Hand Impairments Flashcards
____ Effect – demonstrates the interconnectedness of digits whereby the limitations of one digit can cause restriction of the uninjured other digits
Quadriga
The hands are a organ of _____
Expression
There are __ bones in the hand
27
There are __ long bones and __ carpal bones
19
8
There are ___ intrinsic and about the same amount of ___ that originate in the forearm
19
Tendons
The stages of wound healing are?
Inflammatory Phase: (hemostasis)
Fibroplasia Phase: (Proliferation and migration)
Maturation or Remodeling Phase:
The inflammatory Phase: (hemostasis) lasts ___, marked by ___ followed by ___ with WBCs migrating to the injured tissue site
several days
vasoconstriction
vasodilation
Fibroplasia Phase: (Proliferation and migration) starts ~ day __ & continues __ to __ weeks
4
2-6 weeks
The fibroplasia phase is marked by?
marked by scar tissue formation & increased collagen fibers -> increased wound tensile strength
- Maturation or Remodeling Phase: could last for __ with tissue being responsive earlier vs. later
years
more
Edema can lead to ____ of the hand
Deformity
Tension on extrinsic structures of the hand can cause?
Zig-Zag Collapse
Common deformity position
Wrist in flexion,
MCP in hyperextension,
PIP and DIPS in flexion,
thumb in Adduction
Common patterns of stiffness, MCPs in ___; IPs in _____
MCP’s in Extension
IP’s in Flexion
The Antideformity Position is also Called
Intrinsic plus position
Describe the antideformity position
- Wrist in neutral or extension
- MPs flexed
- IPs extended
- Thumb in ABD or opposition
- Counterforces zigzag collapse
Immature scars visual description
red/purple and blanch (change color) to touch
Mature scars are ___ and ____ , neutral in __ and do not blanch to touch
flatter and softer
color
Decreased PROM may be due to?
- Tight muscles/tendon
- Tendon adhesions
- Joint limitations
- Capsule, ligament shortening/adhering
- Mechanical block
- Decreased AROM may be due to:
- Weakness * Adhesions * Disruption of the musculotendinous unit
- If the JOINT is tight then PROM will ____with repositioning of the proximal or distal joints
not change
If it is Musculotendinous Tightness will __ with repositioning of the proximal or distal joints
vary
What is a Lag?
Limited AROM in joint, but PROM is feasible
Four Cardinal symptoms of CRPS
- pain* 2.stiffness * 3swelling. * 4.discoloration
A Boxer’s Fracture is a fracture of
4th or 5th transverse neck of Metacarpal Fx
Smith Fracture
Fracture of distal end of radius is displaced volarly.
Usually from a fall on the dorsal aspect of the wrist
The ____ fracture is the most common carpal bone fracture
scaphoid
Jersey finger is an injury to the ___ Tendon at the ___
Flexor Digitorum Profundus
DIP
Mallet Finger is an Injury to the ____ Tendon
Extensor Digitorum
Trigger Finger (Flexor Tenosynovitis)
- Hypertrophy or stenosis of the A1 pulley
- Strongly associated with Diabetes and RA
- Present with pain with resisted grip, pain with palpation over A1 pulley, and painful catching or locking of the finger in flexion
Dupuytren’s Contracture
- Nodules and cords formation on the palmerdigital fascia of the hand
- Typically 4th and 5th digit
- Bands can displace neurovascular bundles and cause soft tissue and joint contractures
- Cause is unknown
- Highly associated with Diabetes and RA
De Quervain’s Tenosynovitis
Tenosynovitis of the Abductor Pollicis Longus (APL) and Extensor Pollicis Brevis (EPB)
- Run through 1st dorsal wrist compartment
- Occurs from repetitive thumb hyperabduction or wrist radial deviation
- Identified by positive Finkelstein’s Test
