Hand and Wrist OSCE

Question 1

what is being assessed in the hands

Answer 1

colour, temperature, pitting, clubbing

Question 1

how to start exam?

Answer 1

wash hands, introduce self, identify patient, explain procedure and consent
ask if patient has any pain

Question 2

what does the allens test show

Answer 2

perfusion of the hand by the ulnar and radial artery

Question 3

what are you feeling in the hands

Answer 3

bones and joints (hands, wrist and elbow)
MCPJ

Question 4

what movements are being assessed in the hands

Answer 4

finger extension and flexion
thumb and finger adduction and abduction
grip strength

Question 5

what movements are being assessed in the wrist

Answer 5

extension flexion and eversion

Question 6

which nerves are being assessed for sensation

Answer 6

c6-8 (radial, median and ulnar)

Question 7

which special tests are used to assess the nerves

Answer 7

Carpel tunnel: Phalens (reverse prayer) and tinels (tapping on the CT)
Median: thumb abduction and sensation
ulnar: cross fingers, paper grip, abduct and sensation
radial: wrist dorsiflexion and sensation (snuff box)

Question 8

what would you offer at the end?

Answer 8

examine joint above (elbow)