Examination Of The Hand, Tests - Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубликовано: 20 фев 2013
- Dr. Ebraheim’s educational animated video describes examination test of the hand.
Adequate evaluation of the hand is necessary for the management of hand and wrist conditions or injury. Knowledge of certain specific tests will help the clinician to reach the correct diagnosis and provide adequate treatment. These are some of the most useful tests that are used frequently for evaluation of wrist and hand conditions.
De Quervain's syndrome: inflammation of the sheath or tunnel that surrounds the two tendons that control movement of the thumb.
Finklestein’s test: the patient makes a fist with the fingers closed over the thumb and the wrist is bent towards the little finger. The hand is pulled so that the involved tendon is stretched, causing a sharp, local pain if injury and inflammation are present.
What is carpal tunnel syndrome? Pressure placed on the median nerve due to thickening of the transverse carpal ligament. Can lead to numbness, tingling or weakness of the hand and fingers.
Tinel’s test: the tinel’s test is used to determine symptoms of carpal tunnel syndrome. The test is considered positive if symptoms of tingling worsen while tapping on the median nerve at the wrist.
•Pahlen’s test: the Phalen’s maneuver is a diagnostic test performed to determine if the patient has CTS. The back of the hands are pressed together, compressing the nerve, which may cause symptoms of CTS.
•Froment’s test: the Froment's test is used to test for palsy of the ulnar nerve which may occur with entrapment of the ulnar nerve within the cutibal tunnel.
What is cubital tunnel syndrome? Occurs due to compression of the ulnar nerve at the elbow.
Froment’s test: when pinching a piece of paper between the thumb and index finger, the thumb IP joint will flex if the adductor pollicis muscle is weak due to ulnar nerve palsy.
•The OK sign is used to check for paralysis of the anterior interosseous nerve due to entrapment or compression injury.
This nerve is a branch of the median nerve that innervates the muscles of the deep group of the anterior compartment of the forearm. Patients with paralysis of the anterior interosseous nerve will unable to make the OK sign.
•Wrist drop: condition of the hand and wrist that determines the presence of radial nerve injury.
•The Allen's test: The examiner applies pressure with the thumbs occluding the ulnar and radial arteries. Patient is asked to make a fist. Patient is then asked to open the hand. When the examiner releases the ulnar artery, the patient;s ulnar artery will cause blood flow to the hand.
What is basal thumb arthritis? Arthritis affecting the thumb joint .
Grind test: by axial loading, pushing and rotating the thumb metacarpal bone, grinding may be felt within the joint.
•Watson’s test: also called the scaphoid shift test, it is diagnostic test used to evaluate scaphoid stability. The examiner places a thumb over the patient’s scaphoid tuberosity which is the distal pole of the scaphoid on the volar surface. The other fingers of the examiner’s same hand are placed dorsally above the radius. The patient’s wrist is placed initially into an ulnar deviation and the examiner's other hand deviates the wrist radially and flexes it slightly. With pressure on the tuberosity of the scaphoid, the scaphoid is pushed dorsally out of the radial fossa. If there is instability of the scaphoid, the test will be positive and produce pain and a “clunk”.
•Lumbrical plus finger: caused by laceration of the flexor digitorum profundus distal to the origin of the lumbricals. Lumbrical is tighter than FDP. Most common in the middle finger. With injury of the flexor digitorum profundus tendon, the patient is unable to maintain the grip when the examiner releases the finger.
•Testing the integrity of the flexor tendon: keep the PIP of the finger extended and see if the patient can flex the DIP. Keep the other fingers extended and then see if the patient can flex the PIP joint of the involved finger. When multiple slips of the superficialis tendon are cut, identify the tendon properly. The superficial tendon of the long and ring fingers are volar at the wrist.
•Bunnell test
•Elson’s test: used to determine if the patient has a central slip tear before the deformity is present.
•When holding a relaxed cascade, the fingers should normally point towards the region of the scaphoid. Malrotation of the finger will causes the affected finger to deviate from its normal rotational direction. Malrotation is especially important with finger metacarpal fractures.
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Fiklestein's Test 0:33
Tinel's Test 1:17
Phalen's test 2:11
Froment's test 2:23 - Cubital Tunnel syndrome - Ulnar N
OK Sign 3:19 - Ant Interosseous N (branch of Med N)
Wrist drop 3:56 - Radial N palsy
Hitch hike sign 4:29 - Post interosseous N (branch of Radial N)
Allen's Test 4:54 - Volar Ganglion n Arterial circulation
Grind Test 5:31 - Basal thumb arthritis
Watson's test 6:10 - Instability btw Scaphoid n Lunate
Parodoxical Ext. of IP - attempted finger flexion (lumbrical plus finger) 7:02 - Presence of of laceration of the flexor digitorum profundus distal to the origin of the lumbricals
Testing the integrity of the flexor tendons
- Flexor digitorum profundus 7:37
- Flexor digitorum superficialis 7:48
Bunnell Test 8:18 - test for intrinsic muscle/capsular tightness
Elson's Test 8:40 - determine if pt has a central slip tear b4 the deformity
Finger alignment Test 9:37 - cascade sign
Thank you for your informative, educational and easy to understand videos. I've learned more from watching these videos about all of my conditions than I have going to 6 different Dr's, who have yet to explain my conditions including Cervical Spinal Stenosis, Radiculopathy, and torn Supraspinatus. I had to get my results from all of the tests and educate myself.
