Wrist/Hand Special Tests

Question 1

Valgus stress test

Answer 1

Tests the Ulnar collateral lig
pt arm supported, elbow flexed 20-30 deg. give valgus force (lat ->med)
med elbow pain/inc valgus movement w/out firm endpoint - damage to UCL

Question 2

Varus Stress test

Answer 2

Tests Radial Collateral Lig
arm supported, elbow flexed 20-30 deg, apply a varus stress (med->lat)
lat elbow pain/ inc varus movement w/out firm endfeel - damage to RCL

Question 3

Tinels Sign

Answer 3

Tests Ulnar Nerve Compromise
arm supported, elbow flexed to 90, tap in the ulnar notch
tingling along ulnar nerve distribution - damage to the nerve

Question 4

Phalens Test

Answer 4

Tests for Carpal Tunnel Syndrome
pt flexes both wrists and pushes dorsal aspect of hands together for 1 min
numbness/tingling in med nerve distribution - CTS

Question 5

Finklesteins Test

Answer 5

Tenosynovitis of AbPL and EPB (first dorsal compartment)
thumb tucked into fist, ulnar deviate
pain along tendons

Question 6

Allens Test

Answer 6

Tests Radial and Ulnar artery occlusion
elbow rests on the plinth, pt holds a fist, compress radial and ulnar arteries. pt opens fist to see blanched hand. release radial artery - see the hand pink up. repeat with releasing ulnar artery
vascular compromise if the hand does not pink up quickly

Question 7

Murphys Sign

Answer 7

Tests for Lunate dislocation
arm on the plinth, pt makes a fist, notice the 3 metacarpal
if the 3 is level with the 2 and 4 metacarpals - dislocation
(3 should be slightly higher)

Question 8

Med/Lat epicondylitis test

Answer 8

arm supported, bring wrist into flex/ext, then passively bring into ext/flex.
lat epicondylitis - resist mid finger ext - ECRB
pain at epicondyle - epicondylitis