Hand Palpation

Question 1

Extensor Carpi Radialis Longus

Answer 1

1. Forearm resting on plinth palm facing down
2. Have patient make a fist
3. Palpate for the Lister’s tubercle on the ulnar side
4. Ask patient to extend wrist while maintaining fist

Question 2

Extensor Carpi Radialis Brevis

Answer 2

1. Palpate at the base of 3rd metacarpal
2. Have patient make a fist
3. Ask patient to extend wrist while maintaining fist

Question 3

Extensor Carpi Ulnaris

Answer 3

1. Forearm resting on plinth, palm face down
2. Palpate the meaty part near the elbow joint
3. Ask patient to actively extend wrist & ulnar deviate (move hand outwards w/o moving forearm)

Question 4

Extensor Digitorum Communis

Answer 4

1. Have patient’s forearm resting on plinth with palm facing down
2. Palpate roughly at the tendon areas
3. Have patient extend wrist while keeping the fingers straight
4. The tendons are vv observable (the things that pop out (index to pinky))

Question 5

Extensor Indicis

Answer 5

1. Have patient’s forearm resting on plinth with palm facing down
2. Palpate where? At MCP joint or slighlty lower down?
3. Ask patient to flex and extend index finger (alternate, up & down)

Tendon closer to the other fingers = extensor indicis

Question 6

Extensor Digiti Minimi

Answer 6

1. Have patient’s forearm resting on plinth with palm facing down
2. Palpate at area distal to ulnar syloid process (pinky side of hand, the most bulgy thing, move in front a bit)
3. Ask patient to push down gently on table and alternately flex and extend pinky finger (move up and down)

Question 7

Palmaris Longus

Answer 7

1. Have patient’s forearm resting on plinth with palm facing up
2. Have patient to touch tips of thumb & pinky finger together
3. Palpate at the wrist, roughly can see the tendon alr when aft step 2
4. Ask patient to flex the wrist

Question 8

Flexor Carpi Radialis

Answer 8

1. Have patient’s forearm resting on plinth with palm facing up
2. Ask patient to make a fist
3. Palpate next to the palmaris longus (after step 2, can roughly see the two tendons, palpate the one on the radial side - thumb side)
4. Ask patient to flex the wrist

Question 9

Flexor Carpi Ulnaris

Answer 9

1. Have patient’s forearm resting on plinth with palm facing up
2. Ask patient to make a fist
3. Palpate between the pisiform (pokey bone on top of ulnar styloid) and ulnar styloid process (feels like a depression a fter the ulnar styloid process - its there
4. Instruct patient to flex and ulnarly deviate wrist

Question 10

Flexor Digitorum Superficialis

Answer 10

1. Have patient’s forearm resting on plinth with palm facing up
2. Ask patient to make a fist
3. Palpate towards the ulnar side of the Palmaris Longus (can roughly see where it is after step 2)
4. Instruct patient to flex the wrist and bend towards the ulnar side (pinky finger side)

Palpate in between the two prominant tendens (palmaris longus & flexor carpi ulnaris)

Question 11

Flexor Digitorum Profundus

Answer 11

1. Have patient’s forearm resting on plinth with palm facing up
2. Stabilise patient’s middle finger (around the proximal interphalangeal joint, don’t let the lower part of fingerr movee)
3. Palpate just below the distal interphalangeal joint
4. Instruct patient to flex distal phalanx (the very very top part of finger)

Question 12

Extensor Pollicis Longus

Answer 12

1. Have patient’s forearm resting on plinth with palm facing down
2. Ask patient to make the ‘anatomical snuffbox’ - ask them to bring their thumb outwards and upwards
3. Palpate the tendon closer to your other fingers (ulnar side)

Question 13

Extensor Pollicis Brevis

Answer 13

1. Have patient’s forearm resting on plinth with palm facing down
2. Ask patient to make the ‘anatomicall snuffbox’ - ask them to bring their thumb outwards and upwards
3. Palpate the tendon on the radial side (basically the tendon thats further away from the rest of the fingers
4. Ask patient to relax then slowly extend thumb w/o abducting thumb

Question 14

Abductor Pollicis Longus

Answer 14

1. Have patient’s forerarm resting on plinth with palm facing down
2. Ask patient to make the ‘anatomicall snuffbox’ - ask them to bring their thumb outwards and upwards
3. Palpate SLIGHTLY below the extensor pollicis brevis (or on it also can)
4. Ask patient to slowly abduct the thumb more
   (Should be able to feel the abductor tendon contract as thumb is being abducted)

Question 15

Abductor Pollicis Brevis

Answer 15

1. Have patient’s forearm resting on plinth with palm facing up
2. Palpate at the fleshy part of the palm, below the thumb (more towards the lateral side)
3. Ask patient to point the thumb towards the ceiling (basically will lift the thumb up)

Question 16

Flexor Pollicis Brevis

Answer 16

1. Have patient’s forearm resting on plinth with palm facing up
2. Palpate below the Abductor Pollicis Brevis (still at fleshy part, but less fleshy)
3. Ask patient to bend thumb inwards towards the pinky finger

Question 17

Opponens Pollicis

Answer 17

Deep & cannot be palpated; During opposition of thumb, abductor, flexor & opponens pollicis are active

Question 18

Abductor Digiti Minimi

Answer 18

1. Have patient’s forearm resting on plinth with palm facing up
2. Palpate ulnar side of 5th metacarpal (basically the ulnar side of hand, the side of the pinky bone, sightly below the pinky side fleshy part)
3. Ask patient to abduct pinky finger away from hand