Hand

Question 1

hands - look overall

Answer 1

nails (pitting, onycholysis; infarcts)
scars (carpal tunnel)
skin changes (bruising/thinning, palmar erythema)
wasting (hypo/thenar, 1st DI, guttering)
deformity (fingers, subluxation, deviation, dupuytrens)
swelling (boggy, nodules, B+H, gouty tophi, cystic)

Question 2

hand - feel overall

Answer 2

temperature
joints (squeeze, individuals)
palms (tendons, wasting, snuffbox)
wrist (ulnar border, processes)

Question 3

hand - look sequence

Answer 3

N SCWADS WE

Question 4

nails - look

Answer 4

nail fold infarcts - vasculitis

pitting + oncholysis - PsA

Question 5

wrist - look

Answer 5

carpal tunnel (scars)
subluxation + deviation (deformities)
RA nodules, ganglions, gouty tophi (swellings)

Question 6

elbow - look (hand exam)

Answer 6

psoriasis (check behind ears)
RA nodules
gouty tophi

Question 7

hand - scars + skin changes

Answer 7

thinning/bruising - steroids

palmar erythema - RA

Question 8

hands - wasting

Answer 8

hypo/thenar eminences

1st DI

Question 9

hands - deformities

Answer 9

swan, boutonn, Z
ulnar dev, subluxation MCPs (all RA)
dupuytrens

Question 10

hands - swelling

Answer 10

heberdens + bouchards (OA)
boggy (synovitis - RA, trauma)
cystic (ganglion)

Question 11

hand - feel sequence

Answer 11

temperature - palm - joints - wrist

Question 12

palm of hand - feel

Answer 12

wasting hypo/thenar eminences
thickening flexor tendons - dupuytrens
tender anatomical snuffbox - #scaphoid if trauma

Question 13

wrist - feel

Answer 13

ulnar border
ulnar head - extensor carpi ulnaris tendinitis
radial styloid process - de quervains tenosynovitis

Question 14

hand - move - function

Answer 14

squeeze my fingers
pinch my finger
touch thumb to fingers
play piano

Question 15

fingers - move

Answer 15

flexion (fist or individual FDP/Ss)
extension - straighten
abduction - spread

Question 16

thumb - move

Answer 16

abduction
adduction
flexion
extension
opposition

Question 17

hand - move steps

Answer 17

function fingers thumb

Question 18

hand - test

Answer 18

phalens (reverse prayer) - carpal tunnel

paper - ulnar palsy

Question 19

hand - joint above

Answer 19

wrist movements

flexion - reverse prayer
extension - prayer 
resisted extension - radial nerve
radial + ulnar deviation
pronation + supination

Question 20

hand - neurovascular sequence

Answer 20

motor
sensation
pulses

Question 21

hand - neurovascular - motor

Answer 21

radial - resisted finger extension
median - resisted thumb to little finger
ulnar - resisted little finger abduction

Question 22

hand - neurovascular - sensation

Answer 22

median - index finger (palm)
ulnar - little finger (palm)
radial - thumb web space (dorsum)

Question 23

hand - neurovascular - pulses

Answer 23

CRT
radial
ulnar/allen’s

Question 24

what could wasting indicate?

Answer 24

longstanding joint pathology

isolated wasting of thenar eminence - carpal tunnel

Question 25

what could it mean if patient can’t straighten fingers fully?

Answer 25

joint disease
extensor tendon rupture
neurological damage

Question 26

what could it mean if patient couldn’t form a fist properly (had difficulty tucking fingers into palm)?

Answer 26

early sign of tendon or small joint involvement

Question 27

if patient can’t actively straighten fingers or make into a fist, what does passive movement tell you?

Answer 27

whether problem is in tendons or nerves or in the joints

i assume joint problem you can’t move passively but nerve/tendon problem you can

Question 28

describing hand exam that has rheumatoid type swelling

Answer 28

“there’s a symmetrical deforming polyarthropathy +- active synovitis (joints red + swollen)”

Question 29

inflamed hand - differentials

Answer 29

RA
psoriatic arthropathy
SLE
OA with inflammatory component