In this case, the patient confirms that there is pain below the thumb and not in the other areas of the arm. The next step in the examination is the palpation of the regions and all bones of the upper limb (Appendix A). The palpation enables the examination of these regions for pain or other disorders that are related to the wrist sprain. The forearm is also palpated to determine if the patient feels pain within the anatomical regions of the forearm (Woitzik, deGraauw & Easter, 2014, p. 403). Preceding the examination of the upper regions of the forearm is the diagnostic assessment of the wrist and the fingers that constitute the primary centre of attention in this case.
At the wrist, the examiner palpates the distal radius extending to the carpal bones and leaves the painful area that undergoes examination in the last stages of the diagnostic assessment (Yamamoto, 2008, p. 134). The palpation of the metacarpals of the hand and fingers then follows. Finally, the anatomical snuffbox is also palpated (Pistohl et al. , 2013, p. 6). The patient complains of tenderness over the anatomical snuffbox.
Therefore, acute pain is detected in this region of the wrist and forms an imperative diagnostic assessment result in relation to sensitivity to pain (Allouch et al. , p. 14). The assessment of sensation over both forearms and the medial ulna and radial nerve distribution is mandatory and imperative (Takahashi, Tonogai & Sairyo, 2014, p. 218). The assessesment determines whether or not reduction is notable. Warmth and circulation are also some of the characteristics that are assessed in this stage. Assessing sensation enables the examiner to determine the effects that the injury has on the nerves and the subsequent effect on detection of stimuli such as pain (Appendix A).
Blood circulation and warmth may remain affected by the injury making it vital for an examiner to assess this in the process of determining the extent of the effects that result from wrist injuries (Thapa, Iyer & Gross, 2013, p. 106). In the next stage of the assessment, an examiner is expected to check or examine movements at the elbow, wrist and the hand. The examination begins with the assessment of the movements at the elbow in terms of flexion, extension, supination and pronation.
The extension, flexion and ulnar and radial deviations around the wrist are also examined (Abe & Tominaga, 2011, p. 179). The same movements are then assessed passively to assess if there are significant differences in the pattern of pain.