Hand and Thumb

Question 1

MCP flexion

Answer 1

P: Sitting with the forearm, wrist, and hand supported in neutral
A: Dorsal MCP joint
S: Dorsal midline of the metacarpal
M: Dorsal midline of the proximal phalanx

Question 2

MCP extension

Answer 2

P: Sitting with the forearm, wrist, and hand supported in neutral
A: Palmar MCP joint
S: Palmar midline of the metacarpal
M: Palmar midline of the proximal phalanx

Question 3

MCP abduction

Answer 3

P: Sitting with the forearm supported in pronation with the palm facing down on the surface. The wrist and hand are in neutral. The proximal phalanx of the test finger should be in line with the adjacent metacarpal in the start position
A: Dorsal MCP joint
S: Dorsal midline of the metacarpal
M: Dorsal midline of the proximal phalanx

Question 4

MCP adduction

Answer 4

P: Sitting with the forearm supported in pronation with the palm facing down on the surface. The wrist and hand are in neutral. The proximal phalanx of the test finger should be in full MCP abduction in the start position
A: Dorsal MCP joint
S: Dorsal midline of the metacarpal
M: Dorsal midline of the proximal phalanx

Question 5

PIP flexion

Answer 5

P: Sitting with the elbow flexed at 90 degrees and forearm/wrist/hand supported in neutral. All fingers should be allowed to flex together and MCP should remain extended.
A: Dorsal PIP joint
S: Dorsal midline of the proximal phalanx
M: Dorsal midline of the middle phalanx

Question 6

PIP extension

Answer 6

P: Sitting with the elbow flexed at 90 degrees and forearm/wrist/hand supported in neutral. All fingers should be allowed to flex together and MCP should remain extended.
A: Palmar PIP joint
S: Palmar midline of the proximal phalanx
M: Palmar midline of the middle phalanx

Question 7

DIP flexion

Answer 7

P: Sitting with the elbow flexed 90 degrees and forearm/wrist/hand supported in neutral with palm perpendicular to surface. All fingers should be allowed to flex together at PIP/DIP, MCP should be extended.
A: Dorsal DIP joint
S: Dorsal midline of the middle phalanx
M: Dorsal midline of the distal phalanx

Question 8

DIP extension

Answer 8

P: Sitting with the elbow flexed 90 degrees and forearm/wrist/hand supported in neutral with palm perpendicular to surface. All fingers should be allowed to flex together at PIP/DIP, MCP should be extended.
A: Palmar DIP joint
S: Palmar midline of the middle phalanx
M: Palmar midline of the distal phalanx

Question 9

thumb CMC flexion

Answer 9

P: Sitting with the wrist and hand supported in neutral. Thumb rests along 2nd metacarpal
A: Palmar surface of first CMC joint
S: Ventral midline of the radius in line with the radial head
M: Palmar surface of the first metacarpal in line with the center of the first MCP joint

Question 10

thumb CMC extension

Answer 10

P: Sitting with the wrist and hand supported in neutral or supinated. Thumb rests along 2nd metacarpal
A: Palmar surface of first CMC joint
S: Ventral midline of the radius in line with the radial head
M: Palmar surface of the first metacarpal in line with the center of the first MCP joint

Question 11

thumb CMC abduction (palmar)

Answer 11

P: Sitting with the wrist and hand supported in neutral. Thumb rests along 2nd metacarpal
A: Dorsal surface between the 1st and 2nd CMC joints (V shape)
S: Lateral midline of the 2nd metacarpal in line with the 2nd MCP joint
M: Dorsal surface of the 1st metacarpal in line with the 1st MCP joint

Question 12

thumb CMC adduction (palmar)

Answer 12

P: Sitting with the wrist and hand supported in neutral. Thumb rests along 2nd metacarpal
A: Dorsal surface between the 1st and 2nd CMC joints (V shape)
S: Lateral midline of the 2nd metacarpal in line with the 2nd MCP joint
M: Dorsal surface of the 1st metacarpal in line with the 1st MCP joint

Question 13

CMC opposition

Answer 13

P: Sitting with the forearm supinated, wrist and hand supported in neutral. The thumb begins in a fully abducted position.
A: Examiner measures the smallest distance between the interphalangeal crease of the thumb and the proximal digital crease of the little finger using a ruler or tape measure.

Question 14

CMC radial abduction (AMA)

Answer 14

P: Sitting with the forearm supported in pronation. The wrist and hand are supported in neutral
A: Dorsal surface between the 1st and 2nd CMC joints (V-shape)
S: Along the dorsal midline of the 2nd metacarpal in line with the 2nd MCP joint
M: Dorsal surface of the 1st metacarpal in line with the 1st MCP joint

Question 15

thumb MCP flexion

Answer 15

P: Sitting with forearm, wrist, and hand supported in neutral
A: Dorsal surface of the 1st MCP joint
S: Dorsal midline of the 1st metacarpal
M: Dorsal midline of the 1st proximal phalanx

Question 16

thumb MCP extension

Answer 16

P: Sitting with forearm, wrist, and hand supported in neutral
A: Dorsal surface of the 1st MCP joint
S: Dorsal midline of the 1st metacarpal
M: Dorsal midline of the 1st proximal phalanx

Question 17

thumb IP flexion

Answer 17

P: Sitting with forearm, wrist, and hand supported in neutral
A: Dorsal 1st IP joint
S: Dorsal midline of the 1st proximal phalanx
M: Dorsal midline of the 1st distal phalanx

Question 18

thumb IP extension

Answer 18

P: Sitting with forearm, wrist, and hand supported in neutral
A: Dorsal 1st IP joint
S: Dorsal midline of the 1st proximal phalanx
M: Dorsal midline of the 1st distal phalanx