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NBCOT > Hand > Flashcards

Hand Flashcards

1
Q

Resting hand splint degrees

A

Wrist 20-30 extension
MCP 45 to 60 flexion
PIP and DIP 15 to 30 flexion
Thumb in opposition

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2
Q

Anti deformity or intrinsic plus position degrees

A

MCP flexion 70-90
PIP and DIP full extension
Thumb in abduction and opposition
Wrist extension 20-30

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3
Q

What is anti deformity or intrinsic plus position used for

A

Burns, trauma and invasive suegery

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4
Q

For sensation how is SCI tested

A

Proximal to distal following dermatome patterns

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5
Q

For sensation, how is peripheral nerve injuries tested

A

Distal to proximal

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6
Q

What is the order of return for sensation for peripheral nerve injuries

A

Pain
Moving touch
Static light touch
Touch localization

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7
Q

Nerve healing and testing order if recover for sensation

A

1 Point moving
1 Point discrimination
2 Point moving
2 Point discrimination

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8
Q

What is steregnosis

A

Recognition by touch of objects

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9
Q

What is moving 2 point discrimination

A

Tests begins with points 5-8mm apart
Proximal to distal on fingertips in longitudinal orientation

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10
Q

What is static 2 point discrimination

A

Begins at 5mm
Applied to fingertips in longitudinal orientation

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11
Q

What is the Purdue pegboard

A

Test of fingertip dexterity and assembly job stimulation

Perferred

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12
Q

What is the Minnesota manual dexterity test

A

Test of gross hand and arm movements

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13
Q

What is the o’Connor tweezer test

A

Test of hand eye coordination using tweezers

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14
Q

What is the Crawford small parts dexterity test

A

Test of fine motor dexterity using small tools (tweezers and screwdrivers)

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15
Q

What is 9 hole peg test

A

Measures finger dexterity

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16
Q

What is codmans exercise

A

Common form of PROM
Lean on table and let arm dangle

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17
Q

What is isometric contraction

A

Contraction without movement
Can produce forceful contraction

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18
Q

What type of individuals is isometric contraction contraindicated for

A

Hypertension and cardiovascular problems

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19
Q

What is isotonic contraction

A

Concentric- shortening
Eccentric- lengthening

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20
Q

What population uses isotonic exercises

A

For people with hypertension and heart disease

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21
Q

What splint would a child under 12 use

A

Immobilization splint

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22
Q

What splint is used for brachial plexus injury

A

Flail arm splint for positioning
Greatest degree of abduction OTR should allow is 90

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23
Q

Splint for radial nerve injury

A

Colditz splint or radial nerve splint to assist with partial wrist motion and finger extension

Wrist cock up

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24
Q

Splint for median nerve injury

A

Opponens splint, C bar and thumb post splint used to hold thumb in opposition

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25
Q

Splint for ulnar nerve injury

A

Anticlaw splint or lumbrical bar splint to position MCPs in flexion of 4 and 5 digit

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26
Q

Splint for combo median and ulnar nerve

A

Figure 8 or lumbricald bar splint to position MCPs in flexion for digits 2-5

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27
Q

Splint for carpal tunnel

A

Wrist cock up
Wrist slight extension (10 degrees), fingers and thumb free

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28
Q

Splint for cubital tunnel syndrome

A

Elbow splint position at 30 flexion

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29
Q

Splint for de quervains and skiers thumb

A

Thumb spica splint

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30
Q

Splint for cmc arthritis

A

Hand based thumb splint

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31
Q

Splint for ulnar drift

A

Ulnar drift/ deviation splint

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32
Q

Splint for flexor tendon injury and degrees

A

Dorsal protection splint
20-30 wrist flexion
50-70 IP flexion
IP extension

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33
Q

Splint for boutonnière and Swan neck

A

Silver ring

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34
Q

Splint for flaccidity

A

Resting/ functional hand splint

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35
Q

Splint for spasticity

A

Cone splint

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36
Q

What PAMs used for CRPS

A

Contrast bath- type 1
Biofeedback- Type 2

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37
Q

What is dupuytrens disease

A

Disease of fascia of palm and digits
Results in flexion deformities of involved digits

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38
Q

What is skiers thumb

A

Rupture of ulnar collateral ligament of MCP joint of thumb

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39
Q

OT interventions for skiers thumb

A

Thumb spica splint- 4-6 weeks
AROM and pinch strength- 6 weeks
ADL that focus on opposition and pinch strength

