AOP 2 Midterm Flashcards
no question
What grade is considered Full ROM?
2 to 5
What is considered less than full ROM?
3-, 2-
What grade is considered no ROM?
1, -0
What grade is against gravity ?
3- to 5
What grade is gravity eliminated?
2+ to 2-
When someone becomes pale, alters changes in consciousness, and feels lightheaded alter sitting up, they are most likely experiencing?
Orthostatic hypertension
Dehydration
Orthostatic hypotension
Blood loss
Orthostatic hypotension
An occupational therapist can help a person with orthostatic hypotension by? select all
Stay sitting up
elevate feet
sit up-slowly
abdominal binder
compression stockings
overhead pumping fist
Wrist pumps
Lay back down
elevate feet
sit up-slowly
abdominal binder
compression stockings
overhead pumping fist
ankle pumps
Decubiti has 4 stages. Put them in the correct order
Stage 1:
Stage 2:
Stage 3:
Stage 4:
Open (loss of skin) or blister
Full thickness wound that extends down to muscle and bone
Red area, inflamed and does not blanch or become pale when pressure is applied
Full thickness wound that extends down to subcutaneous tissue
Stage 1: Red area, inflamed and does not blanch or become pale when pressure is applied
Stage 2: Open (loss of skin) or blister
Stage 3: Full thickness wound that extends down to subcutaneous tissue
Stage 4: Full thickness wound that extends down to muscle and bone
The two most common types of arthritis are?
Osteoarthritis
Psoriatic arthritis
Lupus
Rhumatoid arthritis
Osteo and RA
These symptoms are indicative of what type of arthritis?
Pain
Joint stiffness
Muscle weakness
Decrease ROM
Crepitus
Osteoarthritis
A Degenerative joint disease that changes and causes damageto articular cartilage mainly caused by ”wear and tear” and is hereditary
Osteo arthritis
This arthritis diseases is unknown why it happens and is classified as an inflammatory disease
Rheumatoid arthritis
Symptoms such as pain, symetrical, morning stiffness, edema and fatigues are commonly found in someone with…
RA
Stages of RA include? place in order
Chronic active
acute
Subacute
Chronic inactive
acute subacute chronic active chronic inactive
Which joints do Bouchards’ nodes affect?
PIP
MCP
DIP
PIP
Heberden’s nodes affect which?
PIP
MCP
DIP
DIP
What type of pinch causes basal joint arthritis pain?
Lateral
Tripod
Power pinch
Pincer pinch
Lateral pinch
True or False, The level of the MCP joints start to drift radially during rheumatoid arthritis
FALSE they drift ulnar and this is called extensor tendon drift
Swan neck deformity is when the lateral bands are no longer in ____ but are now in _____
Flexion, extension
Neutral , Extension
Extension, Flexion
Flexion, extension
RA can cause select all
Swan Neck Deformity
Trigger finger
Boutonniere Deformity
Ulnar Drift
Radial Drift
Zig zag deformity
Avoid assessing grip using the dynamometer during what?
A flair up
Thumb strength evaluation looks at all BUT
Radial abduction
Palmar abduction
Extension
2 point pinch
3 point pinch
Key pinch
Extension…its flexion
Assess thumb stability by having the client perform a tip to tip pinch while holding the___ and ___ in neutral.
Ip, PIP
MCP, IP
DIP, MCP
MCP, IP
Assess DIP and PIP stability by stabilizing the ______ and then perform lateral and medial _____ to the distal phalanx (collateral ligaments). Then move anterior and posterior to assess volar plate and joint capsule.
Assess DIP and PIP stability by stabilizing proximal phalanx and then perform lateral and medial gliding to the distal phalanx (collateral ligaments). Then move anterior and posterior to assess volar plate and joint capsule.
The goal of intervention is to?
Decrease pain, improve joint motion and improve function
Contraindication: Heat or ice is contraindicated during an acute flare up.
heat
True or False If joints are unstable or during the chronic phase - strengthening is contraindicated
false.. it is during the acute phase
The goal for MCP arthroplasty is to achieve ___ degrees MCP flexion and extension in neutral and by what week
50 ,2
70,3
45,3
30,5
70,3
Dynamic MCP extension orthosis are when fingers should be pulled into _____ about ____ degrees of ___deviation
flexion, 15, ulnar
Extension, 15, radial
Flexion, 15, radial
Extension, 15, radial
For PIP Artho plasty the goal is to achieve what degrees and position?
PIP Extension and extension to neutral
PIP Flexion and extension to neutral
PIP flexion and extension
PIP Flexion and extension to neutral
True or False :
Dynamic extension orthosis can be used during the day (be cautious not to cause any lateral stress while wearing the orthosis or during exercise) ADLs with splint on
True
total wrist arthrodesis should be fused at what degree and position?
10-20, flexion
10-20, extension
20-30, flexion
10-20 extension
The role of OT in orthopedics is? select all.
