Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
16 Cards in this Set
- Front
- Back
|
Observation Wrist |
Deformity, discoloration, arches Atrophy of thenar/hypothenar eminences Lesions (scars, abrasions, burns, Sx wounds)
Color of fingers: Ischemic? Raynaud disease Blotchy, red hand? Liver disease Blue Redness or heat: RA or infectious Neurological deficit |
|
|
Quick Functional Scan |
Fan & fold (open hand & spread fingers) Make a fist (grip) Pinch
Form a ‘O’ with thumb, forefinger |
|
|
ROM |
Wrist: Flexion: 85° Extension: 85° Radial deviation: 15° Ulnar deviation: 30
All: caps EF Patient is sitting at the edge of the plinth with elbows flexed to 90
degrees; when applying OP, always stabilize |
|
|
Finger MCP, PIP, DIP ROM |
Always stabilize proximal bone and move distal MCP Flexion: 85-90° Extension: 30-45° Abduction: 20-30° Adduction: 0° Finger PIP: Flexion: 100-115° Extension: 0° Finger DIP: Flexion: 90° Extension: 10-20° All caps EF except finger MCP add = approximation |
|
|
Radiocarpal joint glide for extension |
Palmar Glide Pt seated, F/A pronated/lying against Rx table & wrist in RP Pht: Standing, close to pt’ hand One hand stabilizes distal radius/ulna close to jt line One hand palp dorsal carpal prox row Apply a ventral glide = extension For ventral glide hand faces down
|
|
|
Radiocarpal glide for flexion |
Dorsal Glide Pt F/A supinated or pronated/lying against Rx table & wrist RP Pht: Standing, close to pt’ hand One hand stabilizes distal radius/ulna, close to jt line Other hand palp ventral carpal prox row Apply a dorsal glide = flexion
use your webspace to push at the joints For dorsal glide: palm face up |
|
|
Radiocarpal glide for ulnar deviation |
Radial Glide Pt seated, Radial side F/A lying against Rx table & wrist RP Pht: Standing, close to pt’ hand One hand stabilizes distal RU jt, close to jt line Other hand palp ulnar side prox carpal row Apply a radial glide = ulnar deviation
|
|
|
Radiocarpal joint for radial glide |
Ulnar glide Pt seated, Ulnar side F/A lying against Rx table & wrist RP Pht: Standing, close to pt’ hand One hand stabilizes distal RU jt close to jt line Other hand palp prox carpal row Apply a ulnar glide = radial deviation
|
|
|
Traction and compression Radiocarpal joint |
Traction & Compression Pt: Seated with F/A pronated & wrist in resting position Pht: Standing, facing ulnar side of pt’ F/A One hand stabilizes distal radius/ulna close to jt line
Other hand palp carpal prox row Traction: Apply a longitudinal pull along line of radius/ulnar
Compression: Apply a longitudinal compression along R&U |
|
|
Wrist Radial Collateral ligament RCL |
Pt: wrist in ext (just out of CPP) Pht: Prox hand: Fixes distal radius/ulna Caudal hand: grasps prox row of carpal bones Stress RCL with ulnar deviation & radial gapping For proximal and distal radioulnar ligaments: Palpate distal RU joint; put thumb and index fingers on either side of the joint; put hand on palm, bring into passive extension then apply axial load --> push directly down towards the plinth; make sure you apply compression at the JOINT; you feel with your other hand if their splaying of the bone --> Testing the distal and proximal radioulnar ligaments (the palmar and dorsal portions) You're doing gapping = you're trying to break the biscuit; similar to the
ankles |
|
|
Wrist Ulnar Collateral Ligament (UCL): |
Pt: wrist in ext (just out of CPP)
Pht: Prox hand: Fixes distal radius/ulna Caudal hand: grasps prox row of carpal bones Stress UCL with radial deviation & ulnar gapping
Same positioning than RCL, but you are doing a radial deviation and a gap |
|
|
MCP Collateral Ligament: |
Pt: MCP in full flex (just out of CPP) Pht: Prox hand: Fixes head MC Caudal hand: grasps base prox phalanx MCP Radial Collateral Lig (RCL): Stress: gap radially prox phalanx MCP Ulnar Collateral Lig (UCL): Stress: gap ulnarly prox phalanx |
|
|
IP Collateral Ligament |
Pt: IP in full extension (just out of CPP)
Pht: Prox hand: Fixes head IP Caudal hand: grasps base proximal phalanx IP Radial Collateral Lig (RCL): Stress: gap radially prox phalanx IP Ulnar Collateral Lig (UCL):Stress: gap ulnarly prox phalanx |
|
|
IP Collateral ligament |
Pt: IP in full extension (just out of CPP)
Pht: Prox hand: Fixes head IP Caudal hand: grasps base proximal phalanx IP Radial Collateral Lig (RCL): Stress: gap radially prox phalanx IP Ulnar Collateral Lig (UCL):Stress: gap ulnarly prox phalanx |
|
|
Finkelstein |
Pt makes a fist with thumb tucked inside the fingers Pht: Ulnar deviates wrist with extension
(+)ve: Pain over APL & EPB at the wrist |
|
|
Palpation |
Carpals - Pisiform - Triquetrum: Palm facing down; locate styloid process of ulna, go over the ditch to the triquetrum; bone disappears upon adduction - Hamate: Draw line from the pisiform to the index finger; go along that line, you will find the hook of the hamate - Scaphoid: Locate radius’ styloid process then go distally; disappears upon abduction - Trapezium: Locate the scaphoid then slide distally
- Lunate and capitate: Draw a line from lister’s tubercle to the base of the 3rd MC; extend wrist and go distally, you should fall into cavity; then flex wrist= lunate will press into your fingers; slightly distal is the capitate |
