Hand and Wrist Exam Flashcards
where do you look in a hand and wrist exam
look at hands whilst palms facing down + check for clubbing
check fingers
check palm and wrist
check elbow
what should you feel in a hand and wrist exam
temp + compare
palpate for tenderness, start ar wrist and feel
perform a squeeze test of MCJPs (mid hand)
feel each joint individually
check sensation of each nerve, (radial - anatomical snuffbox, ulnar - little finger, median - tip of index finger)
check radial + ulnar pulse + do an allen’s test
what should you move in a hand and wrist exam
fingers: flexion + extension - make a full fist then striaghten out fingers
abduction + adduction: extend and spread out fingers, then pack to normal
thumb: flexion + extension - bending and straightening the thumb
abduction - away from palm upwards, adduction - bringing it back to palm
opposition - bring thumb to little finger
wrist - prayer + reverse prayer
how do you test function in a hand and wrist exam
power grip - pen in a clenched fist and get them to stop you pulling it out
lateral pinch grip - ask them to hold a key or pen normally
precision - undo and do up buttons
how do you test the median nerve (including testing for carpal tunnel syndrome)
light touch sensation over median nerve distribution
test palmar abduction against resistance (push thumb down to palm)
tinel’s - tap over median nerve as it goes into carpal tunnel
phalen’s - reverse prayer for a min
compression test - direct pressure over carpal tunnel
how do you test ulnar nerve
light touch sensation on little finger
cross index and middle finger
grip piece of paper between thumb and index finger without thumb bending (froment’s sign)
abduct fingers against resistance
how do you test the radial nerve
sensation in anatomical snuffbox
dorsiflexion of wrist and fingers against resistance (hands upwards)
how would you complete a hand and wrist exam
examine elbow joints