Decreased ROM
Wound care
Decrease pain
Increase strength
Wound care
Decrease pain
Increase strength
When splinting it is important to consider the metacarpal heads being higher on the ___side vs the ___side
Radial, ulnar
For the distan end of the orthosis is is important to not BLOCK what?
Thenar eminence or distal palmar crease
What is this position considered?
Safe position
The safe position is when the wrist is in ___, MCP_____ IP ____ and thumb____
wrist extension, MCP flexion IP extension and thumb opposition
This position is called?
Functional hand position
The functional hand position is when the wrist is in slight___, slight MCP and IP ____and the thumb is in ____
slight wrist extension, slight MCP and IP flexion and the thumb is in palmar abduction/opposition
which type of orthosis is common for radial nerve palsy?
Dynamic extension
What type of orthosis allows a patient to return to writing?
Tripod grasp orthosis
Anticlaw orthosis
Anti flexion orthosis
anticlaw
What type of sling is this to help with distal support?
GivMohr
A counter force strap is used to limit muscle contractions of the ___extensors and used for _____epicondylitis
Wrist, Medial
Wrist, Lateral
Forearm, medial
wrist, lateral
This type of splint is used to immobilize the wrist. It is called?
Volar wrist immobilization splint
This splints purpose is used for DeQuervains
long opponens orthosis
This orthosis keeps your hand in what position?
intrinsic plus (safe)
If your client comes in with a repaired flexor tendon…the best splint to use would be?
Forearm based metacarpophalangeal
dorsal blocking
proximal interpherangeal
dorsal blocking
What type of splint is this?
oval 8
Formed by the trochlea and the trochlear notch of the humerus
ulnohumeral
Radiohumeral
Proximal Radioulnar
Ulnohumeral Joint
Formed by the radial head and the capitulum
ulnohumeral
Proximal Radioulnar
Radiohumeral
Formed by the radial head and the radial notch of the ulna
ulnohumeral
Proximal Radioulnar
Radiohumeral
Weakness of power grip
* Positive Tinel’s Sign
* Positive Froment’s Sign
* Positive Wartenberg’s Sign
Are signs of what?
Cubital tunnel syndrom
This sign is called??
- Positive Tinel’s Sign
- Positive Froment’s Sign
- Positive Wartenberg’s Sign
Froment’s
What sign is this?
* Positive Tinel’s Sign
* Positive Froment’s Sign
* Positive Wartenberg’s Sign
wartenberg
Match the week to the post op treatment
A. 6 Weeks
B. 2 Weeks
C.3 Weeks
- Long arm splint and AROM of elbow forearm and wrist (avoid supination for intramuscular and submuscular transpositions)
2.PROM and strengthening
3.Unrestricted AROM
2 wks post op: Long arm splint and AROM of elbow forearm and wrist (avoid supination for intramuscular and submuscular transpositions
3wkspostop: Unrestricted AROM
6 wks post op: PROM and strengthening
Tendinopothy, also known as tennis elbow, is a repetitive microtrauma of the?
FCR
ECRB
ECR
ECRB
Time frames are always guided by?
OT
PT
PCP
Surgeon
surgeon
Golfers elbow is also known as?
Medial epicondylitis
A client has a fall directly on
elbow with forearm pronated. What type of fracture do they most likely have?
Ulnar head fracture
Radial head fracture
Radioulnar head fracture
Radial head
Major complication of elbow fractures are all BUT ?
Elbow flexion contractures
Heterotopic Ossifications
Olecranon fracture
Complex regional pain syndrome
olecranon fracture
F or F. Begin with PROM of the elbow and near by joints. DO NOT start with AROM
FALSEEEEE
begin with AROM of elbow and near by joints
Edema management includes? select all
elevation
cold packs
Hot packs
massage(gentle)
Tight compression wraps
(tubi grip)
elevation
cold packs
massage(gentle)
light compression wraps
(tubi grip)
T or F:
OT intervention would include making an elbow orthosis
True
T or F : the MAIN goal is to produce PROM for an elbow injury
FALSE AROM
Function of the wrist is very strongly linked to the function of?
the hand
The most common type of fracture is?
Ulnar radial fracture
Distal Radial fracture
distal radial FOOSH
When is OT typically done on a non op patient?
week ?
1
2
3
4
6
4
true or false
Splinting is not a defense an OT should do for a nonop distal radius fracture patient
FALSE it is. Access mobility of the forearm wrist and hadnd
True or False
If a patient doesnt have surgery of a DRF, pronation and flexion are limited and difficult.
false
extension and supination!
A DRF non op can cause?
