Rec and Care: Clinical Lab Exam 2: Wrist/Hand/Thumb

Bony anatomy: distal radius

thumb, soft divet, medial

Bony anatomy: ulna

lateral, on the pinky side

Bony anatomy: 8 carpal bones

two rows of four

Bony anatomy: 14 phalanges

three in fingers, only two in thumb

Bony anatomy: radial styloid

Bony anatomy: ulnar styloid

Bony anatomy: listers tubercle

top of wrist on radius, little bump of bone that points out , landmark for the lunate

Bony anatomy: hook of hamate

pull up, find pisiform , draw line towards web space , of thumb, there is a flat space , bone comes up like a hook

Bony anatomy: scaphoid

pull thumb - anatomical snuffbox , bone underneat

Bony anatomy: capitate

bone in divet space, middle of wrist , lunate grinds over this bone

Bony anatomy: lunate

commonly dislocated

Bony anatomy: pisiform

palm up, pinky side, above radius

Bony anatomy: thenar eminance

put pinky and thumb together, and the meaty parts of wrist that stick up on the thumb side

Bony anatomy: hypothenar eminance

put pinky and thumb together, meaty part on the pinky side

articular anatomy: radial-carpal joints

most proximal joint, line across the radius and ulna just above the carpal bones

articular anatomy: mid-carpal joints

between the two rows of four carpal bones , middle of wrist , distal to the radial-carpal joints

articular anatomy: carpal-metacarpal joints

between the wrist and the finger bones, middle of the hand, distal to the mid-carpal joints

articular anatomy: metacarpal-phalangeal joints

along the first knuckle, last joint on the hand before moving onto the fingers

articular anatomy: proximal interphalangeal joints

second knuckle, in the middle of the fingers, distal to the meta-carpal phalangeal joints

articular anatomy: distal interphalangeal joints

the fingertip knuckles, dont have on the thumb

muscular anatomy: flexion - common flexor origin

muscular anatomy: extension - common extensor origin

muscular anatomy: extension - extensor pollicus longus

muscular anatomy: extension - extensor pollicus brevis

muscular anatomy:ulnar deviation

muscular anatomy: radial deviation

muscular anatomy: supination

muscular anatomy: pronation

muscular anatomy: circumduction

muscle testing: flexor digitorium superficialis

flexes digits, quite superficial
MMT: resist at proximal phalanx, block at wrist

muscle testing: flexor digitorium profundus

flexes fingertips, deepm
MMT: hook fingertips with theirs

muscle testing: flexor carpi radialis

flexes the carpals , make a fist, and radially deviate. Two tendons on the lateral side
MMT: straight arm, cock wrist up, resist on the thenar eminence; radial side

muscle testing: flexor carpi ulnaris

flexes wrist, ulnar side, push on the ulnar side
MMT: fly fish muscle, cock wrist up and resist on the ulnar side, hypothenar eminence

muscle testing: palmaris longus

thumb to pinky, and flip wrist up, tendon that sticks out, tendon brings fingers together and flexes wrist
MMT: put hand in upward position, resist on both sides on each eminence

muscle testing: flexor pollicus longus

hook thumb, flexes thumb, deep on the inside
MMT: shake hands, push thumb down on hand, or can hook thumb and resist

muscle testing: extensor digitorium

bend at the proximal phalange joint, it will pop out on the top of hand; extends fingers
MMT: push down at the PIP, palm downwards, resist against

muscle testing: extensor carpi radialis longus

band of tissue, extend wrist, radial side, reverse wrist curls
MMT: resist on radial side, extend arm

muscle testing: extensor carpi radialis brevis

extend wrist, bent elbow
MMT: resist on radial side, and bent elbow

muscle testing: extensor carpi ulnaris

same as the ECRL on the ulnar side, over the top of the styloid, with full extension
MMT: extend wrist, resist ulnar side, hand in fist

muscle testing: extensor digiti minimi

pinky's up, extends just the pinky
MMT: resist pinky up, lots of grip strength in pinky

muscle testing: extensor pollicus longus

tendon, border for snuff box, lateral side, lifting of thumb
MMT: thumb up and push at the end

muscle testing: extensor pollicus brevis

tendon,border for snuff box , lifting of thumb , medial side
MMT: thumb up and push at the PIP

Special testing: Tinel's sign

for carpal tunnel, tap between the eminances

Special testing: Phalens

to compress/provoke carpal tunnel
put the backs of the hands together and push for 30-60 seconds. If hands start to go to sleep, then positive

Special testing: Finkelstein

Thumb extension, tendonitis
-thumb into hand, ulnar deviation