Hand and Wrist Examination Checklist Flashcards
(21 cards)
What is the first step in a hand examination?
Greet the patient and confirm their identity.
What should be clarified before proceeding with a hand examination?
Clarify the nature of the task and seek consent to proceed.
What should be checked before examining the hands?
Check for any pre-existing discomfort.
What should be inspected on the palm and dorsum of the hand?
Look for skin changes, nails, deformities, and swelling.
What are signs of steroid use to look for during examination?
Sclerodactyly and scarring.
What deformities should be noted in a hand examination?
Dupuytren’s contracture, mallet finger, gouty tophi, and interphalangeal joint swelling.
What are Bouchard’s nodes and Heberden’s nodes associated with?
Bouchard’s nodes are swelling at PIPJs and Heberden’s nodes are swelling at DIPJs, both associated with osteoarthritis.
What digit deformities are associated with rheumatoid arthritis?
Swan neck deformity, Boutonniere deformities, and Z-shaped thumb.
What muscle wasting should be assessed in the hand?
Interossei, thenar, and hypothenar eminence.
What should be felt for during the examination?
Warmth at the wrist and MCPs, and tenderness in MCPs.
What is the purpose of bimanual palpation of swollen joints?
To assess whether the swelling is synovitic (soft) or bony (hard).
What movements should be assessed in a hand examination?
Finger extension/flexion, finger abduction/adduction, and thumb opposition.
What grips should be assessed for function in rheumatoid arthritis?
Power of pincer grip, fine pinch, chuck or tripod grip, power grip, and hook grip.
What should be checked in a patient with a hand injury?
Capillary refill time, nerve function distal to the injury, and tendon integrity.
What special test is used for suspected Dupuytren’s contracture?
Hueston’s tabletop test.
What should be included in a general examination for rheumatological conditions?
Examine the eyes for episcleritis/scleritis and check for rashes, weight loss, and lymphadenopathy.
What should be done at the conclusion of the hand examination?
Thank the patient, discuss findings, and perform hand hygiene.
What is the Finklestein’s test used for?
To test for suspected De Quervain’s tenosynovitis.
What is the Scaphoid compression test used for?
To test for suspected scaphoid fracture.
What tests are used for suspected Carpal Tunnel Syndrome?
Tinnel’s, Durkan’s, and Phalen’s tests.
What indicates a positive result in Tinnel’s, Durkan’s, and Phalen’s tests?
Pain, altered sensation, or paraesthesia in the median nerve distribution.
