Hand Exam

Question 1

Outline the sequence of the hand exam?

Answer 1

1. General inspection
2. Palpate all the joints
3. Movements
   - Active
   - Passive (if required)
   - Strength (UL exam)
   - Ulnar (forment’s test)
   - Radial nerve
4. Functional tests
5. Special tests
   - Tinel’s, Phalen’s
   - Vascular supply
   - Sensation for each peripheral nerve

Question 2

What do you perform in a neurovascular exam in the setting of trauma?

Answer 2

Vascular

• Capillary refill
• Pulse
• Allan’s test

Neuro Exam

• Active movements - pronation/supination
• Wrist extension/flexion
• Finger abduction/adduction
• Finger extension/flexion
• Median: thumb abduction
• Ulnar: Froment’s test
• (Radial = wrist extension)

Sensation - peripheral nerve areas

Feel - joints, bones, anatomical snuffbox, Phalen’s test, and Tinel’s