practical skills of the wrist and hand Flashcards
goniometry, special tests, limiting factors, accessory movements
classify the radiocarpal joint
synovial, bi-axial, complex, ellipsoid
classify the first carpometacarpal joint
synovial, bi-axial, saddle, simple
classify the metacarpophalangeal joint
synovial, simple, bi-axial, condyloid
classify the interphalangeal joint
synovial, simple, uni-axial, hinge
normal ROM wrist flexion
0-90 degrees
normal ROM wrist extension
0-80 degrees
limiting factors wrist flexion
dorsal radiocarpal ligament
tension in extensor tendons
limiting factors wrist extension
Palmar radiocarpal and ulnocarpal ligaments
tension in flexor tendons
normal ROM radial deviation at wrist
0-15 degrees
normal ROM ulnar deviation at wrist
0-40 degrees
limiting factors radial deviation at wrist
ulnar collateral ligament
apposition of scaphoid tubercle on radial styloid
limiting factor ulnar deviation
radial collateral ligament
normal ROM flexion of thumb
0-50 degrees
limiting factors thumb flexion
posterior oblique ligament
tension in extensor muscles
size/bulk of thenar eminence
normal ROM thumb extension
0-80 degrees
limiting factors thumb extension
anterior oblique ligament
tension in flexor muscles
normal ROM thumb abduction
0-80 degrees
limiting factors thumb abduction
tension in thumb web space
adductor muscles
limiting factors thumb adduction
approximation to 1st digit
normal ROM of MCPJ and IPJ flexion
0-90 degrees
limiting factors MCPJ/IPJ flexion
collateral ligaments
tension in extensor tendons
nomrla ROM MCPJ extension
0-50 degrees
normal ROM IPJ extension
0-10 degrees
limitinf factors MCPJ / IPJ extension
palmar ligament
tension in flexor tendons
which fingers are affected by carapal tunnel syndrome
thumb, middle and ring finger
how to conduct carpal compression test
supinate model’s arm, apply firm direct pressure over the carpal tunnel (just above wrist crease)
hold pressure for 30 seconds
positive carpal compression test
familiar symptoms of sensory change or pain are reproduced
how to conduct phalen’s manoeuvre
patient asked to hold their wrists in complete and forced flexion by pushing the dorsal surfaces of both hands together
they hold position for no longer than 60 seconds
positive phalen’s manoeuvre
presence of familiar neurological symptoms such as sensory changes
what might occur if the carpal compression test is held for longer than 60 seconds
may produce symptoms in individuals without carpal tunnel syndrome
how to conduct finkelstein’s test
model opposes thumb, and brings other fingers over thumb to make a fist
over edge of table, ask them to produce ulnar deviation - slowly lowering wrist downwards
next, apply a bit of pressure and repeat
positive finklestein’s test
familiar pain in region of anatomical snuffbox
what techniques mimic wrist flexion
AP proximal row of carpal bones
AP distal row carpal bones
techniques mimicking wrist extension
PA proximal and distal row of carpal bones
what techniques mimic radial deviation
lateral glide radiocarpal joint
what technique mimics ulna deviation
medial glide radiocarpal joint
movements mimicking thumb flexion
PA 1st carpometacarpal joint
PA metacarpophalangeal joint
PA interphalangeal joint
movements mimicking thumb extension
AP metacarpophalangeal, carpometacarpal and interphalangeal joints
movements mimicking finger flexion
PA metacarpophalangeal, proximal and distal interphalangeal joints
movements mimicking finger extension
AP metacarpophalangeal, proximal and distal interphalangeal joints
