Wrist And Hand

Question 1

radial styloid

Answer 1

Sitting with hand
supported on a table and
pillow

Identify the model’s anatomical snuffbox. Palpate proximally within the floor of this space to
identify a pointed bony prominence which is the radial styloid

Question 2

head of ulna

Answer 2

Sitting with hand
supported on a table and
pillow

Position the model’s forearm in pronation and identify a bony prominence over the posteromedial
aspect of the wrist joint (head of the ulna). Palpate its full extent.

Question 3

unlar styloid

Answer 3

Sitting with hand
supported on a table and
pillow

Position the model’s forearm in pronation and identify the head of the ulna (seeabove). Now, palpate over the posteromedial aspect of the ulnar head to identify a pointed bony projection which is the ulnar styloid

Question 4

scaphoid tubercle

Answer 4

Sitting with hand
supported on a table and
pillow

Palpate distally with in the floor of the anatomical snuff box to identify the scaphoid bone.Now slide
your finger around on to the palmar aspect of the hand maintaining the same level and palpate through the soft tissues to identify a bony ridge which is the tubercle of the scaphoid

Question 5

pisiform

Answer 5

Sitting with hand
supported on a table and
pillow

With the model’s arm insupination, palpate over the anteromedial aspect of the hand at the level of
the wrist creases and identify a pea-shaped bony prominence which is the pisiform bone

Question 6

head of metacarpal

Answer 6

Sitting with hand
supported on a table and
pillow

Ask the model to make a fist and then,palpate over their levant bony prominence or‘knuckle’on
the dorsal aspect. Then ask the model to open his/her palm and palpate through the soft tissues to
identify the relevant metacarpal head on the palmar aspect

Question 7

radiocarpal joint

Answer 7

Sitting with hand
supported on a table and
pillow

The joint line can be represented by a curved line (concave distally) between the radial and ulnar styloid processes. Using the index and middle fingers of one hand,palpate the extent of the anterior joint line from the radial styloid to the ulnar styloid Passively moving the model’s hand into ulna & radial deviation with your other hand makes identification of the anterior joint space through the flexor tendons easier
Repeat the same technique of palpation over the posterior aspect of the joint

Question 8

metacarpalphalangeal joint

Answer 8

Sitting with hand
supported on a table and
pillow

The joint line can be represented by a curved line (concave distally) drawn from the tip of the metacarpal head.
For the posterior surface marking of the joint, identify the appropriate metacarpal head (knuckle) with one hand whilst passively moving the corresponding proximal phalanx by
gripping it firmly at its base with your other hand.This will make identification of the posterior joint space a little easier.
For the anterior joint surface marking, identify the appropriate metacarpal head and
then draw a curved line (convex distally) approx.1cm proximal to the finger web on the palmar aspect of the hand

Question 9

1st carpometacarpal joint

Answer 9

Sitting with hand
supported on a table and
pillow

Identify the tubercle of the scaphoid on the palmar aspect of the hand and then slide your finger distally and slightly laterally onto another bony prominence (this is the crest
of the trapezium and identifies the proximal bone involved in the articulation).Maintain this position with one hand.
With your other hand, grip the proximal end of the model’s thumb at the level of the base of the 1st metacarpal and gently passively move this bone. Mark the joint line by palpating through the soft tissues just distal to the crest of the trapezium as this passive
movement is being performed.

Question 10

interphalangeal joint

Answer 10

Sitting with hand
supported on a table and
pillow

The joint line is represented by the skin creases over the palmar and dorsal aspects of
the appropriate joint.