Hand Exam Flashcards
First question after intro
Which hand is dominant
Inspection
Ask if they have any pain numbness or tingling
Ask them to do clubbing
Inspect skin of the hands, palms and dorsum
look at elbow
What to do before palpating
Ask where is painful
Feel
Assess temp, Palpate all joints in the wrist, squeeze MCP’s, Pulses (ulnar and radial), Allens, Sensation in nerve distributions (radial, medial, ulnar, c6,7,8) anatomical snuffbox
What are the five parts of a hand exam
Look, Feel, Move, Function Special tests
Move for fingers
Fingers - flex and extend - Full fist and then striagten fingers
Abduction and adduction- spread fingers and bring back together
Move for thumb
Thumb flexion and extension - Move thumb tom side and back
Abduction and adduction - Palms up point thumbs to ceiling
Opposition - touch thumb to all fingers
Move for wrist
Dorsiflexion - make a prayer sign for me
Palmar flexion - reverse prayer sign
Ulnar and radial deviation - move palm side to side
Function
Power grip - Grip my finger as hard as you can and dont let me pull it out
Lateral pinch - hold a key or pen normally
Precision - can you do up your buttons?
Special tests for median
Carpal tunnel - light touch on median nerve ditribution
- Test palmar abduction against resistance
Tinels: tap strongly on median nerve
Phalens - Hold both wrist in palmar flexion for a minute
Compression test - Direct pressure over carpal tunnel
Special tests for ulnar
Sensation, Cross index and middle, grip a piece of paper
Special tests for radial
Anatomical snuffbox, wrist and finger dorsiflexion against resistance
Present for hand
Today I performed a hand examination on patient X. On general inspection, their hands were comfortable at rest with no obvious signs of pathology. On palpation there was no tenderness and there was a full range of motion of all modalities tested
