Final: Hand Therapy Flashcards
Static
Looking from top of hand down. Can make clenched fist, open palm, a weight or hook. 20% of function
Dynamic
Movement of hand. ROM, end feels, sensation, pinch and grip
Common pinch
tip to tip
pad to pad
tripod
Common grasp
spherical grasp, hook grasp, bilateral palmar
Pinch vs Grasp
pinch involves distal part of fingers
grasp is stronger than pinches
Tip to tip pinch
Common tip to tip pinch (making an O)
Pad to Pad
Pad of index to pad of thumb
Provides sensory info
Tripod pinch
Most common
Used to pencil grip - involves pads of 3 fingers
Lateral pinch
Pad of thumb against lateral side of index
Turning a key, holding a plate etc
Cylindrical grasp
Fingers wrap around and fold towards hand as if holding a dowel
holding a hammer, pot handle, glass/can
Spherical grasp
Palm cupped, wrist extended.
Using door knob, apple etc
Hook grasp
Fingers flexed into palm
Carrying suitcase
Bilateral Palmar grasp
Both hands open
Fingers spread apart
Basketball
Prehension components
A. Reach B. Grasp C. Hold D. Carry E. Placement F. Release
Function of radial side
Manipulation and dexterity
Function of Ulnar side
power and stability
Hand therapy goals
Function
Strength
Functional sensation
Aesthetically acceptable
Distal manipulation:
picking up a pen, having it face the wrong way and rotate it
Squirreling
collecting or hoarding items using only one hand
Translation:
translating one object to another
Evaluation of hand
How client holds arm
Body language
Posture, facial expression
Appearance/ odor
Amputations
mostly caused by power tools
Avulsion injuries:
fingers pulled right off. Water skiing
Flexor tendon
lacerations, crush/ fracture injuries
Treatment for amputations
wound care edema reduction ROM desensitization functional restoration
Zones of Flexor tendon injuries
Zone 1: distal fingers
Zone 2: middle section - most challenging
Zone 3, 4, 5
Treatment for flexor tendon
Early active motion
Controlled passive
Immobilization - kleinart splint
Treatment for extensor tendon injuries
caused by laceration/ fracture or crushed
focus on preventing extensor lag
Neurapraxia:
contusion/ bruising of nerve
Axontmesis
nerve fibres distal to injury degenerate
Neurotmesis:
complete laceration of nerve
Radial nerve injury
most commonly injured
Median Nerve Injury
Median nerve often called the eyes of the hand (provides sensation to much of the palmar hand surface)
Ulnar Nerve Injury
hyperextension of the MCPJs of the ring and small finger (clawing
repetitive stress or strain, overuse syndromes:
tennis elbow, DeQuervain’s tenosynovitis, and carpal tunnel syndrome.
Characteristics of stiff hand
edema, immobility, pain
Treatment for the stiff hand
Proper positioning- splinting. Hand and thumb,
Assure client involvement and understanding
Increase mobility- PROM, stretch, progressive splinting, activity
Control edema
how to control edema
Elevation
Compression- gloves, Coban, AROM, retrograde massage
Contrast baths
