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Hand and Wrist Evaluation

This guide offers an in-depth overview of the anatomy and evaluation of the hand and wrist, focusing on key articulations, intrinsic and extrinsic muscles, and relevant nerves (radial, median, and ulnar). It outlines important history-taking points, including pain location, duration, and symptoms. The evaluation components include thorough inspection techniques for posture, deformities, and soft tissue examination. Range of motion (ROM) tests and neurological assessments are also covered, along with specific tests such as Phalen's and Finkelstein's, essential for identifying injuries or conditions.

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Hand and Wrist Evaluation

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  1. Hand and Wrist Evaluation Ms. Bowman

  2. Anatomy Review

  3. Anatomy Review • Articulations: • Metacarpophalangeal joints • Carpometacarpal joints • Intermetacarpal joints • Intercarpal joints • Radiocarpal joints • Distal Radioulnar joint

  4. Anatomy Review Intrinsic Muscles Extrinsic Muscles

  5. Anatomy Review • Nerves of the hand: • Radial • Median • Ulnar

  6. History • Location of Pain • MOISounds and Sensations (Rice Crispies) • Duration of Symptoms • Description of Symptoms/Pain • aching, throbbing, sharp, dull, burning, numbness, tingling • Previous history • General medical health • arthritis, vascularization issues

  7. Inspection Posture Deformity Edema Cuts or scars Alignment Cysts Skin and fingernails

  8. Palpation Bones • Radius • Radial Styloid Process • Ulna • Ulnar Styloid Process • Carpal Bones • Metacarpals • Phalanges Soft Tissue • Thenar eminence • Central compartment • Hypothenar eminence • Webspace • Collateral IP ligaments

  9. ROM Tests Wrist • Flexion • Extension • Ulnar Deviation • Radial Deviation Finger • Flexion • Extension • Abduction • Adduction Thumb also has opposition.

  10. Ligamentous Tests Valgus/Varus Stress Test of Radiocarpal joint Glide testing of the wrist Valgus/Varus Stress Test of the IP joints Ulnar Colleral Ligament of the thumb

  11. Neurological Tests Radial Nerve Median Nerve Ulnar Nerve Upper Quarter Screen (will learn with shoulder)

  12. Special Tests Phalen’s Test Finkelstein Test Tap Test Compression Test Tinel’s Sign Murphy’s Sign

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