Wrist & Hand - Motion Palpation

Question 1

Flexion & Extension of the Carpal
Patient Position?
Practitioner Position?
Primary Contact?
Secondary Contact?
Motion Palpation?

Answer 1

Patient Position - Supine, homolateral side of couch slightly flexed, wrist pronated
Practitioner Position - Facing cephalad
Primary Contact - Pincer grip between thumb on individual carpal
Secondary Contact - Other side of wrist with firm thenar pad contact
Motion Palpation - Pre position wrist into flexion or extension, apply slight traction then A-P, P-A glide. Move to adjoining carpal and apply same motions

Question 2

Inferior Radioulnar Joint
Patient Position?
Practitioner Position?
Contacts?
Motion Palpation?

Answer 2

Patient Position - Supine, contralateral side. Forearm pronated resting on couch
Practitioner Position - Facing cephalad
Contacts - Dorsal aspect of distal radius and ulnar. Crooked index
Motion Palpation - A-P push pull against the couch

Question 3

Radial and Ulnar Radiocarpal Joint
Patient Position?
Practitioner Position?
Contacts?
Motion Palpation?

Answer 3

Patient Position - Supine. Forearm pronated.
Practitioner Position - Homolateral side of couch facing cephalad
Contacts - Index contact distal to the styloids on both sides
Motion Palpation - Radial and ulnar deviation

Question 4

Long Axis Extension
Patient Position?
Practitioner Position?
Primary Contact?
Secondary Contact?
Motion Palpation?

Answer 4

Patient Position - Supine. Forearm pronated against couch
Practitioner Position - Facing transverse
Primary Contact - Index finger and thumb around radiocarpal joint
Secondary Contact - Other hand directly adjacent same contact. Then squeeze index fingers in
Motion Palpation - Separate creating long axis extension

Question 5

Metacarpo-Trapezium Joint
Patient Position?
Practitioner Position?
Primary Contact?
Secondary Contact?
Motion Palpation?

Answer 5

Patient Position - Supine. Slight flexion of arm. Semi supinated hand laying against practitioner waist
Practitioner Position - Homolateral side facing transverse
Primary Contact - Cephalad hand contacts trapezium with pincer grip
Secondary Contact - Crooked index supporting first metacarpal and creating slight traction
Motion Palpation - A-P, P-A

Question 6

Metacarpophalangeal & Interphalangeal Joints
Patient Position?
Practitioner Position?
Contacts?
Motion Palpation?

Answer 6

Patient Position - Supine, hand pronated resting against practitioner waist
Practitioner Position - Homolateral side facing transverse
Contacts - Either side of joint being tested e.g MCP, PIP or DIP
Motion Palpation - Traction before every movement then
Long axis extension
Internal and external rotation
Medial and lateral glide (shear)
Anterior (A-P) and posterior (P-A) glide (shear)
Then same on the other side before moving to next joint