Hand and wrist examination Flashcards
Where is the CMCJ
At the base of the fingers
Base of the thumb
Trapezium articulates with base of the thumb
Which bones articulate with radial bone
Scaphoid, lunar
Base of fourth and fifth
Hamate
Thumb side
Radius
Other side
Ulnar
Front of arm
Flexor
Back of arm
Extensor
Carpi
Wrist
When you flex you thumb and finger
Flexor carpi radialis
Three muscles you can flex in wrist and see
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
Digiti
Fingers
Mobile wad henry
Brachioradialis
ECRL
ECRB
What is between the median and ulnar nerve in the upper arm
Brachial artery
Which nerve runs behind the medial epicondyle
Ulnar nerve
Which nerve could be affected when taking blood from the brachial artery
Median nerve
Which nerve is on the posterior of the forearm
Radial nerve
Ulnar nerve
Ulnar 1.5 digits
FCU
Ulnar 2 FDP
Small muscles hand (
Median nerve
Radial 3.5 digits
Forearm flexors
Fingers flexors
ABP
Radial nerve
Extensor forearm
Dorsum 1st web sensory
Radial nerve
Extensor forearm
Dorsum 1st web sensory
Hand history
Age Sex Occupation/hobbies Right or left handed PMH Drugs Allergies
Hand questions
What problem have they got with it? Pain- SOCRATES Loss of function Pins and needles Activities of daily living
What is dupuytrens
Where one or more of the digits is permanently flexed
Looking at nails
For signs of elsewhere disease
Look for local problems
Onycholysis
Lifting off of the nails
Onychogryphosis
Very long nails
Pigementation on a nail
Melanoma
4 things to look at in hand
Skin (colour)
Scarring
Muscle wasting
Deformity
OA signs
Heberdens nodes
Bouchards nodes
CMCJ swelling
RA signs
Ulnar drift MCPJ
Swan neck
Boutonniere
Things to look at in wrist
Ganglion
Synovitis
Look at in palm
Scars
Skin changes
Muscle wasting
Dupuytrens
Palm up feel
Temperature Radial pulse Allens test Capillary refill Muscle bulk (hypothenar and thenar) Sensation
Where to test sensation
Back of first web (radial) Index finger (median) Little finger (ulnar)
How to feel for temperature
Use the back of your hand on the joints
Palpate joints for
Tenderness
Swelling
Bony deformity
Examination: move
Active range of movement. Passive range of movement
4 reasons for not being able to move
Nerve
Muscular tendinous junction
Joint
Skin
How to test FDP
How PIP straight and see if you can flex DIPJ
How to test FDS
Flex middle, extend others. The DIP can be flexed
Carpol tunnel treatment
Neutral wrist splint
Steroid injection
Surgeon