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40
Q

Complex regional pain syndrome

A

Follows trauma
Pain, edema, discoloration, osteoporosis, sudomotor changes, temp changes, tropic changes, vasomotor instability

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41
Q

OT intervention for CRPS

A

STRESSLOADING

42
Q

Colles fracture

A

Distal radius fracture with dorsal displacement
Fall with outstretched hand

43
Q

Smiths fracture

A

Distal radius with volar displacement
Fall with wrist in flexion

44
Q

Boxer fracture and splint

A

4 and 5 MCP

Ulnar gutter fracture

45
Q

Mallet finger and splint

A

Avulsion injury to terminal extensor tendon

Splint in full extension for 6 weeks

46
Q

Elbow fractures

A

Humerus ROM as early as 2 weeks
Aggressive strengthening 4-6 weeks

47
Q

Immobilization phase of fractures

A

Stabilization and healing is goal
AROM of joints above and below stabilized parts
Edema control
Light ADL with no resistance

48
Q

Mobilization phase of fractures

A

Consolidation is goal
Edema control
Splint for protection
AROM
Light purposeful occupation based activities
Pain management
Strengthening when approved

49
Q

De quervains

A

Abductor pollicis longus and extensor Pollicis brevis
Pain and sweeping over radial styloid
Positive finklesteins test
Thumb spica

50
Q

Lateral epicondylitis

A

Overuse of wrist extensors
Tennis elbow

51
Q

Medial epicondylitis

A

Overuse of wrist flexors
Golfers elbow

52
Q

Treatment for lateral and medial epicondylitis

A

Elbow strap/ wrist splint
Ice and deep friction massage
Stretching
Activity and work mods

53
Q

Trigger finger

A

Tensynovitis of finger flexors A1 pully

54
Q

Treatment for trigger finger

A

Hand or finger splint- MCP extended and IP joints free
Scar massage
Edema control
Tendon gliding
Activity and work mods

55
Q

When is a repaired tendon at its weakest

A

10-12 days post op

56
Q

Early mobilization program for flexor tendons kleinert approach

A

Passive flexion and active extension

57
Q

Kleinert protocol early phase

A

0-4 weeks
Dorsal block splint
Passive and active extension

58
Q

Kleinert protocol immediate phase

A

4-7 weeks
Continue dorsal splint but wrist in neutral
Place/ hold exercises and differential flexor tendon gliding exercises

59
Q

Kleinert protocol 6-8 weeks

A

AROM
Differential tendon gliding
Light purposeful and occupation based activities
Discharge splint

60
Q

Duran protocol

A

Passive flexion and extension of digits

61
Q

Duran protocol 0-4 1/2 weeks

A

Dorsal blocking splint
Exercises in splint

62
Q

Duran protocol 4 1/2- 6 weeks

A

Tendon gliding
Place and hold
Active flexion and extension

63
Q

Duran protocol 6-8 weeks

A

Tendon gliding and differential tendon gliding
Scar management
Light purposeful and occupation based

64
Q

Duran protocol 8-12 weeks

A

Strengthening and work activities

65
Q

Carpal tunnel syndrome

A

Median nerve compression
Positive tinel and phalen test

66
Q

Treatment for carpal tunnel

A

Wrist splint in neutral
Median nerve gliding
Activity mod
Surgical release
Edema control
AROM

67
Q

Pronator teres syndrome

A

Median nerve compression between pronator heads
Aching pain in proximal forearm
Positive Tinels sign at forearm

68
Q

Treatment for pronator teres syndrome

A

Elbow splint at 90 with forearm neutral
Avoid pronation and supination
AROM (8 weeks)
Nerve gliding
Strengthening
Sensory re-education

69
Q

Guyons canal

A

Ulnar nerve compression at wrist
Positive tinels syndrome at guyons canal

70
Q

Treatment for Guyons canal

A

Wrist splint in neutral
Work/ activity mod
Edema control
AROM
Nerve gliding
Strengthening (2-4) weeks- power grip

71
Q

Cubital tunnel syndrome

A

Ulnar nerve compression at elbow
Avoid elbow flexion
Positive tinels sign at elbow
Weakness of power grip

