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Hand Examination

MusculoskeletalYear 3

The hand station tests whether you can separate rheumatoid from osteoarthritis and localise a nerve lesion. This checklist covers deformities, function, and the three-nerve motor and sensory screen.

Marking points
55
Run-through
~14m
Progress
Saved on your device only
1

Introduction

0/8
2

Look

0/9

  • Clue to nerve or tendon damage

  • Thenar vs hypothenar eminence, small muscles of hand

  • Diffuse vs localised (subcutaneous tissue, tendon sheath, joint)

3

Feel

0/7

  • Use back of hands, compare sides

4

Move

0/18

      • FDS/FDP/lumbricals

      • ED (+ EDM little finger)

      • Dorsal interossei

      • Palmar interossei

      • Flexor pollicis brevis

      • Abductor pollicis brevis

      • Adductor pollicis

      • Opponens pollicis

    • Squeeze examiner's fingers

    • Hold piece of paper in 2nd web space and resist removal

5

Sensation

0/3

  • C8/T1: Hypothenar, ulnar 1/3 palm, ulnar 1½ fingers palmar and dorsal

  • C5-T1: Thenar, radial 2/3 palm, radial 3½ fingers palmar, distal dorsal radial 3½ fingers

  • C5-T1: Radial 2/3 dorsum of hand, proximal dorsal radial 3½ fingers

6

Special tests

0/10

  • Suspect direct flexor tendon injury if unable to flex one or more digits

  • Extend PIPJ with MCPJ held in extension

    • Tap nerve in carpal tunnel to elicit pain in median nerve distribution

    • Hold wrist in flexion for 60 seconds

  • Stabilise 1st MCPJ in 10° flexion, stress thumb radially

  • Stabilise phalanx above IPJ, stress joint with radial then ulnar deviation

0/55

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