Note that when you look at a normal hand the palmar surface will be pink and the creases will appear dark. If you ask your patient to hyperextend the fingers (or you hyperextend them), the hand should blanch and the creases will become dark red. When this doesn't happen it is a sign of anemia. This exam has limited usefulness on non-caucasian, cold, or vasoconstricted patients.
Updated: April 1, 1998