Hand Injuries

Question 1

What are the three main components of a hand and wrist examination?

Answer 1

Inspection, palpation, and movement.

Question 2

What should be observed during inspection of the hands?

Answer 2

Muscle wasting, deformities, swellings, scars, rashes, or skin changes.

Question 3

Which muscle bulk is assessed in the hand during inspection?

Answer 3

Thenar and hypothenar eminences, and interossei.

Question 4

What hand deformity is characterized by hyperextension of the PIP joint and flexion of the DIP joint?

Answer 4

Swan neck deformity.

Question 5

What is the typical hand position in a ulnar nerve lesion?

Answer 5

Claw hand.

Question 6

What is Dupuytren’s contracture?

Answer 6

Fibrosis of the palmar fascia causing flexion contracture of the fingers.

Question 7

What does the ‘prayer sign’ indicate?

Answer 7

Limited joint mobility, often due to diabetes.

Question 8

How is active wrist extension tested?

Answer 8

Ask the patient to lift their hand backwards at the wrist.

Question 9

What nerves are assessed during hand sensory examination?

Answer 9

Median, ulnar, and radial nerves.

Question 10

Which test evaluates the function of the ulnar nerve?

Answer 10

Froment’s sign.

Question 11

What is Froment’s sign?

Answer 11

Positive when the thumb flexes at the IP joint during pinch grip, indicating ulnar nerve palsy.

Question 12

What is the purpose of Tinel’s sign?

Answer 12

To test for carpal tunnel syndrome.

Question 13

How is Tinel’s sign performed?

Answer 13

Tap over the carpal tunnel to elicit tingling in median nerve distribution.

Question 14

What does Phalen’s test assess?

Answer 14

Carpal tunnel syndrome.

Question 15

How is Phalen’s test performed?

Answer 15

Patient flexes wrists and holds dorsal surfaces of hands together for 60 seconds.

Question 16

Which movement is lost in radial nerve palsy?

Answer 16

Wrist extension (wrist drop).

Question 17

Which muscles are innervated by the median nerve in the hand?

Answer 17

Thenar muscles and lateral two lumbricals.

Question 18

What is the function of the interossei muscles?

Answer 18

Finger abduction and adduction.

Question 19

What causes ‘Z-thumb’ deformity?

Answer 19

Rheumatoid arthritis.

Question 20

What is the common site of Heberden’s nodes?

Answer 20

Distal interphalangeal joints.

Question 21

What is the common site of Bouchard’s nodes?

Answer 21

Proximal interphalangeal joints.

Question 22

Which deformity is typical in rheumatoid arthritis?

Answer 22

Ulnar deviation of fingers.

Question 23

Which nerve is tested with the OK sign?

Answer 23

Anterior interosseous nerve (branch of median nerve).

Question 24

What is the tenodesis effect?

Answer 24

Passive finger flexion with wrist extension and vice versa.

Question 25

What muscle causes thumb abduction?

Answer 25

Abductor pollicis brevis.

Question 26

What is tested when asking the patient to spread fingers against resistance?

Answer 26

Dorsal interossei (ulnar nerve).

Question 27

Which nerve is responsible for sensation over the dorsal web space of the thumb?

Answer 27

Radial nerve.

Question 28

What joint movements are tested in the fingers?

Answer 28

Flexion, extension, abduction, and adduction.

Question 29

What movement is assessed by touching the thumb to the little finger?

Answer 29

Opposition (median nerve).

Question 30

What condition causes thenar wasting?

Answer 30

Median nerve injury or carpal tunnel syndrome.

Question 31

Which fingers are affected in carpal tunnel syndrome?

Answer 31

Thumb, index, middle, and radial half of ring finger.

Question 32

What is the anatomical snuffbox?

Answer 32

Depression on the lateral wrist bounded by tendons of the thumb.

Question 33

Tenderness in the anatomical snuffbox suggests what injury?

Answer 33

Scaphoid fracture.

Question 34

What causes boutonniere deformity?

Answer 34

Rupture of extensor hood at the PIP joint.

Question 35

What is mallet finger?

Answer 35

Flexion deformity of the DIP joint due to extensor tendon rupture.

Question 36

How is power grip tested?

Answer 36

Ask patient to squeeze examiner’s fingers.

Question 37

Which muscle flexes the distal phalanx of the thumb?

Answer 37

Flexor pollicis longus.

Question 38

Which nerve supplies the hypothenar muscles?

Answer 38

Ulnar nerve.

Question 39

What is the function of the lumbricals?

Answer 39

Flex MCP and extend IP joints.

Question 40

What test assesses median nerve motor function in thumb?

Answer 40

Thumb abduction against resistance.

Question 41

What deformity presents with flexion of PIP and hyperextension of DIP?

Answer 41

Boutonniere deformity.

Question 42

What sign is associated with De Quervain’s tenosynovitis?

Answer 42

Finkelstein’s test.

Question 43

How is Finkelstein’s test performed?

Answer 43

Thumb is grasped and ulnar deviated to elicit pain.

Question 44

What is the function of the radial nerve in the hand?

Answer 44

Wrist and finger extension.

Question 45

What condition presents with loss of thumb opposition?

Answer 45

Median nerve lesion.

Question 46

How is pinch grip tested?

Answer 46

Ask patient to pinch paper between thumb and index finger.

Question 47

What is a ganglion cyst?

Answer 47

Benign fluid-filled swelling often on dorsum of wrist.

Question 48

What causes trigger finger?

Answer 48

Inflammation and narrowing of the flexor tendon sheath.

Question 49

What does the term ‘ulnar drift’ refer to?

Answer 49

Deviation of fingers towards the ulnar side in RA.