Theoretical cases have been included to provide context. However, if there is an injury that makes you concerned about the integrity of deep structures in the hand, wrist, or forearm, knowing the course and function of each muscle and tendon is useful. Ī full muscle/tendon exam doesn’t need to be a part of every exam in the Emergency Department, we don’t have the time. Active ROM provides information about nerve function, muscle strength, joint congruity/stability, and tendon integrity. You may feel clicking, catching or crepitance. Passive ROM gives you information about the joint. Test range of motion both passively and actively in each joint. When palpating the anatomic snuffbox you can maximize the surface area that you are palpating by having the patient move their hand into ulnar deviation and thumb abduction. Previous studies have demonstrated that tenderness at the scaphoid tubercle is actually more sensitive than the anatomic snuffbox (95% v.
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