Wrist Flashcards
What does Tinels test
Neuropathy
Tinels technique
Gently tap over carpal tunnel
+ve Tinels
Parasthesia from median N (thumb, index, middle)
Ulnar distribution- ring and pinky (palm and dorsal)
Tinels sens
23-97
Tinels spec
53-100
What does pronator stretch test
Neuropathy
Pronator stretch test technique
Pt elbow flexed 90 deg
Supinate forearm
Pt pronate + ext elbow
Resist pronation during ext
+ve Pronator stretch technique
Parasthesia- medial N compress pronator teres (little/middle finger)
What does Allens test
Artery stenosis or occlusion- Peripheral vascular disease
Allens technique
Pt makes fist, place contact over radial + ulnar arteries
Pt continuously open + closes fist until palm is white
Release radial artery, allow hand to fill
Repeat with ulnar artery
+ve Allens
Skin remains white for longer than 5s
Allens clinical notes
May compress nerves, be mindful of carpal tunnel like symptoms
What does Finklesteins test
Tenosynovitis of abductor pollicis longus + extensor pollicis brevis tendon
Finklesteins technique
Pt grip thumb with fingers (fist)
Ulnar deviate/move hand to floor
+ve Finklesteins
P abductor pollicis longus + extensor pollicis brevis tendons
Finklestein clinical notes
Test may be performed actively or passively
P is often sharp and local
False +ve test can result from 1st MCP Jt patho
What does Phalens test
Carpal tunnel syndrome
Phalen technique
Dorsal side of hands together
Hold for 2 mins
If P is felt during, no need to continue
+ve Phalen
P, numbness, tingle distal to compression
What does reverse Phalens test
Carpal tunnel syndrome
Reverse Phalens technique
Prayer position
Hold for 2 mins
If P is felt, stop
+ve Reverse Phalens
P, numbness, tingle distal to compression
What does Ulnomeniscotriquetral dorsal glide test
Triangular fibrocartilage complex damage
Ulnomeniscotriquetral dorsal glide technique
Pt seat, pronate arm
Place thumb over ulnar (just over styloid process)
Index on pisiform
Produce ‘clicking motion’
+ve Ulnomeniscotriquetral dorsal glide
P or laxity of TFCC
What does TFCC dorsal glide test
TFCC damage
TFCC dorsal glide technique
Apply grip around wrist
Other hand around metatarsals
Produce ulnar deviation with slight compression
+ve of TFCC dorsal glide
P or laxity of TFCC
Crepitus
Bracelet test procedure
Pt seated
Apply lateral compression around distsl radius and ulna
Bracelet test interpretation
Forearm, wrist or hand P- RA, OA/DJD at wrist
Abnormal ROM- ligament laxity, instability
Median nerve compression procedure
Pt seated
Examiner places thumbs over median as it passes through the carpal tunnel + apply pressure for 30-60s
Median nerve compression test interpretation
P, numbness or tingling distal to compression site- carpal tunnel syndrome
Scaphoid # test procedure
Pt seated
Grip Pts thumb and apply pressure in Pts anatomical snuff box
Scaphoid # interpretation
P following injury- scaphoid #
Scaphoid # clinical notes
Most commonly # carpal is scaphoid
Risk of avascular necrosis
20% of # are false -ve
Thumb grind
Pt seated
Examiner grips and stabilises Pts wrist and thumb
Apply long axis compression while circumducting thumb
Thumb grind interpretation
P or crepitus- trapeziometacarpal arthritis or DJD, scaphoid #
