손목, 손의 이학적 검진(Physical examination)
손목의 굴곡, 신전, 요측 변위, 척측 변위, 내회전, 외회전의 수동적, 능동적 운동 범위를 기록해야 한다. 명백한 통증이나 염발음도 기록해야 합니다.
손의 굴곡, 신전의 수등적, 능동적 운동범위를 기록해야 합니다.
무지에 대한 검사는 추가적으로 내전, 외전, 대립의 능력을 포함해야 한다.
관절의 안정성을 검사해야 하며, 어떤 종물이나 압통이 확인되면 기록해야 합니다.
- Wrist
1) Distal radioulnar joint ROM
Supination and Pronation : 80-90º
Ulna moves posteriorly and laterally with pronation
2) Radiocarpal joint(and Ulnocarpal joint) ROM
Flexion(80-90º) and Extension(75-85º)
Radial(20º) and Ulnar(35º) Deviation
3) Intercarpal joint : Gliding
- Thumb
1) Thumb Flexion/Extension at MCP and IP : Touch pad at base of little finger
2) Thumb Abduction/Adduction at carpometacarpal joint
3) Opposition : Touch tip of thumb to tip of each finger
- Finger
1) Flexion/Extension at MCP, PIP, DIP : Tight fist and open, Do all fingers work in unison
2) Abduction/Adduction at MCP : Spread fingers apart and then back together
- Palpation
- Wrist(Dorsum)
Radial/Ulnar styloid, Scaphoid, TFCC, 1st MC/Trapezium joint, Triquetrum/Lunate/Pisiform, Lister’s tubercle, Hook of hamate, Guyon’s canal
* 6 Dorsal compartments
① 1st Dorsal Compartment : Abductor Pollicis Longus and Extensor Pollicis Brevis, Radial border of Anatomic Snuff Box
② 2nd Dorsal Compartment : Extensor Carpi Radialis Longus and Extensor Carpi Radialis Brevis, Make fist : Becomes prominent
③ 3rd Dorsal Compartment : Extensor Pollicis Longus, Ulnar side of Anatomic Snuff Box
④ 4th Dorsal Compartment : Extensor Digitorum Communis and Extensor Indicis, Palpate from the carpus to the MCP joints
⑤ 5th Dorsal Compartment : Extensor Digiti Minimi
⑥ 6th Dorsal Compartment : Extensor Carpi Ulnaris
- Wrist(Palmar)
Pisiform and Hamate, Guyon’s canal, Ulnar artery, Carpal tunnel, Flexor Carpi Radialis, Flexor Carpi Ulnaris
- Hand
① Thenar eminence : 3 muscles of thumb
② Hypothenar eminence : 3 muscles of little finger
③ Palmar Aponeurosis : Dupuytren’s contracture
④ 5 Metacarpals, 14 Phalanges
- Finger : Flexor tendons, Extensor tendons