A 42-year-old male is admitted to the ICU for septic shock and hypotension. Vital signs include heart rate of 115 beats/min, respiratory rate 22 breaths/min, blood pressure of 82/40 mmHg, and oxygen saturation of 88% on 2L nasal cannula. A vasopressor is needed to address this patient’s hypotension.
Prior to placement of an arterial line at the radial artery, which of the following describes the most appropriate diagnostic test?
A. Instruct the patient to flex the elbow to 90 degrees while the physician shakes hands with the patient. The patient is then asked to supinate and the physician provides resistance against supination.
B. Instruct the patient to flex his wrists against one another for 1 minute.
C. Instruct the patient to hold …show more content…
The Phalen test is used to diagnose carpal tunnel syndrome. Carpal tunnel syndrome is caused by compression of the median nerve in the carpal tunnel of the wrist. The median nerve provides sensation to the palmar surface of the first 3 1/2 digits of the hand. Severe cases of carpal tunnel syndrome can also present with wasting of the thenar eminences of the hands. The Phalen test is performed by flexing the patient’s wrists against one another for 1 minute; a positive test elicits paresthesias in the distribution of the median nerve. The reverse Phalen technique is also a test for carpal tunnel syndrome and is performed in a similar fashion to the Phalen test, but with the wrist held in extension instead of in flexion.
Choice “C” is not the best answer. The Finkelstein test is used for de Quervain tenosynovitis—tenosynovitis of the extensor pollicis brevis and abductor pollicis longus tendons of the wrist. To perform this test, the patient is instructed to hold his or her thumb inside the fingers, and then the physician ulnar deviates the patient’s hand. A positive test elicits pain over the extensor pollicis brevis and abductor pollicis longus tendons. The cause of de Quervain tenosynovitis is not firmly established, but is thought to be related to overuse and is also commonly seen during and after
Prior to placement of an arterial line at the radial artery, which of the following describes the most appropriate diagnostic test?
A. Instruct the patient to flex the elbow to 90 degrees while the physician shakes hands with the patient. The patient is then asked to supinate and the physician provides resistance against supination.
B. Instruct the patient to flex his wrists against one another for 1 minute.
C. Instruct the patient to hold …show more content…
The Phalen test is used to diagnose carpal tunnel syndrome. Carpal tunnel syndrome is caused by compression of the median nerve in the carpal tunnel of the wrist. The median nerve provides sensation to the palmar surface of the first 3 1/2 digits of the hand. Severe cases of carpal tunnel syndrome can also present with wasting of the thenar eminences of the hands. The Phalen test is performed by flexing the patient’s wrists against one another for 1 minute; a positive test elicits paresthesias in the distribution of the median nerve. The reverse Phalen technique is also a test for carpal tunnel syndrome and is performed in a similar fashion to the Phalen test, but with the wrist held in extension instead of in flexion.
Choice “C” is not the best answer. The Finkelstein test is used for de Quervain tenosynovitis—tenosynovitis of the extensor pollicis brevis and abductor pollicis longus tendons of the wrist. To perform this test, the patient is instructed to hold his or her thumb inside the fingers, and then the physician ulnar deviates the patient’s hand. A positive test elicits pain over the extensor pollicis brevis and abductor pollicis longus tendons. The cause of de Quervain tenosynovitis is not firmly established, but is thought to be related to overuse and is also commonly seen during and after