Hand and wrist.

Question 1

Where do Herberden’s nodes show up?

Answer 1

posterior surface of DIP joints.

Question 2

Where do bouchard’s nodes show up?

Answer 2

posterior surface of PIP joint

Question 3

What are some extra things to look for in observation of hand?

Answer 3

Herberden and Bouchard’s nodes
Thenar atrophy
Clubbing fingers.

Question 4

What are alignment impairments associated with rheumatoid arthritis ?

Answer 4

Swans neck
boutonnieres hand
thumb z hand
ulnar drift

Question 5

excessive PIP extension and DIP flexion.

Answer 5

Swans neck

Question 6

What are causes of swans neck?

Answer 6

• synovitis of MCP causing intrinsic spasm

- synovitis of PIP causing lateral restraint

Question 7

excessive PIP flexion and DIP extension.

Answer 7

boutonniere’s hand.

Question 8

thumb positions in MCP flexion and IP extension

Answer 8

Thumb Z hand.

Question 9

wrist in radial deviation and MCP in ulnar deviation

Answer 9

ulnar drift.

Question 10

what alignment impairments are associated with peripheral nerve injury?

Answer 10

ape hand
bishops hand
claw hand
drop wrist

Question 11

thump MCP in same plane as digits 2-5.. can’t move into opposition

due to

Answer 11

ape hand.

median nerve damage.

Question 12

can’t extend IP jt of digit 4 and 5?

Answer 12

Bishops hand

ulnar nerve damage.

Question 13

IP of all fingers flexed and mcp hyperextended

Answer 13

claw hand.

ulnar and median.

Question 14

wrist and fingers position in flexion and cannot extend actively.

Answer 14

drop wrist

radial nerve damage.

Question 15

Along with hand and wrist ROM you should take

Answer 15

shoulder and elbow.

especially in on splint.

Question 16

grip strength done with:

men normals:
women normals:

how much grip strength needed for ADLs?

Answer 16

dynamometer

102-113 pounds

60-71 pounds.

3-5 lbs.

Question 17

Special tests of hand/wrist

Answer 17

Phalens
Tinels
Finkelstein

Question 18

Contracture of palmar fascia.

common area?

Answer 18

dupytren’s contracture.

digit 4-5

Question 19

compression of anterior compartment of forearm, resulting occlusion of radial artery and subsequent contracture of long flexors.

Answer 19

Volkmann’s ischemic contracture

compartment syndrome.

Question 20

numbness and tingling in radial 3 digits worse at night

Answer 20

carpal tunnel syndrome.

Question 21

physical finding of wrist fractures

Answer 21

pain with AROM
localized tenderness
Pain with PROM
pain with gripping/ supination.

Question 22

Fall on outstretched arm, with forearm pronated and wrist extended

Answer 22

colles fracture.

Question 23

what do patient heal in for college fracture?

Answer 23

wrist extension
wrist radial deviation
forearm supination

Question 24

with collet fracture patients may limit ROM in

Answer 24

wrist flexion
wrist ulnar deviation
forearm pronation.

Question 25

interventions for college fracture?

Answer 25

6 weeks in cast. or surgery if angle is severe. Tx. address wrist ROM, accessory motion, strength, pain, swelling.

Question 26

>70% of all carpal fractures

Answer 26

scaphoid fractures.

Question 27

___ %Scaphoid Fx. heal with _____ if Dx. delayed, there is risk of

Answer 27

90%/early treatment. malunion/nonunion/avascular necrosis.

Question 28

With is TFCC. how is it characterized and who commonly gets it?

Answer 28

triangular fibrocartilage complex tear. ulnar writ pain and clicking. lunotriquetrial tenderness common in athletes.

Question 29

how is TFCC Dx? and what is the immediate Tx?

Answer 29

MRI or arthrogram immobilization or surgery.

Question 30

CRPS _____ times more common in what?

Answer 30

4x> in women than men.

Question 31

characteristics of CRPS in acute stage?

Answer 31

- burn/ache in "stocking glove distribution" - edema - warm/dry/red skin - Hyperesthesia

Question 32

Characteristics of CRPS in dystrophic stage?

Answer 32

- burn/ache/throbbing pain. - edema - cool/grey/cyonatic skin - slowed hair/nail growth - muscle wasting/stiff joints.

Question 33

Characteristic of CRPS in atrophic stage?

Answer 33

pain cool/thin skin atrophy + contractures. Severe osteoporosis.

Question 34

management of CRPS?

Answer 34

nerve blocks. sympathectomy Meds.

Question 35

PT interventions for CRPS

Answer 35

``` stress loading exercise Massage Limb desensitization Compression garments Graded motor imagery. ```

Question 36

3 components of graded motor imagery?

Answer 36

1: Laterality: RvsL. 2: Imagery: mental practice 3: Mirror therapy

Question 37

a neuro-rehabilitation technique designed to remodulate cortical mechanisms by using vision to reprogram motor and sensory processes.

Answer 37

mirror therapy.

Question 38

Etiology of CPS is _ attributed to

Answer 38

unknown. prolonged typing/ repetitive activity of wrist extension and finger flexion.

Question 39

Characteristics of CPS?

Answer 39

numb/tingle/motor loss in area innervated by median nerve.

Question 40

Differential Dx. of Carpal Tunnel Syndrome

Answer 40

- tendinopathy of finger flexor - lesion of median nerve proximal to carpal tunnel. - double crush injury