Hand Flashcards
1
Q
Observation for the hand
A
- Thenar eminence
- Hand posture
- Scapula
2
Q
AROM/PROM
A
- Wrist flex/ext
- Radial deviation (inwards)
- Ulnar deviation (outwards)
- Finger flex/ext
- Thumb ext (thumb up)
- Thumb flex (4)
- Thumb abduction (z-plane)
- Thumb adduction (back to hand)
- Opposition
3
Q
Strength test for thumb
A
- Wrist flex/ext
- Radial deviation (left)
- Ulnar deviation (right)
- Finger flex/ext
- Thumb ext (thumb up)
- Thumb flex (4)
- Thumb abduction (z-plane)
- Thumb adduction (back to hand)
- Opposition
- Grip strength
4
Q
Ligament stress test for hand
A
- Ulnar collateral ligament of thumb
- Radial collateral ligament of thumb
- Ulnar and radial collateral ligaments of IP joints
5
Q
Special test for hand
A
- Phalen test
- Tinnel tap test
- Derkan test
- Scaphoid compression test
- Pinch test
6
Q
Phalen test
A
- Dorsal side of wrist touching each other
- Bring arms up
- Tests for carpal tunnel
7
Q
Tinel tap test
A
- Tap on the carpal tunnel
- Tingling feeling
8
Q
Derkan Test
A
- Apply pressure on carpal tunnel and hold
- Test for sensory
9
Q
Scaphoid compression test
A
- Handshake
10
Q
Pinch test
A
- Get patient to pinch thumb and index finger and try to break it a part
11
Q
Palpation for the hand
A
- Anatomical snuff box
- Ulnar collateral ligament of thumb
- Radial collateral ligament of thumb
- Ulnar and radial collateral ligaments of IP joints
- Carpal tunnel
- Thenar
12
Q
Injuries for the hand
A
- Carpal tunnel syndrome –> chronic
- Scaphoid fractures –> acute
- Thumb hyperextension –> acute
- Collateral ligament sprain of fingers –> acute
13
Q
History for carpal tunnel syndrome
A
- Pain or numbness, tingling in median nerve
- Hand feeling clumsy
- Worse with direct pressure or using hand
14
Q
Assessment for carpal tunnel syndrome
A
- Atrophy of thenar eminence
- Decreased grip strength
- Positive Phalen’s test
- Positive Tinel’s tap test
- Positive Derkan’s test
15
Q
Treatment for carpal tunnel syndrome
A
- Rest, ice, brace
- No compression
- ROM exercises –> palm side bring fingers into ext to stretch flex muscles, dorsal side bring fingers into flex to stretch ext muscles, prayer stretch slowly lower hands
- Strengthening exercises –> wrist flex and ext with dumbbell, grip strengthening with stress ball
- Correct any loading issues
16
Q
History for scaphoid fracture
A
- FOOSH injury
- Frequently confused for a wrist sprain
- Lots of pain in wrist on radial side
- Pain with movement
17
Q
Assessment for scaphoid fracture
A
- Decreased ROM in all directions
- Especially painful into radial deviation
- Weakness with thumb movements
- Positive scaphoid compression test
- Positive pain with palpation of anatomical snuff box
18
Q
Treatment for scaphoid fractures
A
- Send for medical attention with doctor and xray
- Immobilize, ice, cast
- Restore ROM –> wrist flex/ext, radial, ulnar, finger flex/ext
19
Q
History for thumb hyperextension
A
- Fall on hand with thumb being forced backwards
- Thumb getting jammed back or stuck
- Common with sports involving a ball and catching
20
Q
Assessment for thumb hyperextension
A
- Swelling around MCP joint of thumb
- Limited AROM/PROM into extension and ABD
- Positive pinch test
- Laxity and pain with UCL stress test of 1st MCP
- Possible damage to RCL ligament
21
Q
Treatment for thumb hyperextension
A
- POLICE
- ROM and strengthening –> thumb extension, abduction with and without resistance
- Tape job
- Splint at night
22
Q
History for collateral ligament sprain of the fingers
A
- Common in ball sports
- Jamming end of finger
- Valgus or varus force
- Finger is quite swollen
- Limited mobility
23
Q
Assessment for collateral ligament sprain of the fingers
A
- Swelling around injured finger
- Limited AROM/PROM into flex/ext
- Pain and laxity either UCL or RCL
24
Q
Treatment collateral ligament sprain of the fingers
A
- Ice bucket
- Splint finger
- Self massage
- Gentle ROM and strengthening –> extension and abd of finger with and without resistance
- Deep transverse friction massage
- Buddy tape for return to sport
