Wrist & Hand Assessment

Question 1

Wrist & Hand Assessment

Wrist Snapshot:

• Flexion = ?
• Extension = ?
• Radial Dev. = ?
• Ulnar Dev. = ?

Answer 1

Flexion

• 80 degrees w/ Firm end feel

Extension

• 70 degrees w/ Firm end feel

Radial Dev.

• 20 degrees w/ Hard or Firm end feel

Ulnar Dev

• 30 degrees w/ Firm end feel

Question 2

Wrist & Hand Assessment

Hand Snapshot:

• Flexion = ?
• Extension = ?
• Abduction = ?
• Opposition = ?

Answer 2

Question 3

Wrist & Hand Assessment

Scaphoid Compression Test

Answer 3

video

Scaphoid Fracture Screening

Question 4

Wrist & Hand Assessment

Anatomical Snuffbox Tenderness

Answer 4

Client Position:

• Sitting with arms relaxed.

Clinician Position:

• Sitting next to the client.

Movement:

• The clinician palpates and provides pressure on anatomical snuffbox.

Assessment:

• A (+) test is pain or tenderness during palpation with pressure.

Statistics:

• SN 90 (80-100)
• SP 40 (33-47)

video

Scaphoid Fracture Screening

Question 5

Wrist & Hand Assessment

Dorsal Hand Large Bony Anatomy

Answer 5

• Radial and Ulnar Styloid = Widest Projection of the Wrist
• Metacarpals = “V” Notches and Proximal Edges
• DRUJ = Extensor Digiti Minimi Points to this Joint
• Lister’s Tubercle = Prominent Bump on Radius, In Line with 2nd Metacarpal

Question 6

Wrist & Hand Assessment

Dorsal Hand Small Bony Anatomy

Answer 6

Scaphoid

• Anatomical Snuff Box

Trapezium

• Between Scaphoid and Base of the 1st Metacarpal

Trapezoid

• Between Scaphoid and 2nd Metacarpal

Capitate

• In a Divot Proximal to the 3rd Metacarpal

Lunate

• Proximal to the Capitate, Prominent in Wrist Flexion

Hamate

• Proximal to the 4th and 5th Metacarpals

Triquetrum

• Proximal to the Hamate

Question 7

Wrist & Hand Assessment

Palmar Bony Anatomy

Answer 7

• Pisiform = Prominent Base of Ulnar Side | FCU points to it
• Hook of the Hamate = Between Pisiform and 2nd MCP Joint, 2cm up.
• Scaphoid Tubercle = Base of the Thenar Eminence | FCR points to it
• Trapezium Tubercle = 1cm Distal to Scaphoid Tubercle | Protrudes in Ulnar Dev.
• Capitate = Halfway: Hook of Hamate and Trapezium Tubercle
• Lunate = Halfway: Pisiform and Radial Styloid

Question 8

Wrist & Hand Assessment

Wrist Flexion ROM

Answer 8

Question 9

Wrist & Hand Assessment

Wrist Extension ROM

Answer 9

Question 10

Wrist & Hand Assessment

Wrist Ulnar Deviation ROM

Answer 10

Question 11

Wrist & Hand Assessment

Wrist Radial Deviation ROM

Answer 11

Question 12

Wrist & Hand Assessment

2-5 MCP/PIP/DIP Flexion ROM

Answer 12

Question 13

Wrist & Hand Assessment

2-5 MCP/PIP/DIP Extension ROM

Answer 13

Question 14

Wrist & Hand Assessment

2-5 Metacarpophalangeal Abduction ROM

Answer 14

Question 15

Wrist & Hand Assessment

1st Carpometacarpal Flexion ROM

Answer 15

Question 16

Wrist & Hand Assessment

1st Carpometacarpal Extension ROM

Answer 16

Question 17

Wrist & Hand Assessment

1st Carpometacarpal Abduction ROM

Answer 17

Question 18

Wrist & Hand Assessment

1st Metacarpophalangeal Flexion ROM

Answer 18

Question 19

Wrist & Hand Assessment

1st Interphalangeal Flexion/Extension ROM

Answer 19

Question 20

Wrist & Hand Assessment

Wrist Flexion MMT (3-5) * *

Answer 20

Question 21

Wrist & Hand Assessment

Wrist Extension MMT (3-5) * *

Answer 21

Question 22

Wrist & Hand Assessment

2-5 MCP Flexion MMT (3-5) * *

Answer 22

Question 23

Wrist & Hand Assessment

2-5 MCP Extension MMT (3-5) * *

Answer 23

Question 24

Wrist & Hand Assessment

2-5 MCP Abduction MMT (0-5)

Answer 24

Question 25

Wrist & Hand Assessment

2-5 MCP Adduction MMT (0-5)

Answer 25

Question 26

Wrist & Hand Assessment

2-5 Proximal Interphalangeal Flexion (3-5) * *

Answer 26

Question 27

Wrist & Hand Assessment

2-5 Distal Interphalangeal Flexion (3-5) * *

Answer 27

Question 28

Wrist & Hand Assessment

1st Carpometacarpal Abduction MMT (0-5)

Answer 28

Question 29

Wrist & Hand Assessment

1st Carpometacarpal Adduction MMT (0-5)

Answer 29

Question 30

Wrist & Hand Assessment

1st Carpometacarpal Opposition MMT (0-5)

Answer 30

Question 31

Wrist & Hand Assessment

1st MCP Flexion MMT (0-5)

Answer 31

Question 32

Wrist & Hand Assessment

1st MCP Extension MMT (0-5)

Answer 32

Question 33

Wrist & Hand Assessment

1st Interphalangeal Flexion MMT (0-5)

Answer 33

Question 34

Wrist & Hand Assessment

1st Interphalangeal Extension MMT (0-5)

Answer 34

Question 35

Wrist & Hand Assessment

Writ (Radiocarpal and Ulnocarpal) Posterior (Dorsal) Glide

Answer 35

Question 36

Wrist & Hand Assessment

Wrist Anterior (Volar/Palmar) Glide

Answer 36

Question 37

Wrist & Hand Assessment

Wrist Ulnar Glide

Answer 37

Question 38

Wrist & Hand Assessment

Wrist Radial Glide

Answer 38

Question 39

Wrist & Hand Assessment

Specific Carpal Bone Posterior (Dorsal) Glide

Answer 39

Carpal Joint Play Testing

Question 40

Wrist & Hand Assessment

Trapeziometacarpal Joint (Thumb) Posterior (Dorsal) Glide

Answer 40

1st CMC Joint Play Testing

Question 41

Wrist & Hand Assessment

Carpometacarpal Joint 2-5 Posterior (Dorsal) Glide

Answer 41

2-5th CMC Joint Play Testing

Question 42

Wrist & Hand Assessment

Metacarpophalangeal Joint 1-5 Glides

Answer 42

MCP Joint Play Testing

Question 43

Wrist & Hand Assessment

Interphalangeal Joints 1-5 Glides

Answer 43

IP Joint Play Testing

Question 44

Wrist & Hand Assessment

Ulnar Collateral Ligament Test (Gamekeeper’s of Skier’s Thumb)

Answer 44

Thumb Instability

Question 45

Wrist & Hand Assessment

Watson Scaphoid Test (Scaphoid Instability)

Answer 45

Scapholunate Instability

Question 46

Wrist & Hand Assessment

Ulnomeniscotriquestral Dorsal Glide or Piano Key Test (TFCC Tear or Triquetral Instability)

Answer 46

Ulnomeniscotriquetral Instability