Excellent, useful video for Physical Therapists. Thank you!!
سمعت جميع المقاطع وذاكرت عليها وساعدتنا كثيييير جداً..
امنياتي لك دوام الصحه والعافيه شكراً دكتورنا العزيز
Very helpful in understanding hand tests. Thank you!
Good description of all the tests for the hand. Thanks.
Thanks Proffessor Nabil Ebraheim for all
You are the best!!!!!! Thank you sooo much.
Very nice video of the examination of hand! Thanks!
mnogo blagodarq za tova video hilqdi blagodarnosti
amazing! everything i learned in school visualized
Thank you very much for your effort
Thanks alot... Helpful video
Thank you very much!!!
Thanks so much, awesome
Mulțumiri, de foarte mare ajutor!🌹
Thank You Dr. Ebilhaim I needed this. I apologize if I misspelled your name.
This is lovely. Thank you so much.
very educative thanks DR
So educational and helpful video dear TEACHER
awesome n so help ful
very good desriptiton of all the tests of the hands thanks so much
Thanks!
great job, congrat
Ghats the great videobi ever watch ... amazing
Thanks so much
Is truly usefull
Thanks Dr
What a great video! I couldn't find help for my 2 finger's problem, and I can't believe it as this seems like such a comprehensive video. My left pointing finger is wanting to close at night and in the morning, with much pain. I'm always trying to push it way open to stop it from closing. :(
Thank you
This really helps me with what is going on with my hand, it has been getting worse for the last few weeks. And now I'm going to see my Dr., this helps me to understand what is all involved with what is causing my pain and problems. thank you.
Did you ever get relief from your hand pain? It's ruining my life.
Its great. Thanx sire
Thank you for your very informative videos. You are my “go to” doctor. Your videos have been very helpful in determining if there is a real issue to be addressed. And I’m learning so much more about the body.
Very informative Dr
Good, thanks
Thank you and you are the best 💖💖💖💖💖
بارك الله فييك وشكرا
Useful
thankx a lot sir
ur genius
Very good person.
I love it
best video in RUclips
Dasi Totkay for left hand base of thum fracture
nice one. tnx
very nice
Very informative sir
Ortho OSCE in 3 weeks and this video saving my life
thank you for this...
good job..=)
this morning 30 dec 2013 , i use your video to explain it more clearly to a patient in my Tablet in consultation room from my heart thanks and god bless you
Higinio 。M你🚼🚶alave
sir thankxxxxxxxxxx alot u r great its very easy for me to learn n persive thankx alot
I watched this to determine what I should expect at my Dr's office. I have an injury where I can't hold anything due to an injury from pulling on something. This will help me explain to my Dr. What I can and can't do. Thank you
شكرًا على هذه المعلومات القيمة.
Youness NOUHI thanks
+nabil ebraheim هل يمكن شرح عملية ترجيع الكتف المخلوع بالفيديو ......the reduction of shoulder dislocation ...type of reduction
thank you so mutch i glad about arabic person nd muslim make that help for society
Nice video. Operated for Kienbock disease stage 3b.
Hi Dr. Ebraheim, I am a 54 year old male, 6'4-220 lbs. I have been to two different hand/wrist surgeons and have been diagnosed (x-ray/mri) with a SL ligament tear-left wrist. I get a significant clucking (I hurt it doing straight barbell curls) noise and if I tape it and play golf it hurts for weeks. I am an avid golfer, and both surgeons have said surgery will make it stiffer, less range of motion etc. They prescribed me a wrist velco widget for $30/cortizone shots/nsaid gel. et al. As a 20 plus year med. implant rep (spent many years in the OR) I thought I had a tfcc tear but that doesn't seem to be the case on the mri? My left wrist cock at the top of my backswing is very important to the swing and I can't believe in this day and age we have no other microsurgery alternatives for a wrist joint ligament/tendon tear on the outside of the wrist? My round ball on the outside of my wrist (pisiform?) by the ulna joint is not pronounced anymore and sits into the joint now vs the right wrist.
