Hand and Wrist

Question 1

Carpal tunnel assessment

Answer 1

MMT: wrist flexion/extension

Tinel’s: tap from fingers up median nerve (thumb to 3rd MTC). Do 4th and 5th MTC to rule out ulnar nerve syndrome (cubital tunnel syndrome)

Looking for tingling, numbness, pins and needles

Phalen’s: max wrist flexion, push hands together

Durkens: handshake and compress median nerve

Question 2

de Quervains’s assessment

Answer 2

MMT: thumb abduction, flexion, opposition
- abductor pollicus longus and extensor pollicus brevis

Finkelstein’s: hold thumb, ulna deviation and resist

Question 3

Ulnar Nerve Syndrome

Answer 3

MMT: wrist Flexion/extension

Special test: elbow flexion test, tap from olecranon process of ulnar nerve down to pinky finger

Question 4

Extensor tendinopathy

Answer 4

ROM: elbow flexion/extension

Special tests
Mill’s Test
Cozen’s test
Maudsley’s test

Question 5

goniometer alignment elbow flexion/extension

Answer 5

patient in supine

fulcrum: lateral epicondyle and radial styloid
stationary arm: midline of humerus
measuring arm: midline of arm

Question 6

lateral pivot shift of elbow

Answer 6

instability of elbow

supine with arm over head. Arm in full extension and bring arm into supination by rotating patients wrist. Flex elbow and apply valgus load

positive test if subluxation of radial head is witnessed by bump on elbow or dimpling on skin

Question 7

Mills Test

Answer 7

testing for lateral epicondylitis

palpate lateral epicondyle, passively pronate forearm and flex the wrist and extend the elbow fully

pain at epicondyle for positive test

Question 8

Cozens test

Answer 8

testing for lateral epicondylitis

palpate lateral epicondyle, make fist, pronate forearm and radially deviate and extend wrist and resist

pain at epicondyle

Question 9

Maudsleys test

Answer 9

3rd finger resisted extension

Question 10

Bones of the Wrist

Answer 10

Scaphoid
Lunate
Triquetral
Pisiform
Trapezium
Trapezoid
Capitate
Hamate

Some Lovers Try Positions That They Cannot Handle