Wrist and Hand

Question 1

Radiocarpal joint

AP
proximal row of carpals

Answer 1

Supine lying with a pillow under the humerus, elbow flexed to 90 degrees and forearm in
mid pronation/supination. Plinth fairly high.

stabilise where the ulnar and radius meet the proximal metacarpals on the dorsal side web grip. then in palmar side apply equal and opposite pressure elbows parallel to the floor

Question 2

Radiocarpal joint

PA
proximal row of carpals

Answer 2

Supine lying with a pillow under the humerus, elbow flexed to 90 degrees and forearm in
mid pronation/supination. Plinth fairly high.

grip the palmar aspect of forearm stabilising it then on the dorsal aspect apply equal and opposite pressure

Question 3

Radiocarpal joint

Lateral transverse glide (proximal row of carpals)

Answer 3

Supine lying with a pillow under the humerus, elbow flexed to 90 degrees and forearm in
mid pronation/supination. Plinth fairly high.

grasp the distal radial head and then at the side where the pinky is apply a horizontal glide

Question 4

Radiocarpal joint

Medial transverse glide (proximal row of carpals)

Answer 4

Supine lying with a pillow under the humerus, elbow flexed to 90 degrees and forearm in
mid pronation/supination. Plinth fairly high.

grasp the distal ulna head and the apply a horizontal glide from the thumb to the pinky

Question 5

Radiocarpal joint

AP
distal row of carpals

Answer 5

Supine lying with a pillow under the humerus, elbow flexed to 90 degrees and forearm in
mid pronation/supination. Plinth fairly high.

grip dorsal surface and like you are holding their hand do an AP

Question 6

Radiocarpal joint

PA
distal row of carpals

Answer 6

Supine lying with a pillow under the humerus, elbow flexed to 90 degrees and forearm in
mid pronation/supination. Plinth fairly high.

grip palmar aspect and like you are holding the back of their hand do a PA

Question 7

THUMB

Carpometacarpal joint

AP
1st metacarpal

Answer 7

supine lying arm in abduction

therapist on affected side fix thumb and trapezium with hand closest to patients head

grip head of 1st metatarsal with index finger and thumb of other hand

glide in an AP direction

Question 8

Carpometacarpal joint

PA
1st metacarpal

Answer 8

suoine lying arm by their side

standing on side of arm being assessed ix thumb and trapezium with hand closest to patients head

grip head of 1st metatarsal with index finger and thumb of other hand

glide in an PA direction

Question 9

Metacarpalphalangeal joint

PA
1st metacarpal

Answer 9

supine lying with their arm by their side

standing on outside of arm being assessed fix the distal aspect of the metacarpal with the hand closest to patients head

grip the prox phalanx with index finger and the thumb of the other hand

glide prox phalanx in a PA direction

Question 10

Metacarpalphalangeal joint

AP
1st metacarpal

Answer 10

supine lying with shoulder in abduction

standing on outside of arm being assessed fix distal aspect of metacarpal with the hand closed to head

grip prox phalanx with finger and the thumb of the other hand

glide prox phalanx in an AP direction

Question 11

Interpalphalangeal joint

PA
1st metacarpal

Answer 11

supine lying with their arm by their side

standing on outside of arm being assessed fix prox phalanx with the hand closest to head

grip distal phalanx with finger and the thumb of the other hand

glide the distal phalanx in a PA direction

Question 12

Interpalphalangeal joint

AP
1st metacarpal

Answer 12

Supine lying with shoulder in abduction

standing on outside of arm being assessed fix prox phalanx with the hand closest to head

grip distal phalanx with finger and the thumb of the other hand

glide the distal phalanx in a AP direction

Question 13

Improve finger flexion

Answer 13

1. Metacarpophalangeal joint (digits 2-5) - PA (proximal phalanx)
2. Proximal interphalangeal joint (digits 2-5) - PA movement (middle phalanx)
3. Distal interphalangeal joint (digits 2-5) - PA movement (distal phalanx)

Question 14

Improve finger extension

Answer 14

1. Metacarpophalangeal joint (digits 2-5) - AP (proximal phalanx)
2. Proximal interphalangeal joint (digits 2-5) – AP (middle phalanx)
3. Distal interphalangeal joint (digits 2-5) - AP (distal phalanx)

Question 15

Improve thumb flexion

Answer 15

1. Carpometacarpal Joint (Thumb) - PA (1st metacarpal)
2. Metacarpophalangeal joints (Thumb) - PA (proximal phalanx)
3. Interphalangeal joints (Thumb) - PA (distal phalanx)

Question 16

Improve thumb extension

Answer 16

1. Carpometacarpal Joint (Thumb) - AP (1st metacarpal)
2. Metacarpophalangeal joints (Thumb) - AP (proximal phalanx)
3. Interphalangeal joints (Thumb) - AP (distal phalanx)