Hand Examination

Question 1

Hand Examination - Look

Answer 1

Nails, Dorsum, Muscles, Deformity
Don’t forget to look at the elbow.

Question 2

Hand Examination - Palpation

Answer 2

Temperature
MCPJ Squeeze
Dorsal and Volar Metacarpals
Neuro (Sensation in C6,7,8)
Vascular - Pulses and Allen’s

Question 3

Hand Examination - Move

Answer 3

Fingers - flexion, extension, abduction, adduction.
Thumb - flexion, extension, abduction, adduction and opposition.
Wrist - Prayer and reverse prayer signs.

Question 4

Hand Examination - Functional Tests

Answer 4

Power Grip
Lateral Pinch - Hold a pen
Assess Precision - Can they do buttons?

Question 5

Carpal Tunnel Syndrome - Median Nerve Assessment

Answer 5

Sensory - Sensation of Palmar 2.5 fingers + thumb.
Motor - Palmar abduction against resistance.
Provocation - Tinel’s, Phalen’s.

Question 6

What is Tinel’s Test?

Answer 6

Tap strongly over the carpal tunnel which will lead to the reproduction of pain, numbness or tingling.

Question 7

What is Phalen’s Test?

Answer 7

Reverse Prayer Sign - Pain

Question 8

Ulnar Nerve Assessment

Answer 8

Sensory - Test sensation, lateral palmar 1.5 fingers.
Motor - Cross fingers, resisted abduction, try to remove paper from between finger and thumb.

Question 9

Radial Nerve Assessment

Answer 9

Sensory - Sensation in anatomical snuffbox.
Motor - Wrist and finger dorsiflexion.