Stiff hands
Decreased poor grip
Finger flexion
decreased poor grip
Visually we will see an active _____ lag and collapse into _____ when attempting a fist
extension;flexion
flexion;extension
extension;flexion
True or False
Ulnar side pain due to the styloid will persist, worsen and go away
true
OT Treatment week 4-8 includes all BUT
Educating to not use hand
Explain fracture feeling
Tell them to use their hand
educating to not use their hand
T or False continuing to reinforce use of the the wrist and hand MOST important?
TRUE
True or False
Early focus should be learning to isolate wrist Flexors (perform wrist extension while maintaining gentle fist)
FALSE
Early focus should be learning to isolate wrist extensors (perform wrist extension while maintaining gentle fist)
What type of progressive splinting is best?
Static or Dynamic
Static
T or F
Week 12 of non op management includes no restrictions but as tolerated with pain
T
It takes up to _____ to achieve full potential, regardless of injury
3 years
2 years
1 year
6 months
1 year
Scaphoid fractures are difficult due to mainly?
blood supply to heal
If youre making a splint for a scaphoid injury do you include the thumb?
yes
which bone is the most common fractured in the hand?
scaphoid
SL tear, left untreated leads to?
SLAC
Which ligaments are color coated for an SL tear?
dorsal, proximal and volar
what injury is this?
Scapholunate ligament tear
SL TEAR most important is to protect the integrity or reach full mobility?
integrity
With an SL tear, what test would you preform to see the injury?
CT scan, open hand
Xray, clenched fist
MRI clenched fist
xray, clenched fist
True or False
Must consider indication for surgery as a salvage procedure with primary goal to gain full functionality
false
Must consider indication for surgery as a. salvage procedure with primary goal to alleviate pain
Goal is to ______________with some expected limitations long term (expected return of ~50% motion and strength)
restore functional mobility and strength for basic use
Name the four rotator cuff muscles
Supraspinatus:
* Infraspinatus
* Teres minor
* Subscapularis
Match the rotator cuff muscle with the function
Subscapularis
Teres Minor
Supraspinatus
Infraspinatus
internal rotation
external rotation
shoulder elevation or abduction in the scapular plane
external rotation
Supraspinatus: shoulder elevation or abduction in the scapular plane
Infraspinatus:
Teres minor: external rotation
Subscapularis:
internal rotation
external rotation
shoulder elevation or abduction in the scapular plane
external rotation
Which rotator cuff is most injured ?
Supraspinatus
Isometrics are contradictions, do not preform them on this type of patient
Cardiac
When assessing a patient with a shoulder injury we look for all of the following BUT
Posture
Scapula Symmetry
Size of scapulas
Incision/Scar
Atrophy
Size of scapulas
While assessing a shoulder using scapula symmetry, the most important movement is?
Adduction and upward rotation
Abduction and internal rotation
Abduction and upward rotation
abduction and upward rotation
For shoulder pain, what sleeping position would be MOST ideal to recommend ?
Back with pillow on the knee
Select the BEST functional assessment for shoulder injuries. HINT: insurance usually requires it
American Shoulder and Elbow Surgeons Self Report
(ASES)
Penn Shoulder Score (PSS)
Shoulder Disability Questionnaire (SDQ)
Disabilities of Arm, Shoulder, and Hand (DASH)
Shoulder Pain and Disability Index (SPDI)
DASH
Functional movements to assess are all BUT
Raise your arm above your head
Reach behind your head
Reach to your upper of back
Reach to opposite axilla
Reach to uppers, its LOWER
Your client is having trouble with fwd flexion, placing a ___pack may help when trying to do this during PROM
Hot
Cold
hot
What type of test is this? Forced forward flexion with IR.
What positive sign?
What muscle?
Impingement sign/neer
face will express pain
over use of supraspinatus or long head of the biceps
What test is this?
Shoulder and elbow flexed to 90 degrees followed by forced internal rotation.
positive sign
muscle
Hawkins kennedy
Positive sign is the patient will express pain.
Indicates overuse of the supraspinatus and/or the long head of the bicep
what test is this?
Abduct shoulder to 90 degrees, then have the patient slowly lower the arm to the side.
positive sign
muscle
Drop arm- to assess a tear
Positive sign is patient’s arm will drop to side.
Indicates a
tear of the rotator cuff
What test is this?
Shoulder elevation and internal rotation followed by resistance to elevation.
Positive sign
Muscle
Empty Can
Positive sign is weakness or pain.
Indicates a large or massive tear in the supraspinatus tendon
Shoulder flexed to 90 degrees, forearm supinated and elbow extended.Resistance is applied to flexion.
Positive sign
Muscle
Biceps Speeds
Positive sign is pain over the biceps groove.
Indicates biceps tendinitis
Name 3 conservative techniques for treatment of shoulder injuries
Activity modification
Educate in sleeping postures
Decrease pain
Restore pain free ROM
Strengthening (below shoulder level) Occupation and Role specific training
T or F
Protocols will vary depending on surgeon, size of repair, type of repair/tension and quality of tissue.
True
