Motor – confirm finger abduction & adduction (tests palmar and dorsal interossei).Sensation – check at the dorsal surface of first digital web space.Motor – confirm MCPJ extension is present (tests ED).Sensation – check at the radial border of tip of index finger.Motor – confirm thumb abduction is present (tests APB).Ask the patient to pick up a penny or do up the buttons on a shirtĬheck the sensorimotor function of the terminal branches of the brachial plexus*:.Ask the patient to pinch the tip of you finger.Place two fingers in to the patient’s palm and ask them to squeeze as firmly as possible.Check the action of the thumbs, asking the patient toĪssess the functioning of the hand by assessing:.Check the action of the wrists, asking the patient.Isolate the proximal and middle phalanges by holding them firmly and then asking the patient to flex the distal phalynx of that finger (FDP).Isolate the 3 fingers that are not being tested (simply hold them in the natural anatomical position) and ask the patient to flex the finger being tested (FDS).Check the flexors of the hand, asking the patient to.Flex the fingers to 90 oat the MCP joints and ask the patient to extend their fingers again (lumbricals).Hold the wrist passively in extension and ask the patient to extend their fingers (ED).Raise the thumb off of the pillow (EPL).Extend the wrist against resistance (extensors).Check the extensors of the hand, asking the patient to.This is best done by placing the thumb and index finger around the joint in a pincer like grip, and the other hand the same at 90 o to the first hand, feeling for tenderness and laxity in the jointĪsk the patient to keep the hands in the pronated position:.Bimanually palpate all of the MCP joints, PIP joints, and DIP joints.Gently squeeze all 4 MCP joints together (often painful in inflammatory arthropathies).Palpate the bony anatomy of the hands, feeling for any tenderness.Assess again by running down with the pad of your thumb.Assess the tendons of the hand, feeling for nodules or contractures.Compare for asymmetry, caused commonly by disuse or denervation (i.e.Run the pad of your thumb firmly over these areas.Assess the muscle bulk of the thenar eminence and hypothenar eminence.Using the dorsal surface of your own hand, feel distal to proximal along the patient’s hand and forearm, and compare with the contralateral side.Ask the patient to again place their hands back on the pillow, in a supine position:

Hand compartments of palm