F&A II CH. 30 Acute Hand Injuries

Question 1

When observing a Pt., what observations & inspections are made?

Answer 1

Condition of the skin, edema, odor, scars, trophic changes, skin colors, & temp.

Question 2

Name 2 methods of gathering information for a Pt when trying to determine hand injuries.

Answer 2

• Review Pt’s chart for areas of concern

- Perform the Canadian occupational performance measure (COPM)

Question 3

Name 2 tools for measuring edema.

Answer 3

• Volumeter

- Tape measure

Question 4

Before performing a strength test on the Pt., he must be ……… for full resistance.

Answer 4

Cleared

Question 5

Name the purpose of sensory mapping of the volar surface of the hand.

Answer 5

Sensibility assessment

Question 6

Name the 4 types of tests for sensibility assessment.

Answer 6

• Threshold test
• Functional tests for the quality of sensibility
• Objective tests
• Provocative or stress tests

Question 7

Name the 4 tests for assessing threshold.

Answer 7

• Pain
• Vibration
• Temp
• Touch pressure

Question 8

Name the tests necessary to reproduce Pt complaints of pain or determine peripheral nerve regeneration.

Answer 8

Provocative or stress tests

Question 9

Name the 2 tests for determining dysfunction for sympathetic function.

Answer 9

• O’Riain wrinkle test

- Ninhydrin sweat test

Question 10

Name the observable symptoms that indicate the need for determining dysfunction for sympathetic function.

Answer 10

Smooth, shiny skin, nail changes, tapering of fingers

Question 11

Name 3 tests for assessing nerve compression & nerve regeneration.

Answer 11

• Tinel sign
• Phalen test
• Provocative tests

Question 12

What is the purpose of the vibration test?

Answer 12

Assess vibratory sensation

Question 13

When determining touch pressure, name 2 tests.

Answer 13

• Moving touch

- Semmes-Weinstein monofilaments test

Question 14

How is moving touch assessed?

Answer 14

Assessed with the eraser end of a pencil

Question 15

Name the test that is most accurate for cutaneous pressure thresholds.

Answer 15

Semmes-Weinstein monofilaments test

Question 16

Describe the monofilaments of the Semmes-Weinstein test.

Answer 16

20 nylon monofilaments of increasing thickness

Question 17

Name the 2 purposes for static & moving 2-point discrimination.

Answer 17

• Distinguishes between two direct stimuli

- Elicits information about the potential for function

Question 18

Name the 2 purposes of modified Moberg pick-up test.

Answer 18

• Recognition of common objects by sensation

- Ability of the hand to perform complex functions by feel

Question 19

What are the 2 tests for evaluating hand function?

Answer 19

• Jebsen hand function test

- Dexterity tests

Question 20

Name the standardized test for overall hand function.

Answer 20

Jebsen hand function test

Question 21

What is the purpose of dexterity tests?

Answer 21

Determines the ability to manipulate small objects with speed & accuracy

Question 22

Name the 3 categories for outcome measures.

Answer 22

• Generic: overall health
• Regional: specific body systems
• Disease specific

Question 23

What is the purpose of edema reduction?

Answer 23

Prevents permanent stiffness & disablility

Question 24

Name 3 interventions for edema reduction.

Answer 24

• Elevation
• Contrast baths
• Retrograde massage

Question 25

What is the process of elevation for edema reduction & the contraindication?

Answer 25

Hand above the heart; avoid slings

Question 26

Name the intervention that causes vasodilation & vasoconstriction, resulting in a pumping action on the edema.

Answer 26

Contrast baths

Question 27

When performing retrograde massage, what is the direction of motion.

Answer 27

Move from distal to proximal

Question 28

After performing retrograde massage, what should the Pt do?

Answer 28

Perform active motion following the massage

Question 29

What is manual edema mobilization based on?

Answer 29

Manual lymphatic treatment

Question 30

Name the different pressure wraps.

Answer 30

• Light coban wrap
• Isotoner glove
• Custom made garments

Question 31

If pressure wraps are too tight, what is the effect?

Answer 31

Reduction in circulation

Question 32

Name the 2 physical agent modalities

Answer 32

• Neuromuscular electrical stimulation

- High voltage pulsed current stimulation

Question 33

What does normal blood flow depend on?

Answer 33

AROM

Question 34

How may a Pt improve ROM?

Answer 34

PROM tx

Question 35

What does PROM tx consist of?

Answer 35

• Modalities
• Joint mobilization
• PROM
• Splinting

Question 36

Name the 3 techniques for soft tissue mobility improvement.

Answer 36

• Pressure
• Massage
• AROM

Question 37

What is the purpose of applying pressure for soft tissue mobility improvement?

Answer 37

Modify hypertrophic scar

Question 38

What is the purpose of massage for soft tissue mobility improvement?

Answer 38

Soften the scar tissue

Question 39

How does AROM affect soft tissue mobility improvement?

Answer 39

Provides internal stretch against the scar

Question 40

Name the test that bombards sensory receptors with a variety of stimuli in a repetitive manner.

Answer 40

Sensory reeducation

Question 41

What does the process for sensory reeducation consist of?

Answer 41

Sequence of eyes closed, eyes opened, eyes closed

Question 42

Name the intervention when using pressure, rubbing, vibration, transcutaneous electrical nerve stimulation, percussion, & active motion.

Answer 42

Sensory desensitization