A Spearhand Thrust (also commonly called a Fingertip Thrust or Spearhand Strike) is essentially a punch that's performed with a spearhand. The Spearhand may be held horizontally (i.e., palm downward) for vertically (palm to the side). Typically the intended target is the eyes or the throat, since this technique is generally unsuitable for harder targets due to the likelihood of injuring the fingers. The advantage of the spearhand is that it increases the range of your arm by a few inches.
In a Low Fingertip Thrust (also called a Turn-Over Fingertip Thrust) the spearhand is thrust downward, as if to attack the groin. In this case, the palm of the spearhand faces upward.