Hand examination

Inroduce yourself
Explain about your task
Ask about any pain
Correct positioning of the hands e.g pillow
•inspect the dorum for:
Nails pitting,vasculitis,atrophy
Skin
Small muscle wasting guttering
Deformity (memorise them)
•inspect the palmer aspect for:
Pulp top
Erythema
Wasting of the thener and hypothener
Contracture
Scar of decompansation
•Back to the dorsum:
Palpate the joint for evidance of synovitis
Palpate the wrist
•Back to the palmer aspect:
Perform tenil test
•check the motor system in the hand:
“squeeze my fingers” C8 T1
“hold your fingers striaght” stop me from pending them C7
“spread your fingers”stop me pushing them togerther ulnar
“point your thumb to ceiling”stop me pushing it down median
•check sensation
•Feel for subcut nodules
•Assess disability