Wrist and Hand

Question 1

Pinch grip

Answer 1

Pinch tip to tip or Pulp to Pulp

thumb and index finger

Question 2

Murphy

Answer 2

Make a fist

3rd MCP is same level as 4th and 2nd

Question 3

Boxer

Answer 3

Make a fist

4th and/or 5th MCP is depressed

Question 4

Scaphoid

Answer 4

Apply pressure to scaphoid and snuff box

Radial Deviation

Question 5

Axial Load

Answer 5

Apply axial compression to specified joint

Rotate/grind joint while under compression

Question 6

Ballottement/Shuck

Answer 6

Palpate Triquitrum to see if it is displaced dorsally or palmar to lunate
Proximal and lateral to 3rd MC/C joint

Question 7

TFCC Grind

Answer 7

Hold patients hand and forearm
Axial load wrist and ulnar deviate
Flex and extend wrist
Postive: Pain ulnarly
Indicates: TFCC

Question 8

Push Off

Answer 8

Have patient push up on a table or arm rest to standing position
Positive: Pain on ulnar side
Indicates: TFCC

Question 9

Finkelstein

Answer 9

Patient makes a fist with thumb enclosed
Ulnar deviation
Positive: Pain

Question 10

Sweater (Jersey) Finger

Answer 10

Ask patient to make a fist
Positive: DIP does not flex
Indicates: Ruptured flexor digitorum profundus tendon

Question 11

Extensor Hood Rupture

Answer 11

grip edge of table with hand (90 degrees flexion)
Patient tries to extend finger/PIP against resistance
Positive: Cannot extend
Indicates: Extensor Hood Rupture

Question 12

Boutonniere Deformity

Answer 12

Patient tries to extend finger

Positive: DIP and MCP extend but PIP does not and still looks flexed

Question 13

Mallet Fingert

Answer 13

Patient tries to extend finger
DIP does not extend
can perform against resistance

Question 14

Bishops Sign

Answer 14

Cannot extend 4th and 5th phalanges

Indicates Ulnar nerve injury

Question 15

Tinels sign at Wrist

Answer 15

Tap flexor retinaculum

Positive: Numbness/Tingling of median nerve

Question 16

Phalens + Reverse Phalens

Answer 16

Phalens: Firmly hold backs of hands together w. fingers pointed down and arms parallel to floor –> Median nerve compression
Reverse Phalens: Hands in prayer position with elbows parallel to ground –> Median nerve stretch

Question 17

Froment Sign

Answer 17

Patient grasps piece of paper btwn thumb and forefinger while examiner tries to pull it away.
Positive: Flexion of IP thumb to hold paper

Question 18

Capillary Refill

Answer 18

Compress nail bed
Negative: Refill in 3sec or less
Positive: Refill takes longer than 3 sec or no refill

Question 19

Allen’s for circulation

Answer 19

Patient opens and closes fist quickly
Therapist compresses Radial and Ulnar Arteries
Patient opens hand and one artery is released
Positive: If released side does not return in 7-10 seconds
Perform for BOTH ulnar and radial sides