Hand and Wrist Evaluation

Ms. Bowman

Anatomy Review

Anatomy Review Articulations:

• Metacarpophalangeal joints• Carpometacarpal joints• Intermetacarpal joints• Intercarpal joints• Radiocarpal joints• Distal Radioulnar joint

Anatomy ReviewIntrinsic Muscles Extrinsic Muscles

Anatomy Review Nerves of the hand:

• Radial• Median• Ulnar

History Location of Pain MOI

Sounds and Sensations (Rice Crispies) Duration of Symptoms Description of Symptoms/Pain

• aching, throbbing, sharp, dull, burning, numbness, tingling

Previous history General medical health

• arthritis, vascularization issues

Inspection Posture Deformity Edema Cuts or scars Alignment Cysts Skin and fingernails

PalpationBones Radius Radial Styloid

Process Ulna Ulnar Styloid

Process Carpal Bones Metacarpals Phalanges

Soft Tissue Thenar eminence Central

compartment Hypothenar

eminence Webspace Collateral IP

ligaments

ROM TestsWrist

Flexion Extension Ulnar Deviation Radial Deviation

Finger Flexion Extension Abduction Adduction

Thumb also has opposition.

Ligamentous Tests Valgus/Varus Stress Test of

Radiocarpal joint Glide testing of the wrist Valgus/Varus Stress Test of the IP

joints Ulnar Colleral Ligament of the thumb

Neurological Tests Radial Nerve Median Nerve Ulnar Nerve

Upper Quarter Screen (will learn with shoulder)

Special Tests Phalen’s Test Finkelstein Test Tap Test Compression Test Tinel’s Sign Murphy’s Sign