Evaluation Of The Hand

Question 1

Wrist drop signifies nerve damage in what nerve?

Answer 1

Radial

Question 2

3 ways to measure edema

Answer 2

1. Volumetric measurements
2. Circumferential
3. Xerox or hand tracing

Question 3

Volumetric measurements are based on what principle?

Answer 3

Archimedes principle of water displacement

Question 4

Vol measurements of edema are accurate to within _______

Answer 4

10 ml

Question 5

What hand joint would you want to use a circle goni if possible?

Answer 5

CMC

Question 6

How to measure opposition

Answer 6

Ruler to measure distance between pinky and thumb

Question 7

Wrist position for all digital measurements

Answer 7

Neutral

Question 8

Quick and dirty method for composite flexion

Answer 8

Measure linear distance from distal palmar crease (DPC) to tip of finger

Question 9

Measure PIP and DIP flexion together with __________

Answer 9

MP in extension

Question 10

How to record finger ROM

Answer 10

AROM/PROM

Question 11

TAM

Answer 11

Sum of active flexion measurements at MP, PIP, DIP minus active extension deficits

Question 12

TPM

Answer 12

Sum of passive flexion measurements at MP, PIP, DIP minus passive extension deficits

Question 13

Normal TAM values

Answer 13

220-240

Question 14

Normal TPM values

Answer 14

240-260

Question 15

Thumb abduction is sometimes called….

Answer 15

Radial abduction

Question 16

Abduction is ___º from the plane of the hand

Answer 16

90º

Question 17

MP Capsular pattern

Answer 17

More restriction in flexion than extension

Question 18

IP capsular pattern

Answer 18

More restriction in extension than flexion

Question 19

Wrist capsular pattern

Answer 19

Equal loss of flexion and extension

Question 20

CMC capsular pattern

Answer 20

Abduction and extension limited, flexion relatively free

Question 21

Applies a series of increasing forces to a stiff joint to quantify a measurement of PROM

Answer 21

Torque angle ROM

Question 22

How is torque angle ROM measured?

Answer 22

Strain gauge

Question 23

Torque angle ROM has _________ repeatability

Answer 23

Excellent

Question 24

Torque angle ROM determines….

Answer 24

Whether tx is indicated or not

Question 25

Where to place loop for torque angle ROM passive ext

Answer 25

Joint crease

Question 26

Where to place loop for torque angle ROM passive flexion

Answer 26

Tip of gauge is placed on the dorsum of the digit opposite the flexion crease

Question 27

4 causes for passive restriction to extension

Answer 27

1. Palmar plate adhesion 2. Palmar skin contracture 3. Bony block 4. Flexion tendon adhesion

Question 28

2 causes for passive restriction to flexion

Answer 28

1. Dorsal skin tightness | 2. Extensor tendon scar or tightness

Question 29

2 things that can cause active restraint to ext

Answer 29

1. Passive restraint | 2. Extensor lag

Question 30

2 things that can cause active restraint to flexion

Answer 30

1. Passive restraints | 2. Flexor tendon rupture or adhesion

Question 31

2 causes for limited composite passive flexion

Answer 31

1. Extensor tendon tightness | 2. Dorsal skin tightness

Question 32

Reason for limited composite active flexion with normal composite passive flexion

Answer 32

Flexor tendon adhesion or rupture

Question 33

Explain the oblique retinacular ligament tightness test

Answer 33

DIP is passively flexed with the PIP held in extension, then flexed again with the PIP in flexion - if there is greater motion when the PIP joint is flexed, there is a contracture of the ligament

Question 34

Explain the intrinsic tightness test

Answer 34

Intrinsics put on stretch by examiner (MP ext, IP flex), then intrinsics are relaxed by flexing the MPs - if PIP can be passively flexed more w MP in flexion, positive test for tightness

Question 35

4 MMTs with no gravity eliminated position

Answer 35

1. Finger abduction 2. Adduction 3. APL 4. Opposition

Question 36

Give ____________ for a grade of 3 for these two tests

Answer 36

Minimal resistance | Thumb MP and IP flexion tests

Question 37

Patient position for dynamometer testing

Answer 37

Sitting, shoulder adducted, elbow flexed to 90º, wrist in 0-30º extension and 0-15º ulnar deviation

Question 38

How many squeezes should pt perform on dynamometer?

Answer 38

6 total - 3 each hand, alternating to avoid fatigue

Question 39

2 grip tests

Answer 39

1. Static grip | 2. Rapid exchange testing

Question 40

4 positions for pinch testing

Answer 40

1. Lateral pinch 2. 3 pt pinch 3. Palmar 4. Ring/little

Question 41

How many pinch testing trials should the pt perform?

Answer 41

3 - average them

Question 42

Phalen's test

Answer 42

Wrists held together for 1 min + if pt reports parathesias

Question 43

Froment's sign distinguishes between....

Answer 43

Add pollicus weakness vs ulnar N paralysis

Question 44

Froment's sign procedure

Answer 44

Grasp paper between tips of thumb and radial side of index

Question 45

Positive test for froment's sign

Answer 45

Terminal phalanx flexion OR MCP hyperextension

Question 46

Finkelstein's tests for...

Answer 46

Tenosynovitis of AbPL/EPB (deQuervain's disease)

Question 47

Finkelstein procedure

Answer 47

Make fist while holding thumb inside fist and ulnar deviate + if pt reports pain in area of tendons

Question 48

Tinel's sign

Answer 48

Tap over carpal tunnel + if pt reports parathesias