Hand

Question 1

What are the creases of the hand we are concerned about with splinting?

Answer 1

• distal palmar crease
• proximal palmar crease
• simian crease (not all)
• thenar crease

Question 2

What is the distal palmar crease important for? (mvt)

Answer 2

MCP flexion

Question 3

To facilitate MCP flexion, where should a splint stop?

Answer 3

proximal to the distal palmar crease

Question 4

To limit MCP flexion, where should the splint stop

Answer 4

distal to the distal palmar crease

Question 5

Simian crease

Answer 5

• apes have this
• seen in Downs pts
• not seen with everyone
• must accommodate for MCP flexion

Question 6

Thenar crease is important for: (mvt)

Answer 6

opposition

Question 7

Prevent opposition

Answer 7

cover up thenar crease

Question 8

Allow opposition

Answer 8

leave thenar crease exposed

Question 9

No man’s land is where these converge

Answer 9

finger flexors

Question 10

Why is it called no-man’s land?

Answer 10

• finger flexors work together more here

- scar tissue here would cause a contracture

Question 11

What is dual obliquity?

Answer 11

means there’s flexibility in two planes of the hand (arches)

Question 12

What are the arches of the hand

Answer 12

• natural downward arch from 1st »4th phalanx (proximal transverse)
• longitudinal arch

Question 13

What does dual obliquity give us?

Answer 13

• strength

- ability to manipulate objects better than other animals

Question 14

Dual obliquity: remember this about rehab

Answer 14

• hand has curvature that is not spherical

- don’t give a pt a tennis ball to squeeze for strength

Question 15

Skin on palmar surface of hand

Answer 15

• thick, tight

- lots of connective tissue

Question 16

Thick, tight skin on palmar surface helps with

Answer 16

• grip

- shear forces

Question 17

Function of muscles on palmar surfaces

Answer 17

Thenar and hypothenar eminences give cushioning

Question 18

Why would a Z-plasty be done for hand surgery?

Answer 18

allows for greater pliability of tissue

Question 19

Skin: dorsal surface of hand

Answer 19

• thinner, looser than palmar

- less connective tissue

Question 20

Why is it important for the dorsal aspect of the hand to have thinner, looser skin than the palmar aspect?

Answer 20

• important for ROM

- if skin is too tight, can’t flex the wrist

Question 21

Which is more sensitive: dorsal or palmar surface?

Answer 21

dorsal

Question 22

Skin on dorsal surface of hand: impact on therapy

Answer 22

must work on tissue pliability as soon as possible

Question 23

What are the Cleland and Grayson ligaments?

Answer 23

• tiny ligaments in the fingers

- hold skin of your fingers to the bones

Question 24

What happens if the Cleland and Grayson ligaments aren’t intact?

Answer 24

skin can rotate around the finger

Question 25

impact of degloving on skin

Answer 25

• finger skin doesn’t adhere all around the bone when it’s repaired
• loose