar or radial side of the first MCP joint gaps farther than the uninjured side

Question 7

wrist glide test (radoiocarpal & mid carpal joint play)

Answer 7

radial glide, ulnar glide, dorsal glide & palmar glide
- positive test: pain or significant difference in glide compared to opposite side

Question 8

Watson test

Answer 8

• tests for: scapholunate instability
• procedure: starting position for arm wrestling with wrist in ulnar deviation. apply dorsal pressure to the distal part of scaphoid, then move the wrist from ulnar to radial deviation
• positive test: reproduction of pain & notable pop at the scapholunate articulation

Question 9

ulnocarpal stress test

Answer 9

• tests for: ulnar side pathology (including TFCC)
• procedure: one hand under elbow, the other grabs the patients hand across the carpals, move the wrist into ulnar deviation & apply over pressure and apply an axial load to the wrist while pronating & supinating the wrist
• positive test: reproduction of the patient’s symptoms

Question 10

modified phalen’s test

Answer 10

• tests for: carpal tunnel’s syndrome
• procedure: apply overpressure during passive wrist flexion & hold for one minute
• positive test: tingling develops or increases in the distribution of the median nerve distal to the carpal tunnel

Question 11

Finkelstein’s test

Answer 11

• tests for: de Quervain’s syndrome
• procedure: instruct patient to actively ulnarly deviate the hand, apply passive overpressure to the ulnar deviation, passively flex the thumb to the palm
• positive test: increased pain in the area of the radial styloid process and along the length of the extensor polices breves & adductor polices longs tendons