How to examine the hand and wrist
Other platforms explain it with text and video. In Making Synapses you practice it on the patient.
The hand has many small structures. Look, feel, move and then test the three nerves.
Step by step
Look
Both hands palms up and down: swelling, deformity, wasting, scars, nails. [1]
Feel
Temperature, joint tenderness, the snuffbox (scaphoid fracture). [1]
Move
Make a fist, spread fingers, wrist up and down. [1]
Function
Grip, pinch, pick up a coin, undo a button. [1]
Nerves
Median (thumb to little finger, sensation of index), ulnar (spread fingers, little finger sensation), radial (wrist extension, back of thumb). [1]
Carpal tunnel tests
Phalen and Tinel signs. [1]
Common errors
- Missing snuffbox tenderness.
- Not testing all three nerves.
- Examining only the painful hand.
Practice it in Making Synapses
In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
Making Synapses cases that train this skill
- Tardive dyskinesia
- Deaf patient with a service dog
- Radiation exposure
- Restrictive cardiomyopathy
- Hand-foot-and-mouth disease
- Hand eczema (dyshidrotic)
29 Making Synapses cases train this skill: open the case library
Sources
- Stanford Medicine 25 (bedside exam)
- NCCPA PANCE Content Blueprint
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow NCCPA PANCE Content Blueprint; Stanford Medicine 25 (bedside exam). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.