Hand and Wrist Examination Flashcards

1
Q

Where are Bouchard’s nodes present?

A

The proximal interphalangeal joints

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2
Q

Where are Herberden’s nodes present?

A

The distal interphalangeal joints

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3
Q

What may wasting of the thenar and hypothenar eminences indicate?

A

Disuse atrophy as well as LMN lesions

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4
Q

Where do you assess median nerve sensation?

A

Thenar eminence and index finger

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5
Q

Where do you assess ulnar nerve sensation?

A

Hypothenar eminence and little finger

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6
Q

Where do you assess radial nerve sensation?

A

Test sensation over the first dorsal webspace

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7
Q

What does tenderness of the anatomical snuffbox indicate?

A

Scaphoid fracture

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8
Q

How do you get a patient to extend their fingers?

A

‘Open your fist and splay your fingers’

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9
Q

How do you get a patient to flex their fingers?

A

‘Make a fist’

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10
Q

What is the normal range of movement for wrist extension?

A

90 degrees

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11
Q

How do you get a patient to extend their wrist?

A

‘Put the palms of your hands together and extend your wrists fully’

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12
Q

What is the normal range of movement for wrist flexion?

A

90 degrees

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13
Q

How do you get a patient to flex their wrist?

A

‘Put the backs of your hands together and flex your wrists fully’

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14
Q

What nerves are you assessing when you extend the wrist and fingers against resistance?

A

Radial nerve

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15
Q

What muscles are you assessing when you extend the wrist and fingers against resistance?

A

Extensors of the wrist and fingers

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16
Q

What nerves are you assessing when you abduct the index finger against resistance?

A

Ulnar nerve

17
Q

What muscles are you assessing when you abduct the index finger against resistance?

A

First dorsal interosseous (FDI)

18
Q

What nerves are you assessing when abduct the thumb against resistance?

A

Median nerve

19
Q

What muscles are you assessing when abduct the thumb against resistance?

A

Abductor pollicis brevis

20
Q

What is the function of Tinel’s test?

A

Used to identify median nerve compression (useful in diagnosis in carpal tunnel syndrome)

21
Q

What is a positive result of Tinel’s test?

A

If the patient develops tingling in the thumb and radial two and a half fingers - suggestive of median nerve compression

22
Q

What is the function of Phalen’s test?

A

To further support the diagnosis of carpal tunnel syndrome (reverse prayer)

23
Q

What is a positive result of Phalen’s test?

A

Burning, tingling or numb sensation in the thumb, index, middle and ring fingers

24
Q

What further assessments and investigations should be completed after a hand and wrist exam?

A
  • Neurovascular exam of the upper limbs
  • Examination of the elbow joint and shoulder joint
  • Further imaging