Wrist and Hand

Question 1

Bony Palpation

Answer 1

Radial styloid process, Scaphoid(Navicular), Listers Tubercle(Dorsal tubercle), Lunate, Capitate, Trapezoid, Trapezium, Ulnar styloid process, Triquetrum, Pisiform, Hook of hamate, Metacarpals, and Phalanges.

Question 2

Soft Tissue Palpation

Answer 2

Radial artery, Ulnar artery, Palmaris Longus Tendon, Palmar Aponeurosis, Carpal tunnel region, Thenar eminence, Hypothenar eminence, Tissue surrounding proximal interphalangeal joints, Tissue surrounding distal interphalangeal joints, distal tufts of fingers.

Question 3

Tinel Wrist Sign

Answer 3

Positive: Reproduction of pain, tenderness and paresthesia in the median nerve distribution area(fingers 2, 3, and lateral half of 4).
Indicates: Median Neuritis and possibly carpal tunnel syndrome.

Question 4

Phalen Sign AND Reverse Phalen Sign AKA Prayer Sign

Answer 4

Positve: Reproduction of pain and/or paresthesia down the median nerve distribution area(fingers 2, 3, and lateral half of 4).
Indicates: Median neuritis and possibly carpal tunnel syndrome.

Question 5

Finkelstein Test

Answer 5

Positive: Pain distal to the radial styloid process.
Indicates: Stenosing Tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons(also know as DeQuervain’s Disease).

Question 6

Bunnel-Littler Test

Answer 6

Positive: Flexion of the PIP joint can’t be achieved
Indicates: Joint capsule contracture.
Positive: Flexion of the PIP joint is achieved
Indicates: Tight intrinsic muscles.

Question 7

Retinacular Test

Answer 7

Positive: Flexion of the DIP joint can’t be achieved.
Indicates: Joint capsule contracture.
Positive: Flexion of the DIP joint is achieved.
Indicates: Tight retinacular ligament.

Question 8

Allen Test

Answer 8

Positive: A delay of more than 10 seconds(Evan’s 5 sec.) of reddish color returning to the hand.
Indicates: Radial or Ulnar artery insufficiency. The artery held by the examiner is not the artery being tested.