Hand And Wrist Examination

Question 1

Components of LOOK in hand and wrist examination

Answer 1

Nails - pitting, onycholysis, infarcts
Skin - bruising, palmar erythema, scars
Wasting - 1st dorsal interossei, thenar and hypothenar eminences
Swelling - heberdens, bouchards, boggy, cystic
Deformity - swan neck, boutonnières, Z thumb, ulnar deviation, subluxation, dupuytrens
Wrist - deformity, swelling, scars
Elbow - rash, nodules, tophi

Question 2

Components of FEEL in hand and wrist examination

Answer 2

Temperature
Wasting - thenar, hypothenar
Dupuytrens
Suffbox tenderness
MCP squeeze - if tender individual bimanual each MCP
PIP bimanual
DIP bimanual
Base of thumb bimanual
Ulnar border
Ulnar head - extensor carpi ulnaris tendonitis (RA)
Radial styloid process - De Quervains tenosynovitis

Question 3

Components of MOVE in the hand and wrist examination

Answer 3

Function - squeeze my fingers (grip strength), touch thumb to all fingers, pick up small object
Make a fist
Straighten fingers
Spread fingers
Thumb - abduction, adduction, flexion, extension, opposition

Joint above (wrist);
Reverse prayer - flexion
Prayer - extension
Radial and ulnar deviation
Pronation and supination

Question 4

Components of NEUROVASCULAR component of hand and wrist examination

Answer 4

Resisted wrist extension - radial nerve
Resisted little finger abduction - ulnar nerve
Resisted thumb opposition - median nerve

Sensation

Cap refill
Radial pulse
Ulnar pulse
Allens test

Question 5

Which nerve does resisted wrist extension test

Answer 5

Radial

Question 6

Which nerve does resister little finger abduction test

Answer 6

Ulnar nerve

Question 7

Which nerve does resisted thumb opposition test

Answer 7

Median

Question 8

SPECIAL TESTS in hand and wrist examination

Answer 8

Phalens - hold reverse prayer - carpel tunnel syndrome

Froments - paper between thumb and index finger - ulnar nerve palsy

Question 9

Which areas of the hand does the median nerve provide sensation to

Answer 9

Palmar - thumb and two and a half fingers and that whole half of the palm including thenar eminence

Dorsal - distal to PIP of two and a half finger

Question 10

Which areas of the hand does the ulnar nerve provide sensation to

Answer 10

Palmar and dorsal - little finger and half of the 4th and that whole part of the palm on both sides

Question 11

Which areas of the hand does the radial nerve provide sensation to

Answer 11

Dorsal only - thumb and two and a half fingers and that half of hand

Question 12

Radial nerve roots

Answer 12

C5-T1

Question 13

Median nerve roots

Answer 13

C6-T1

Question 14

Ulnar nerve roots

Answer 14

C8-T1