Wrist Hand Lab

Question 1

how many bones in the hand

Answer 1

29

Question 2

what are the 4 powergrips

Answer 2

hook
cylindrical
spherical
fist

Question 3

what are the 3 precision grips

Answer 3

tip pinch

lateral/key pinch

chuck or three fingered pinch

Question 4

T or F: Even with injuries a bell shaped curve should still be evident on grip dynomometer

Answer 4

T

Question 5

how much discrepancy is normal side to side on the grip dyno

Answer 5

10%

Question 6

how should we utilize the grip dynamometer when testing different patients

Answer 6

utilize in the same position theyd normally do their activity that they need to return to

Question 7

An anterior glide (pushing towards pronation) at the DRUJ improves what

Answer 7

pronation

Question 8

A posterior glide of the DRUJ (pushing towards supination) improves what

Answer 8

Supination

Question 9

what is the loose packed position of the radio-carpal joint

Answer 9

Neutral with slight ulnar deviation

Question 10

Which way do we glide to improve wrist ext at the radio-carpal joint

Answer 10

Anterior (towards palm)

Question 11

Which way do we glide at the radio-carpal joint to improve flexion

Answer 11

Posterior (towards the back of hand)

Question 12

An ulnar/medial glide of the Radio-carpal joint improves what

In what position should we apply it

Answer 12

Radial deviation

start in slight radial deviation before gliding ulnarly

Question 13

A radial/lateral glide of the Radio-carpal joint improves what motion

in what position do we apply it

Answer 13

Ulnar deviation

start in slight ulnar deviation before gliding radially

Question 14

Midcarpal joint play:

Answer 14

also opposite just like radio-carpal!

Question 15

to improve thumb CMC flexion we need to glide _______

Answer 15

medially (same)

Question 16

to improve thumb CMC ext we need to glide _____

Answer 16

radially (same)

Question 17

to improve thumb CMC abduction, we need to glide ______

Answer 17

posteriorly (opposite)

Question 18

to improve thumb adduction we need to glide

Answer 18

anteriorly (Opposite)

Question 19

what carpal connects to the thumb CMC?

Answer 19

trapezium

Question 20

All finger PIP/DIP glides are ______

Answer 20

concave on convex (same)

note: remember that abduction/adduction depends on reference to the 3rd ray

Question 21

How do you perform the test for gamekeepers thumb (thumb ulnar collateral ligament instability)

Answer 21

Flex MCP to 30 and apply a valgus stress at the MCP

testing for excess abduction

Question 22

Pt says “I jammed my finger”

Answer 22

Perform ligamentous instability test for fingers

both varus and valgus stress at each DIP/PIP joint looking for excess laxity

Question 23

How to perform Watson Scaphoid shift test?

Answer 23

Slight pronation

Grip wrist with thumb over scaphoid

Start in Ulnar deviation w/ extension and go around the world (circular motion)

Positive test = sublux or clunk felt w/ pain

Question 24

What special test is for a tear of the scapho-lunate ligament

Answer 24

Watson Scaphoid Shift test

Question 25

How do we perform the ballotement test for lunotriquetral instability

Answer 25

Locate lunate: Follow 3rd metacarpal down Locate triquetrium: fall off of the ulnar head Apply dorsal glide to lunate postivive test = laxity, crepitus, pain

Question 26

What test is for luno-triquetrial instability

Answer 26

ballotment test

Question 27

How do you perform murphy test for lunate dislocation

Answer 27

Check if 3rd metacarpal is LEVEL with the 2 knuckles next to it (It should normally higher than the 2nd and 4th)

Question 28

How do we perform the Piano key sign for TFCC tear?

Answer 28

Push down on ulnar styloid in relation to the pisiform/triquetrium your pointer finger: on palmar side pisiform/triquetrium your thumb: On dorsal side of ulnar head pushing down positive: excess laxity

Question 29

What is the test called for dequervains? What muscles/tendons?

Answer 29

Finkelstein test APL/EPB

Question 30

Please note that B is where dr. arnold wants us to perform the Tinel sign for carpal tunnel and its ONLY POSITIVE if you have paresthesia in the RED regions

Answer 30

If she writes a question that you performed tinels sign and they had parasthesia at the pinky, NOT positive

Question 31

What are the 2 tests for Carpal tunnel

Answer 31

Phalens and reverse phalens hold each for 1 minute

Question 32

What is considered a positive tinels/ positive phalen/ positive reverse phalen

Answer 32

Parasthesia in the 1st finger, 2nd, 3rd, and half of the 4th

Question 33

What is fromment's sign?

Answer 33

Test for ulnar nerve paralysis pt cant stop you form pulling piece of paper with their grip as shown without having flexion at their IP (or MCP joint hyperextension)

Question 34

Pt has blue hand or a cold hand, what test do we perform?

Answer 34

Question 35

What is normal for the allen test

Answer 35

Color to return after 6-10 seconds

Question 36

The Watson test is for what joint

Answer 36

Scaphoid moving on lunate

Question 37

The ballotment test is for what joint

Answer 37

Triquetrium moving on lunate