Ortho Exams Week 3

Question 1

What are the 4 carpal tunnel tests?

Answer 1

1) phalen’s sign
2) prayer sign
3) tinel’s tap test
4) carpal compression test

Question 2

What causes carpal tunnel?

Answer 2

-repetitive movements of the wrist
-diabetes
-trauma
-fluid retention

Question 3

What is the patient position for phalen’s sign?

Answer 3

seated or standing

Question 4

What test is this?
-have patient flex wrists and bring the dorsum of both hands together
-hold for 1 min

Answer 4

phalen’s sign

Question 5

What is a positive sign for phalen’s sign?

Answer 5

pain/paresthesia along median nerve

Question 6

What does a positive sign for phalen’s sign indicate?

Answer 6

carpal tunnel

Question 7

What is the patient position for prayer sign?

Answer 7

seated or standing

Question 8

What test is this?
-have patient actively extend their wrists and put palms together
-hold for 1min

Answer 8

prayer sign

Question 9

What is a positive sign for prayer sign?

Answer 9

pain/paresthesia along median nerve

Question 10

What does a positive sign for prayer sign indicate?

Answer 10

carpal tunnel syndrome

Question 11

What is the patient position for tinel’s sign/tap?

Answer 11

seated or standing

Question 12

What test is this?
-doctor percusses over flexor retinaculum/ transverse carpal ligament

Answer 12

tinel’s tap

note: percussing over any tunnel that causes pain/paresthesia is considered tinel’s tap/sign

Question 13

What is the patient position for carpal compression?

Answer 13

seated or standing

Question 14

What test is this?
-thumb on thumb compression is placed over the transverse carpal ligament for 30 sec

Answer 14

carpal compression test

Question 15

What is a positive sign for carpal compression test?

Answer 15

pain/paresthesia along median nerve

Question 16

What does a positive sign for carpal compression test indicate?

Answer 16

carpal tunnel syndrome

Question 17

What is the patient position for froment’s paper sign?

Answer 17

seated or standing

Question 18

What test is this?
-with patient’s hand flat and pronated, have patient grasp a piece of paper between fingers and thumb
-instruct patient to hold onto paper as you pull it away

Answer 18

froment’s paper sign

Question 19

What is a positive sign for froment’s paper sign?

Answer 19

patient cannot hold onto paper or flexes IP joint of thumb to do it

Question 20

What does a positive sign for froment’s paper sign indicate?

Answer 20

ulnar nerve paralysis/ involvement

Question 21

What is the patient position for bracelet test?

Answer 21

seated or standing

Question 22

What test is this?
-doctor applies lateral to medial pressure on distal radius and ulnar of both arms at the same time

Answer 22

bracelet test

Question 23

What is a positive sign for bracelet test?

Answer 23

acute forearm and wrist pain bilaterally

Question 24

What test is commonly done along side with labs and xrays to diagnose RA?

Answer 24

bracelet test

Question 25

What is the patient position for finklestein's test?

Answer 25

seated or standing

Question 26

What test is this? -patient is instructed to make a fist around their thumb and actively ulnar deviate -then doctor passively ulnar deviates patient's arm

Answer 26

finklestein's test

Question 27

What is a positive sign for finklestein's test?

Answer 27

pain in anatomical snuff box compared to uninvolved side

Question 28

What does a positive sign for finklestein's test indicate?

Answer 28

de quervain's tenosynovitis/ stenosing tenosynovitis (thickening of tendon sheath) or scaphoid fx

Question 29

What is the patient position for carpal lift test?

Answer 29

seated

Question 30

What test is this? -patient places hand flat on table and doctor stabilizes metacarpals -patient is asked to lift each finger off of the table as doctor resists

Answer 30

carpal lift test

Question 31

What is a positive sign for carpal lift test?

Answer 31

pain

Question 32

What does a positive sign for carpal lift test indicate?

Answer 32

carpal fx or severe sprain

Question 33

What is the patient position for pinch grip test?

Answer 33

seated or standing

Question 34

What test is this? -have patient do OK sign with their fingers

Answer 34

pinch grip test

Question 35

What is a positive sign for pinch grip test?

Answer 35

finger pads instead of tips touch

Question 36

What does a positive sign for pinch grip test indicate?

Answer 36

anterior interossei nerve pressure

Question 37

When do wrists usually become unstable?

Answer 37

from FOOSH injury (fall on outstretched hand)

Question 38

What are the 3 wrist stability tests?

Answer 38

1) watson's test 2) ballottement test 3) mid carpal stability test

Question 39

What is the patient position for watson's test?

Answer 39

seated or standing

Question 40

What test is this? -patient's radius is stabilized while the tubercle of the scaphoid is pushed A->P and the wrist is moved passively between ulnar and radial deviation

Answer 40

watson's test

Question 41

What is a positive sign for watson's test?

Answer 41

painful clunk or catch

Question 42

What does a positive sign for watson's test indicate?

Answer 42

scapholunate instability

Question 43

What is the patient position for ballottement test?

Answer 43

seated or standing

Question 44

What test is this? -doctor stabilizes patient's lunate and pushes on the triquetrum up and down (beneath pisiform)

Answer 44

ballottement test

Question 45

What is a positive sign for ballottement test?

Answer 45

painful clunk or catch

Question 46

What does a positive sign for ballottement test indicate?

Answer 46

lunotriquetral instability

Question 47

What is the patient position for mid carpal stability test?

Answer 47

seated or standing

Question 48

What test is this? -patient's wrist and hand are palm down -while stabilizing the distal forearm, doctor will ulnar deviate patient hand and further pronate hand

Answer 48

mid carpal stability test

Question 49

What is a positive sign for mid carpal stability test?

Answer 49

painful clunk or catch

Question 50

What does a positive sign for mid carpal stability test indicate?

Answer 50

mid carpal instability