My wrist is weaker and I can't use that hand like in the past (not counting golf) Are there any options for me that won't lead to stiffness/less range of motion/arthritis? Any new technologies on the market that could help me in the future so I can continue to golf pain free into my 70s? Please help
Kind regards,
Jon L
I have a hand pain that is not referenced in this video. Pain for last 4 months when fingers and palm are pressed back as it would in the push up position. also pain with out doing anything between pointer finger knuckle and wrist on top of hand. Any help would be great. Thank you.
excellent sir... I don't have words to appreciate your efforts sir.. a big thank you from India...
I'm glad to remembering your text I'm doing better.
been having wrist pain for a long time since I fell and injured It a few years ago, mostly on thumb side.. positive Watsons test for scaphoid instability also Finkelsteins test for de quervain syndrome but not just down also when wrist is moved up towards thumb. They put me in plaster for a couple of weeks when I injured it as they suspected a scaphoid fracture but when xrayed again said it wasn't and did nothing else. Could it actually have been injured and now I am still suffering or some kind of ligament injury?
It may be psychosomatic.
Thanks a lot my friend , wish I can make contact with you Dr Nabil because I have a problem with my wrist after a MVA. Is it possible?
Excellent video. However, the captions are often obscured by the timeline. Would be even better if this can be corrected.
I literally was at work in the back of a ups freight trailer and they drove off with me in the back I fell and hurt my left wrist it’s been 2 months The is a bulge were my joint it hurts so bad any tips
Dr Nabil where are you located please. Canni have your practice ohone numner. Thanks
Where are the tests for DRUJ instability?
من فضلك دكتور ماهي الجراحة الجيدة لعلاج كينبوك وموت العضمة الهلالية ليدي
I have none of these symptoms and it hurts when I push it downwards or upwards. It hurts less than it did yesterday tho
Good stuff, just had neck surgery, had a full fusion procedure.Two months later my hands are still numb.
How are your hands five years out?
I'm curious as well had full neck fusion 16 months ago having a second trigger finger release opposite hand and this is after a tumor was removed from the spine back in 2013 I got issues carpal tunnel has been done it's cut tip of one of my toes before neck first time walking with pain free feet I need them to cut off the tip of the adjacent toe as it cought the same ingrown callus but they won't do it Dr sated it all just jump to the next toe.I said god then we will have only 1toe tip to go? I continue to limp the best Dr Navbil your the best
thank yo.
I hurt my hand need for pain relief thank you
Sir my left hand scaphoid fractured from the west side (center) 6 months ago. Then the doctor did screw friction. But today even after 6 months, CT scan shows a gap in it. Right now doctors are speaking for grafting. But due to no money now, I cannot get it done. Please tell me that 1- What if I don't do grafting 2- If I come in the condition of getting it done, then how many days can I get it done so that I can benefit
I enjoy your video but the captions are paced too fast for some one of an average reading speed. Thank you.
I have wrist pain on the pirformis. The only test that felt relevAnt was the Watson test. But are there any tests to determine wrist pain on the pirformis? It hurts when I flex that hand, and it feels like it's really tight? It feels a bit achy and like something is out of place or something?
The piriformis is a small muscle in the buttock....did you mean the pisiform?
"Thank you."
Tanks
Sir not support in my rite hand fingers not joint what problem my hand plees soluation (I am kanrataka Kannada language)
Hello dr..iam from nepal..before 15 yrs ago when i was 10 years old..my hand broke on elbow...after that my my finger doesn't work properly specially 3rd 4th and fifth is in worse cindition ..recently i visit to dr and he recommand to do ncv ..after ncv if my nerve is damage what will be the further process ?? is the nerve damage cureable?? is this dangerous?? is nerve damage cause cancer??? If he recommend me to do surgery ?? is this normal or there is much complication ..plzzz reply me dr
Its not playing plz help.
I fell on my wrist while playing tennis and now it hurts a lot when i try to hit a ball. When I perform the Watson's test, I hear a clunk. I mostly feel pain when my hand is bent backwards with the thumb. Also, I feel a weird tingling sensation on my thumb when I rub the side of my forearm near the extensors of the thumb. If anyone can help, that'd be greatly appreciated!
Julio Ochoa sammmmmmeeeeee
Julio Ochoa so today I discovered that when I rub the side of wrist my thumb tingles and it hurts to bend it anyway
What's the treatment of this??
surgery only otherwise final stage will be Arthritic which will give some relief using anti inflammatory drugs
ممكن ترجمة للعربية
Finkelstein's test
I am suffering from herayama dieases..
Sir u have any treatment for this
Arsenicum Album 30 5 drops 3 times a day with sip of clear water
3:16
Enjoy.
dammit you got me
thang
Fcff
wht a boring background sound
Well said Mr Sir. That person obviously doesn't have a wrist/hand problem!
he want to selena gomez.( want you know)
o,noooooo....the same annoying music..........Pleaase..........
very nice