Wrist and Hand Special Tests

Question 1

List the 5 special tests of the wrist and hand?

Answer 1

1. FINKELSTEIN TEST
2. PHALEN’S TEST
3. REVERSE PHALEN’S TEST
4. ALLEN’S TEST
5. BUNNEL-LITTLER TEST

Question 2

Finklestein test assesses for ____________ disease, a tenosynovitis occurring in the first dorsal carpal tunnel. This affects which 2 muscles?

Answer 2

DEQUERVAIN'S DISEASE
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ABDUCTOR POLLICIS LONGUS
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EXTENSOR POLLICIS BREVIS

Question 3

How is Finklestein Test performed?

Answer 3

Px SEATED, ARMS and WRISTS NEUTRAL
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Px FLEXES THUMB and MAKES FIST AROUND IT
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Tx ASKS IF ANY PAIN
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IF POSITION OK - ULNAR DEVIATE TO INTENSIFY

+ = sudden, severe pain at wrist where tendons pass, pain may shoot down into thumb or mm bellies

Question 4

How is Phalen’s test performed?

Answer 4

Px FLEXES BOTH WRISTS PUSHING DORSAL SURFACES TOGETHER
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HOLD FOR ONE MINUTE

+ = parasthesia into thumb and first 2 fingers, pressure on median nerve

Question 5

How is Reverse Phalen’s test performed?

Answer 5

Px EXTENDS BOTH WRISTS PUSHING PALMAR SURFACES TOGETHER (pray position)
+
HOLD FOR ONE MINUTE

+ = parasthesia into thumb and first 2 fingers, pressure on median nerve

Question 6

How is Allen’s Test performed?

Answer 6

Px RAISES HAND ABOVE HEAD, OPENS CLOSES FIST
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Px SQUEEZES FIST TIGHTLY 
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Tx PLACES THUMB OVER RADIAL ARTERY
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MAINTAINS PRESSURE WHILE Px OPENS FIST
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PALE, THERAPIST RELEASE, 
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SHOULD FLUSH IMMEDIATELY

+ artery occluded if flush not present or slow

Question 7

When is the Bunnel-Littler Test used?

Answer 7

WHEN A PATIENT IS UNABLE TO FLEX A PIP JOINT

Question 8

How is the Bunnel-Littler Test performed?

Answer 8

THERAPIST HOLDS AN MCP SLIGHTLY EXTENDED, AND TRIES TO FLEX A PIP

+ = inability to flex the PIP, tight mm or contractures