Wrist

Question 1

Normal Ranges of Motion

Answer 1

Flexion: 80-90
Extension: 70
Radial Deviation: 20
Ulnar Deviation: 30-50
Pronation: 90
Supination: 90

Question 2

PROM End Range Feels

Question 3

Palpation Structures

Answer 3

Scaphoid (Extend and abduct, note tendon on top is extensor policis, one on bottom is abductor policis longus; pull thumb up and feel scaphoid between tendons below thumb)
Ulnar styloid process (bump on ulnar side and palpate largest point)
Radial Styloid Process (bump on radial side and palpate largest point)
Proximal carpal row (palmar hand, trapezium is under thumb)
Thenar eminence (meaty portion under thumb on palmar side)
Hypothenar (meaty portion on pinky side)
TFCC (Media side on palmar side base of wrist)
Extensor tendons (Extend wrist and resist against to see tendons pop up)
Flexor tendons (Flex hand and resist against to see tendons pop up)
Radial pulse (on radial side beside tendons along styloid process, feel lightly with fingers for pulse)

Question 4

Wrist Flexion

Answer 4

AROM: Elbows bent at 90 degrees palms up, “Keeping your elbows stuck to your side, Can you please bring the palms of your hands towards your chest as far as you can”
PROM: Elbow bent at 90 degrees, palms up, stabilize above wrist and thumb (Take fingers out of it), cup hand and pull into flexion
RROM: Elbow bent at 90 degrees, palms up, stabilize above wrist and thumb, flat hand onto of their mid palm and ask them to resist and flex hand upwards

Question 5

Wrist Extension

Answer 5

AROM: Elbows bent at 90 degrees palms up, “Keeping your elbows stuck to your side, Can you please bring the palms of your hands towards the front of the room as you can so your fingertips point downwards”
PROM: Elbow bent at 90 degrees, palms up, stabilize above wrist and thumb, cup hand and pull into extension
RROM: Elbow bent at 90 degrees, palms up, stabilize above wrist and thumb, flat hand onto of their posterior mid palm and ask them to resist and extend hand backwards

Question 6

Radial Deviation

Answer 6

AROM: Elbows bent at 90 degrees, palms upwards “Keeping your elbows to your sides, Can your please turn your your thumbs outwards to the back wall as far as you can”
PROM: Elbow bent at 90 degrees, palms up, stabilize above wrist and thumb, cup hand and pull hand to radial side
RROM: Elbow bent at 90 degrees, palms up, stabilize above wrist and thumb, flat hand onto of their thumb side hand mid palm and ask them to resist and push thumb into my palm

Question 7

Ulnar Deviation

Answer 7

AROM: Elbows bent at 90 degrees, palms upwards, “Keeping your elbows to your side, Can you please bring your pinkies towards your chest as far as you can”
PROM: Elbow bent at 90 degrees, palms up, stabilize above wrist and thumb, cup hand and pull hand to ulnar side
RROM: Elbow bent at 90 degrees, palms up, stabilize above wrist and thumb, cup pinky side of their hand hand and ask them to resist and push pinky side into my hand

Question 8

Wrist Pronation

Answer 8

AROM: Seated with hands at sides and elbows bent 90 degrees, palms inwards and thumbs up, “Can you rotate your palms to the ground as far as you can”
PROM: Elbow bent at 90 degrees, palms up, stabilize above wrist, handshake with other hand and turn hand into pronation
RROM: Elbow bent at 90 degrees, palms up, stabilize above wrist, handshake with other hand and ask them to resist your supination

Question 9

Wrist Supination

Answer 9

AROM: Seated with hands at sides and elbows bent 90 degrees, palms inwards and thumbs up, “Can you rotate your palms to the ceiling as far as you can”
PROM: Elbow bent at 90 degrees, palms up, stabilize above wrist, handshake with other hand and turn hand into supination
RROM: Elbow bent at 90 degrees, palms up, stabilize above wrist, handshake with other hand and ask them to resist your pronation

Question 10

MMT: Flexor digitorum superficialis VS Flexor digitorum profundus

Answer 10

“Superficialis splits in two so profundus can go right through”

SUPERFICIALIS
-Elbows bent 90 degrees
-Palm flat and facing upwards
-Fingers flexed
-Push on their fingers with your hand/try to straighten them and ask them to resist

PROFUNDUS
-Elbows bent 90 degrees
-Palm flat and facing upwards
-Fingers flexed at ITP
-Push on their fingers with your 1-2 fingers/try to straighten them and ask them to resist