An example of a perfect hand examination for OSCE/ISCEs for medical students, or in clinical practice for junior doctors. Step-by-step guide covering an examination, including sensation, dermatomes and special tests. Ideal for arthritis, Parkinson's, Carpal Tunnel Syndrome and other hand-related pa...
Are the findings symmetrical? Any particular joint affected?
2. Feel
- Palms = thenar and hypothenar eminence
- Sensation = ulnar, median, radial sensation
- Temperature change = Raynaud’s syndrome
- Palpate every finger joint – any synovitis
- Palpate wrist and elbow?
3. Movements
- Make a fist
- Straighten fingers
- (30secs) Prayer test – test for flexion deformities
- (30secs) Phalen’s test – backs of hands together like upside-down prayer – test for carpal tunnel syndrome
- Median nerve function = abduct thumb
- Ulnar nerve function = spread fingers
4. Function
- Assess grip strength in fist
- Ask patient to touch every finger to thumb
- Ask patient to write name/do button/pick up small object
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