Hand Function

Question 1

what should you observe when doing the assessment?

Answer 1

• general shape and size of the hand
• appearance of the phalanges
• appearance of the joints
• position of the upper limb
• position of the hand at rest
• appearance of the muscles
• lag or contracture

Question 2

what should you palpate for?

Answer 2

• temperature differences: compare two hands
• each finger: thickness, tenderness, edema and temperature
• passively move each finger
• active flexion and extension
• vascular function- capillary fill

Question 3

what does the formal evaluation of hand function include?

Answer 3

- edema
  \+ circumferential test
  \+ volumeter
  \+ contra-indications
     = open wounds
     = external fixates
     = Kirschner's wires
     = pop
- ROM
  \+ goniometer
  \+ hand charts
  \+ oxford scale
- muscle strength
- sensation
  \+ sensation form
  \+ localization of stimuli ad intensity
     = two-point discrimination
     = Semmes Weinstein Monofilament test
- grip strength
  \+ dinamometer
  \+ blood pressure cuff: 20 mm mercury ( 200mm mercury is normal grip strength)
- grips 
  \+ reach
  \+ grip
  \+ carry
  \+ release
  \+ in hand manipulation
     = translation
        # finger to palm
        # palm to finger
     = rotation
        # simple opening cooldrink bottle
        # complex rotation- uses eraser
     = shift
        # simple: putting coin in piggy bank
        # complex: independent finger movement- pen shift up and down
- endurance
  \+ indicate duration of activity before pt experiences muscle fatigue
  \+ intrinsic muscle activity
  \+ forearm activity
  \+ whole UL activities
- coordination
  \+ hand-eye coordination
- bilateral hand function
  \+ opening bottles
  \+ fill glass and drink
  \+ take match out of box and light it
  \+ toothpaste on toothbrush and brush
  \+ dressing and undressing
  \+ fastening devices
  \+ telephone use
  \+ administrative activities

Question 4

name 5 steps you will follow when you evaluate hand function

Answer 4

1. observe
2. palpate
3. formal evaluation
4. study x-rays
5. note everything

Question 5

name hand grips

Answer 5

precision grips:
- lumbrical grip
- three point pincer
- two point pincer
- adductor/ key grip
power grips
- cylindrical
- skilled grip
- total/ball grip
- palmar grip
- hook grip