Wrist/hand special tests

Question 1

Ulnar collateral ligament instability test position/procedure?

Answer 1

therapist holds the thumb in extension and applies a valgus force to the MCP joint of the thumb

Question 2

(+) thumb UCL test?
- sign
- interpretation

Answer 2

excessive valgus movement of the thumb
may = UCL tear

Question 3

What is Gamekeeper’s thumb?

Answer 3

UCL tear/instability

Question 4

Wrist Allen Test
position/procedure

Answer 4

seated, pt opens and closes the hand several times then keeps hand clsoed, therapist compresses radial and ulnar arteries. Pt relaxes their hand and therapist releases one artery.
Repeat and test the other artery

Question 5

(+) Wrist Allen Test
- sign
- interpretation

Answer 5

• delayed or absent flushing of the hand and fingers of the radial or ulnar distribution
• may = occlusion of the artery

Question 6

Bunnel-Littler Test position/procedure

Answer 6

pt seated with MCP joint held in slight extension
Therapist moves PIP into flexion.
Repeated flexing the PIP with MCP in slight flexion

Question 7

(+) Bunnel-Littler test
- sign
- interpretation

Answer 7

(+) = inability to fully flex PIP
In extension: tight intrinsic muscle or capsular tightness
in flexion: tight intrinsic muscle without capsular tightness

Question 8

Tight Retinacular ligament test
position
procedure

Answer 8

PIP in neutral position while therapist flexes the DIP. Repeat with PIP in flexion

Question 9

tight retinacular ligament test (+)
- sign
- interpretation

Answer 9

(+) = inability to flex DIP
W/ PIP in neutral: retinacular or capsular ligaments may be tight
w/ PIP in flexion: tight retinacular ligaments and normal capsule

Question 10

Test position/procedure for Carpal Compression Test

Answer 10

hold pressure over the median nerve in the carpal tunnel for 30 sec

Question 11

(+) for carpal compression test?

Answer 11

paresthesia or pain in median nerve distribution

Question 12

Test position for Froment’s Sign

Answer 12

patient holds a paper between the thumb and index, Therapist pulls away

Question 13

(+) Froment’s sign
- sign
- interpretation

Answer 13

pt flexes the distal phalanx of the thumb due to adductor pollicis muscle paralysis
Froment’s + Jeanne’s = ulnar nerve compression or paralysis

Question 14

What is the Jeanne’s Sign?

Answer 14

hyperextension of MCP joint of the thumb during Froment’s sign test

Question 15

Phalen’s test position/procedure

Answer 15

Pt holds wrists maximally flexed for 60 seconds

Question 16

(+) Phalen’s Test
- sign
- interpretation

Answer 16

• pain or paresthesia in median nerve distribution
• median nerve compression

Question 17

Finkelstein Test procedure/position

Answer 17

-Pt tucks thumb inside a fist
- Therapist stabilizes pt’s FA and UD the wrist

Question 18

(+) Finkelstein Test
- sign
- interpretation

Answer 18

(+) = pain over the abductor pollicis longus and extensor pollicis brevis
- de Quervain’s disease

Question 19

Murphy sign

Answer 19

3rd metacarpal remains level with 2nd and 4th metacarpals
May = lunar dislocation