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BPK 241 Injury Scenario > Hand > Flashcards

Hand Flashcards

1
Q

Observation for the hand

A
  • Thenar eminence
  • Hand posture
  • Scapula
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2
Q

AROM/PROM

A
  • Wrist flex/ext
  • Radial deviation (inwards)
  • Ulnar deviation (outwards)
  • Finger flex/ext
  • Thumb ext (thumb up)
  • Thumb flex (4)
  • Thumb abduction (z-plane)
  • Thumb adduction (back to hand)
  • Opposition
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3
Q

Strength test for thumb

A
  • Wrist flex/ext
  • Radial deviation (left)
  • Ulnar deviation (right)
  • Finger flex/ext
  • Thumb ext (thumb up)
  • Thumb flex (4)
  • Thumb abduction (z-plane)
  • Thumb adduction (back to hand)
  • Opposition
  • Grip strength
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4
Q

Ligament stress test for hand

A
  • Ulnar collateral ligament of thumb
  • Radial collateral ligament of thumb
  • Ulnar and radial collateral ligaments of IP joints
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5
Q

Special test for hand

A
  • Phalen test
  • Tinnel tap test
  • Derkan test
  • Scaphoid compression test
  • Pinch test
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6
Q

Phalen test

A
  • Dorsal side of wrist touching each other
  • Bring arms up
  • Tests for carpal tunnel
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7
Q

Tinel tap test

A
  • Tap on the carpal tunnel
  • Tingling feeling
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8
Q

Derkan Test

A
  • Apply pressure on carpal tunnel and hold
  • Test for sensory
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9
Q

Scaphoid compression test

A
  • Handshake
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10
Q

Pinch test

A
  • Get patient to pinch thumb and index finger and try to break it a part
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11
Q

Palpation for the hand

A
  • Anatomical snuff box
  • Ulnar collateral ligament of thumb
  • Radial collateral ligament of thumb
  • Ulnar and radial collateral ligaments of IP joints
  • Carpal tunnel
  • Thenar
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12
Q

Injuries for the hand

A
  • Carpal tunnel syndrome –> chronic
  • Scaphoid fractures –> acute
  • Thumb hyperextension –> acute
  • Collateral ligament sprain of fingers –> acute
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13
Q

History for carpal tunnel syndrome

A
  • Pain or numbness, tingling in median nerve
  • Hand feeling clumsy
  • Worse with direct pressure or using hand
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14
Q

Assessment for carpal tunnel syndrome

A
  • Atrophy of thenar eminence
  • Decreased grip strength
  • Positive Phalen’s test
  • Positive Tinel’s tap test
  • Positive Derkan’s test
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15
Q

Treatment for carpal tunnel syndrome

A
  • Rest, ice, brace
  • No compression
  • ROM exercises –> palm side bring fingers into ext to stretch flex muscles, dorsal side bring fingers into flex to stretch ext muscles, prayer stretch slowly lower hands
  • Strengthening exercises –> wrist flex and ext with dumbbell, grip strengthening with stress ball
  • Correct any loading issues
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16
Q

History for scaphoid fracture

A
  • FOOSH injury
  • Frequently confused for a wrist sprain
  • Lots of pain in wrist on radial side
  • Pain with movement
17
Q

Assessment for scaphoid fracture

A
  • Decreased ROM in all directions
  • Especially painful into radial deviation
  • Weakness with thumb movements
  • Positive scaphoid compression test
  • Positive pain with palpation of anatomical snuff box
18
Q

Treatment for scaphoid fractures

A
  • Send for medical attention with doctor and xray
  • Immobilize, ice, cast
  • Restore ROM –> wrist flex/ext, radial, ulnar, finger flex/ext
19
Q

History for thumb hyperextension

A
  • Fall on hand with thumb being forced backwards
  • Thumb getting jammed back or stuck
  • Common with sports involving a ball and catching
20
Q

Assessment for thumb hyperextension

A
  • Swelling around MCP joint of thumb
  • Limited AROM/PROM into extension and ABD
  • Positive pinch test
  • Laxity and pain with UCL stress test of 1st MCP
  • Possible damage to RCL ligament
21
Q

Treatment for thumb hyperextension

A
  • POLICE
  • ROM and strengthening –> thumb extension, abduction with and without resistance
  • Tape job
  • Splint at night
22
Q

History for collateral ligament sprain of the fingers

A
  • Common in ball sports
  • Jamming end of finger
  • Valgus or varus force
  • Finger is quite swollen
  • Limited mobility
23
Q

Assessment for collateral ligament sprain of the fingers

A
  • Swelling around injured finger
  • Limited AROM/PROM into flex/ext
  • Pain and laxity either UCL or RCL
24
Q

Treatment collateral ligament sprain of the fingers

A
  • Ice bucket
  • Splint finger
  • Self massage
  • Gentle ROM and strengthening –> extension and abd of finger with and without resistance
  • Deep transverse friction massage
  • Buddy tape for return to sport

BPK 241 Injury Scenario (11 decks)

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