Wrist Special tests Flashcards
what are the tests for carpal tunnel syndrome?
phalen test
reverse phalen test
carpel tunnel compression test
tinel test
what is the phalen test a test for?
carpal tunnel syndrome
how is the phalen test performed?
press the backs of the hands against each other for 60 seconds
what is a positive phalen test?
reproduction of pain/paresthesia in median nerve distribution
what is the reverse phalen test a test for?
carpal tunnel syndrome
how is the reverse phalen test performed?
press the palms against each other (prayer hands) for 60 seconds
what is a positive reverse phalen test?
reproduction of pain/paresthesia in median nerve distribution
what is the carpal tunnel compression test a test for?
carpal tunnel syndrome
how is the carpal tunnel compression test performed?
apply compression to the carpal tunnel with your thumbs with their hand in supination for 30 seconds
what is a positive carpal tunnel compression test?
reproduction of pain/paresthesia in median nerve distribution
what is the tinel test a test for in the wrist?
carpal tunnel syndrome OR tunnel of guyon
how is the tinel test performed?
tap on the carpal tunnel and span the pisiform to the radial side of the wrist
what is a positive tinel test for carpal tunnel syndrome?
pain/paresthesia in digits 2-3 and thumb
what is a positive tinel test for tunnel of guyon?
pain/paresthesia in the dorsum of digits 4-5
what are the tests for ulnar nerve dysfxn?
froment sign
wartenburg sign
what is the froment sign a test of?
ulnar nerve dysfxn
how do we test for froment sign?
have the pt grasp a piece of paper in the webbing of the hand and try to pull it away
what is a positive froment sign?
can’t hold the paper or flexes the DIP from weakness of the adductor pollicus
what is wartenburg sign a test for?
ulnar nerve dysfxn
how do we test for wartenburg sign?
put the pinky into abduction and see if the pt can hold it there
OR bring the pinky into abduction and resist adduction
what is a positive wartenburg sign?
can’t bring pinky into adduction or when adducting the fingers, the pinky drifts out into abduction
what are the tests for TFCC syndrome?
TFCC load test
TFCC stress test
grip rotatory impaction test (GRIT)
what is the TFCC load test a test for?
TFCC syndrome
how is the TFCC load test performed?
put the pt’s hand into UD and apply axial compression through the ulna
what is a positive TFCC load test?
pain in the ulnar side of the wrist
what is the TFCC stress test for?
TFCC syndrome
how is the TFCC stress test performed?
have the pt in a chair with armrests and push their hands into the armrests to lift themselves up a little putting the wrist in UD with compression
what is the GRIT a test for?
TFCC syndrome
how is the GRIT performed?
have the pt grip the grip dynamometer in pronation and supination and note the strength in each position
what is a positive TFCC load test?
pain in the ulnar side of the wrist
what is a positive TFCC stress test?
pain in the ulnar side of the wrist
what is a positive GRIT?
grip strength in supination>grip strength in pronation
what is the Watson scaphoid instability test a test for?
intercarpal instability
how is the Watson scaphoid instability test performed?
bring the pt’s wrist into UD and extension then RD and flexion while applying pressure to the scaphoid
what is a positive Watson scaphoid instability test?
subluxation or pain
what is the axial loading test a test for?
scaphoid fracture
how is the axial loading test performed?
stabilize the first metacarpal and apply axial compression through the first CMC
what is a positive axial loading test?
pain
what is the Murphy sign a test for?
lunate dislocation
how do we test for the Murphy sign?
have the pt make a fist and observe the position of the knuckles
what is a positive Murphy sign?
third digit MCP in line with the others or depressed
what is the Bunnel-Littler test a test for?
intrinsic tightness or PIP capsular tightness
how is the Bunnel-Littler test performed?
hold the pt’s MCP in extension while you flex the PIP noting the available ROM, then flex the MCP and PIP and note the available ROM
what is a positive Bunnel-Littler test for PIP capsular tightness?
no change in ROM with MCP flexion vs extension
what is a positive Bunnel-Littler test for intrinsic tightness?
less motion with MCP flexion than extension
what is Finkelstein test a test for?
DeQuervain’s tenosynovitis
how is the Finkelstein test performed?
have the pt make a fist with the thumb tucked and carefully and slowly UD
what is a positive Finkelstein test?
pain with UD
