F&A II CH. 30 Acute Hand Injuries Flashcards
When observing a Pt., what observations & inspections are made?
Condition of the skin, edema, odor, scars, trophic changes, skin colors, & temp.
Name 2 methods of gathering information for a Pt when trying to determine hand injuries.
- Review Pt’s chart for areas of concern
- Perform the Canadian occupational performance measure (COPM)
Name 2 tools for measuring edema.
- Volumeter
- Tape measure
Before performing a strength test on the Pt., he must be ……… for full resistance.
Cleared
Name the purpose of sensory mapping of the volar surface of the hand.
Sensibility assessment
Name the 4 types of tests for sensibility assessment.
- Threshold test
- Functional tests for the quality of sensibility
- Objective tests
- Provocative or stress tests
Name the 4 tests for assessing threshold.
- Pain
- Vibration
- Temp
- Touch pressure
Name the tests necessary to reproduce Pt complaints of pain or determine peripheral nerve regeneration.
Provocative or stress tests
Name the 2 tests for determining dysfunction for sympathetic function.
- O’Riain wrinkle test
- Ninhydrin sweat test
Name the observable symptoms that indicate the need for determining dysfunction for sympathetic function.
Smooth, shiny skin, nail changes, tapering of fingers
Name 3 tests for assessing nerve compression & nerve regeneration.
- Tinel sign
- Phalen test
- Provocative tests
What is the purpose of the vibration test?
Assess vibratory sensation
When determining touch pressure, name 2 tests.
- Moving touch
- Semmes-Weinstein monofilaments test
How is moving touch assessed?
Assessed with the eraser end of a pencil
Name the test that is most accurate for cutaneous pressure thresholds.
Semmes-Weinstein monofilaments test
Describe the monofilaments of the Semmes-Weinstein test.
20 nylon monofilaments of increasing thickness
Name the 2 purposes for static & moving 2-point discrimination.
- Distinguishes between two direct stimuli
- Elicits information about the potential for function
Name the 2 purposes of modified Moberg pick-up test.
- Recognition of common objects by sensation
- Ability of the hand to perform complex functions by feel
What are the 2 tests for evaluating hand function?
- Jebsen hand function test
- Dexterity tests
Name the standardized test for overall hand function.
Jebsen hand function test
What is the purpose of dexterity tests?
Determines the ability to manipulate small objects with speed & accuracy
Name the 3 categories for outcome measures.
- Generic: overall health
- Regional: specific body systems
- Disease specific
What is the purpose of edema reduction?
Prevents permanent stiffness & disablility
Name 3 interventions for edema reduction.
- Elevation
- Contrast baths
- Retrograde massage
What is the process of elevation for edema reduction & the contraindication?
Hand above the heart; avoid slings
Name the intervention that causes vasodilation & vasoconstriction, resulting in a pumping action on the edema.
Contrast baths
When performing retrograde massage, what is the direction of motion.
Move from distal to proximal
After performing retrograde massage, what should the Pt do?
Perform active motion following the massage
What is manual edema mobilization based on?
Manual lymphatic treatment
Name the different pressure wraps.
- Light coban wrap
- Isotoner glove
- Custom made garments
If pressure wraps are too tight, what is the effect?
Reduction in circulation
Name the 2 physical agent modalities
- Neuromuscular electrical stimulation
- High voltage pulsed current stimulation
What does normal blood flow depend on?
AROM
How may a Pt improve ROM?
PROM tx
What does PROM tx consist of?
- Modalities
- Joint mobilization
- PROM
- Splinting
Name the 3 techniques for soft tissue mobility improvement.
- Pressure
- Massage
- AROM
What is the purpose of applying pressure for soft tissue mobility improvement?
Modify hypertrophic scar
What is the purpose of massage for soft tissue mobility improvement?
Soften the scar tissue
How does AROM affect soft tissue mobility improvement?
Provides internal stretch against the scar
Name the test that bombards sensory receptors with a variety of stimuli in a repetitive manner.
Sensory reeducation
What does the process for sensory reeducation consist of?
Sequence of eyes closed, eyes opened, eyes closed
Name the intervention when using pressure, rubbing, vibration, transcutaneous electrical nerve stimulation, percussion, & active motion.
Sensory desensitization
