Arterial Assessment of the Hand

Abstract

A guide to the assessment of the circulation to the hand is presented. Optimal restoration of neuromuscular function is dependent upon an adequate blood supply; hence, a detailed assessment of the peripheral circulation is advocated for all patients presenting with hand dysfunction, regardless of aetiology. A brief review of the gross anatomy of the arterial circulation to the hand is followed by a description of the components of the clinical examination. The therapist can use the results of laboratory tests to provide supplemental or corroborative information to the clinical assessment. Thus, the clinical assessment is discussed in three parts: a description of tests performed in a peripheral vascular laboratory, and the history and the clinical assessment performed by the therapist. Inspection, palpation and auscultation constitute the major components of the physical assessment. A thorough knowledge of the circulatory status of the hand will enhance the occupational therapist's ability to formulate treatment goals, implement more rational therapeutic interventions and evaluate treatment outcome.