72
Q

Treatment for cubital tunnel syndrome

A

Elbow splint 30 flexion
Work/ activity mod
Edema control
Scar management
AROM and nerve gliding (post 2 weeks)
Strengthening (4 weeks)

73
Q

Radial nerve palsy

A

Radial nerve compression
Wrist droop

74
Q

Radial nerve palsy treatment

A

Wrist cock up splint
Dynamic wrist and MCP extension splint
Work/ activity mod
Strengthening wrist and finger extensors
AROM
strengthening (6-8 weeks post)
Avoid combo forearm pronation, elbow extension and wrist flecion

75
Q

Low lesion deformity to median nerve

A

Ape hand

76
Q

High lesion deformity to median nerve

A

Benediction

77
Q

Ape hand

A

Low lesion
Flattening of thenar eminence
Fixed position

78
Q

Benediction

A

When asked to make fist- can flex digits 4 and 5 but not digits 2 and 3
High lesion median nerve

79
Q

Splint for ape hand

A

30 flexion dorsal blocking splint

80
Q

Splint for benediction

A

30 flexion dorsal blocking splint with elbow 90 flexion

81
Q

Treatment for ape hand and benediction

A

Dorsal splint
AROM/ PROM of digits with wrist flexed position (2 weeks post op)
Scar management
Strengthening 9 weeks

82
Q

Claw hand

A

Fixed position
Ulnar nerve laceration
Positive froments sign
Loss of power grip and decrease pinch strength
Digits 4 and 5

83
Q

OT intervention for claw hand

A

MCP flexion block splint
Sensory re education at 10-12 weeks
Same as median nerve repair

84
Q

OT intervention for radial nerve injury

A

Dynamic extension splint
ROM
Sensory re-education
Home program
Activity mod
NMES
Isotonic stretching

85
Q

Rotator cuff tendinitis OT conservative treatment

A

Activity mod
Educate in sleep position
Decrease pain
Restore pain free ROM
strengthening below shoulder level
Occupation and role specific training

86
Q

Rotator cuff tendinitis OT postoperative intervention

A

PROM 0-6 weeks
AAROM/ AROM 6-8 weeks
Sling or abduction orthosis between extremities
Decrease pain ice to heat
Strengthening with isometric to isotonic 8-10 weeks
Leisure and work activities 8-12 weeks

87
Q

Adhesive capsulitis

A

Restricted ROM
So encourage ROM through ADL and role
PROM
Modalities

88
Q

Rheumatoid arthritis

A

Remission and exacerbation
Systemic, symmetrical and affects many joints

89
Q

Osteoarthritis

A

Degenerative joint disease
Wear and tear
Affects large joints
Attacks hyaline cartilage

90
Q

Bone spurs at DIP joints

A

Heberden

91
Q

Bone spurs at PIP joints

A

Bouchards

92
Q

OT interventions for OA and RA

A

Resting hand splint in acute phase
Joint protection techniques
Energy conservation
ROM- focus on PROM
Heat modalities- hot pack before exercises, parafinn

93
Q

Radial tunnel syndrome

A

Entrapment of radial nerve in area extending from radial head to supinate muscles
Burning pain in lateral forearm

94
Q

anterior interosseous syndrome

A

Compression to anterior interosseous nerve
Motor loss involving flexor Pollicis longus to thumb and FDP to index finger and pronator quadratus

95
Q

Double crush injury

A

Occurs when peripheral nerve is entrapped in more than 1 location

96
Q

Protective re-education after nerve injury

A

Educates client to visually compensate for sensory loss and avoid working with machinery below temp of 60

97
Q

Discriminative reeducation after nerve injury

A

Uses motivation and repetition in a vision tactile matching process in which clients identify objects with or without vision

98
Q

Inflammatory wound healing phase

A

Acute phase lasts 24-48 hrs to 7 days
Subacute phase 7-14 days
Redness, swelling, heat and pain

99
Q

Proliferators phase of wound healing

A

Wound contraction lasts 5 days to 2-3 weeks

100
Q

Remodeling phase of wound healing

A

Lasts 2 weeks to 1-2years
Dynamic splinting, serial casting, continuous passive motion, positional stretching, NMES, and gel pads to decrease hypertrophic scarring

101
Q

Splint for dupuytrens

A

Extension splint at all times except bathing

NBCOT (6 decks)

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