(CN) The Hand
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| Describe the Bunnel-Littler test. | Tests for finger tightness. Hold the MCP joint in slight extension, and try to flex proximal IP. If it won't flex, there may be capsular or intrinsic muscle tightness. If the proximal IP with flex w/ MCP flexed, there's muscle tightness w/o capsular prob.
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| Describe the Tight retinacular ligament test. | For distal IP tightness. Place proxmal IP in neutral and flex distal IP. If can't flex distal IP, retinacular ligament or capsule may be tight. If distal IP flexes w/ proximal IP flexion, tightness is in ligaments, not capsule.
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| What is a positive Froment's sign indicative of? Describe it. | Indicates ulnar nerve compromise/paralysis. Ask pt to hold paper between thumb and index finger. Try to pull paper away from them, Positive test: Pt flexes distal phalanx of thumb b/c of adductor pollicis muscle paralysis.
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| What does phalen's test test for? Describe it. | Tests for median nerve compression in the carpal tunnel. Flex pt's wrists maximally and ask pt to hold position for 60 sec. Positive test: Tingling in thumb, index, middle finger and lateral half of ring finger.
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| What is the Finkelstein test for? | Tests for deQuervain's disease (tenosynovitis of the thumb). Have pt make a fist w/ thumb tucked inside. Ulnarly deviate the wrist. Positive test: Pain over the AbPL and EPB tendons at the wrist.
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| What does a positive Murphy sign indicate? | A positive test (pt's third metacarpal remains level w/ 2nd&4th metacarpals when making a fist) indicates a disclocated lunate.
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