1. Part 2
Wrist Evaluation

2. Overview Observation Examination AROM/PROM Special tests
Neurological exam
Circulatory exam

3. Observation Overall position of person
Are they using the involved limb?
Is the wrist or hand in an abnormal position?
Is the limb hanging limp?
Swelling
Skin color
Signs of trauma
Skin temperature

4. Observation Deformities Atrophy Abnormalities Compare Carrying angle
Muscle spasm

5. Palpation Navicular /scaphoid Lunate Triquetrium Pisiform Trapezium
Trapezoid
Capitate
Hamate

6. Palpation Lister’s tubercle Metacarpals Phalanges
Thenar eminence (base of thumb, palmar aspect)
Hypothenar eminence (little finger side, palmar aspect)

7. Palpation Radius Ulna Radial styloid process Ulnar styloid process
Metacarpo-phalangeal (MP) joints
Proximal Interphalangeal (PIP) joints
Distal Interphalangeal (DIP) joints

8. Palpation
Anatomical snuff box
Tunnel of Guyon
Carpal tunnel

9. Palpation: Soft Tissue
Median nerve
Ulnar nerve
Radial nerve
Transverse carpal ligament
Ulnar collateral ligament
Radial collateral ligament
Ulnar artery
Biceps brachii
Brachioradialis
Pronator teres
Pronator quadratus

10. Palpation: Soft Tissue
Supinator
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Extensor digitorum
Extensor pollicis longus
Extensor pollicis brevis

11. Palpation: Soft Tissue
Flexor carpi radialis
Flexor carpi ulnaris
Flexor digitorum profundus
Flexor digitorum superficialis
Flexor pollicus longus
Flexor pollicis brevis
Abductor pollicus brevis
Adductor pollicus
Abductor digiti minimi
Palmar interossei
Palmaris longus

12. Examination AROM/PROM Wrist: Flexion Extension Circumduction
Radial deviation
Ulnar deviation
Supination
Pronation

13. Examination AROM/PROM Fingers: Thumb: Flexion (each joint)
Extension (each joint)
Abduction (of each finger)
Adduction (of each finger)
Opposition (thumb and 5th finger)
Pinch (thumb and index finger)
Thumb:
Abduction
Adduction
Circumduction  

14. Neurologic Exam: Sensory
Sensory dermatomes
C2-C3: Occipital area and angle of jaw
C4: Supraclavicular area
Axillary Nerve Patch: Lateral aspect of shoulder
C5: Lateral upper arm
C6: Lateral forearm, thumb, and index finger
C7: Middle finger and palmar aspect of hand
C8: Small finger, ring finger, and medial portion of palmar surface
T1: Medial side of forearm and elbow
T2: Medial aspect of upper arm
T3: Medial aspect of upper arm

15. Neurologic Exam: Motor
C1-C2: Neck flexion
C1-C2: Neck extension
C3: Neck lateral flexion
C4: Shoulder elevation
C5: Shoulder abduction and external rotation
C6: Elbow flexion and wrist extension
C7: Elbow extension and wrist flexion
C8: Thumb abduction and ulnar deviation
T1: Finger approximation

16. Neurologic Exam: Reflexes
Biceps (C5-C6)
Supinator (C5-C6)
Triceps (C7-C8)

17. Circulatory
Carotid
Brachial
Radial