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E&M > Evaluation Of The Hand > Flashcards

Evaluation Of The Hand Flashcards

1
Q

Wrist drop signifies nerve damage in what nerve?

A

Radial

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2
Q

3 ways to measure edema

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

Volumetric measurements are based on what principle?

A

Archimedes principle of water displacement

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4
Q

Vol measurements of edema are accurate to within _______

A

10 ml

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5
Q

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

A

CMC

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6
Q

How to measure opposition

A

Ruler to measure distance between pinky and thumb

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7
Q

Wrist position for all digital measurements

A

Neutral

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8
Q

Quick and dirty method for composite flexion

A

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

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9
Q

Measure PIP and DIP flexion together with __________

A

MP in extension

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10
Q

How to record finger ROM

A

AROM/PROM

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11
Q

TAM

A

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

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12
Q

TPM

A

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

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13
Q

Normal TAM values

A

220-240

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14
Q

Normal TPM values

A

240-260

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15
Q

Thumb abduction is sometimes called….

A

Radial abduction

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16
Q

Abduction is ___º from the plane of the hand

A

90º

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17
Q

MP Capsular pattern

A

More restriction in flexion than extension

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18
Q

IP capsular pattern

A

More restriction in extension than flexion

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19
Q

Wrist capsular pattern

A

Equal loss of flexion and extension

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20
Q

CMC capsular pattern

A

Abduction and extension limited, flexion relatively free

21
Q

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

A

Torque angle ROM

22
Q

How is torque angle ROM measured?

A

Strain gauge

23
Q

Torque angle ROM has _________ repeatability

A

Excellent

24
Q

Torque angle ROM determines….

A

Whether tx is indicated or not

25
Q

Where to place loop for torque angle ROM passive ext

A

Joint crease

26
Q

Where to place loop for torque angle ROM passive flexion

A

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

27
Q

4 causes for passive restriction to extension

A
  1. Palmar plate adhesion
  2. Palmar skin contracture
  3. Bony block
  4. Flexion tendon adhesion
28
Q

2 causes for passive restriction to flexion

A
  1. Dorsal skin tightness

2. Extensor tendon scar or tightness

29
Q

2 things that can cause active restraint to ext

A
  1. Passive restraint

2. Extensor lag

30
Q

2 things that can cause active restraint to flexion

A
  1. Passive restraints

2. Flexor tendon rupture or adhesion

31
Q

2 causes for limited composite passive flexion

A
  1. Extensor tendon tightness

2. Dorsal skin tightness

32
Q

Reason for limited composite active flexion with normal composite passive flexion

A

Flexor tendon adhesion or rupture

33
Q

Explain the oblique retinacular ligament tightness test

A

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
34
Q

Explain the intrinsic tightness test

A

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
35
Q

4 MMTs with no gravity eliminated position

A
  1. Finger abduction
  2. Adduction
  3. APL
  4. Opposition
36
Q

Give ____________ for a grade of 3 for these two tests

A

Minimal resistance

Thumb MP and IP flexion tests

37
Q

Patient position for dynamometer testing

A

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

38
Q

How many squeezes should pt perform on dynamometer?

A

6 total - 3 each hand, alternating to avoid fatigue

39
Q

2 grip tests

A
  1. Static grip

2. Rapid exchange testing

40
Q

4 positions for pinch testing

A
  1. Lateral pinch
  2. 3 pt pinch
  3. Palmar
  4. Ring/little
41
Q

How many pinch testing trials should the pt perform?

A

3 - average them

42
Q

Phalen’s test

A

Wrists held together for 1 min

+ if pt reports parathesias

43
Q

Froment’s sign distinguishes between….

A

Add pollicus weakness vs ulnar N paralysis

44
Q

Froment’s sign procedure

A

Grasp paper between tips of thumb and radial side of index

45
Q

Positive test for froment’s sign

A

Terminal phalanx flexion OR MCP hyperextension

46
Q

Finkelstein’s tests for…

A

Tenosynovitis of AbPL/EPB (deQuervain’s disease)

47
Q

Finkelstein procedure

A

Make fist while holding thumb inside fist and ulnar deviate

+ if pt reports pain in area of tendons

48
Q

Tinel’s sign

A

Tap over carpal tunnel

+ if pt reports parathesias

E&M (24 decks)

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