VERBALS HAND AND WRIST

Question 1

Bony Palpation Wrist and Hand

Answer 1

Radial Syloid Process

Ulnar Styloid Process,

Lister’s Tubercle,

Scaphoid (navicular),

Lunate, Triquetrium,

Pisiform,

Trapezium,

Trapezoid,

Capitate,

Hamate,

Hook of Hamate,

Metacarpals,

Phalanges

Question 2

Soft Tissue Palpation: Wrist and Hand

Answer 2

Ulnar Artery,

Radial Artery,

Palmaris Longus Tendon,

Carpal Tunnel Region,

Thenar Eminence,

Hypothenar Eminence,

Palmar Aponeurosis,

Tissues surrounding proximal interphalangeal joints,

Tissues surrounding distal interphalangeal joints,

Distal tufts of fingers

Question 3

Range of Motion: Wrist and Hand

Answer 3

Wrist Flexion 80,

Wrist Extension 70,

Wrist Ulnar Deviation 30,

Wrist Radial Deviation 20,

Finger Abduction,

Finger Adduction,

Finger Flexion,

Finger Extension,

Thumb Flexion,

Thumb Extension,

Finger Opposition

Question 4

Tinel Wrist Sign

Answer 4

POSITIVE: Reproduction of pain, tenderness, and/or paresthesia in the median nerve distribution area (1st, 2nd, 3rd, and the lateral 1/2 of the 4th digit)

INDICATES: Median Neuritis, possibly Carpal Tunnel Syndrome

Question 5

PHALEN SIGN AND REVERSE PHALEN SIGN

aka Prayer Sign

Answer 5

POSITIVE: Reproduction of pain and/or paresthesia in the median nerve distribution area (thumb, 2nd, 3rd, and the lateral 1/2 of the 4th digit)

INDICATES: Median Neuritis, possibly Carpal Tunnel Syndrome

Question 6

FINKELSTEIN TEST

Answer 6

POSITIVE: Pain distal to the radial styloid process

INDICATES: Stenosing tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons (DeQuervain’s Disease)

Question 7

ALLEN TEST

Answer 7

POSITIVE: A delay of more than 10 seconds (Evans 5 sec) in returning a reddish color to the hand

INDICATES: Radial or Ulnar Artery insufficiency. The artery held (occluded) by the examiner is not the artery being tested

Question 8

RETINACULAR TEST

Answer 8

Patient presents with difficulty flexing the DIP joint

POSITIVE:

1) Flexion of the distal interphalangeal joint cannot be achieved
2) Flexion of the distal interphalangeal joint is achieved

INDICATES:

1) Joint Capsule Contracture
2) Tight Retinacular Ligament

Question 9

BUNNEL - LITTLER TEST

Answer 9

Patient presents with difficulty flexing the PIP joint

POSITIVE:

1. Flexion of the proximal interphalangeal joint cannot be achieved
2. Flexion of the proximal interphalangeal joint is achieved

INDICATES:

1. Joint Capsule Contracture
2. Tight intrinsic muscles