Hand Therapy Flashcards

1
Q

What are the main joints in the hand.

A
Distal interphalangeal joint,
Proximal interphalangeal joint,
Metacarpophalangeal joint,
Carpmetacarpal joint,
Radiocarpal joint.
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2
Q

What are the main joints in the thumb

A
  • Interphalangeal joint,
  • metacarpophalangeal joint,
  • carpometacarpal joint,
  • Radiocarpal joint.
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3
Q

What are the bones in the fingers and hand

A
Distal phalange,
Middle phalange,
Proximal phalange,
Metacarpals,
Carpals,
Radius,
Ulna
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4
Q

Main bones in the thumb

A
Distal phalange,
Proximal phalange,
Metacarpals,
Carpals.
Radius,
Ulna
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5
Q

What are the 8 carpal bones

A

Bottom 3 Left to Right:

  • Scaphold,
  • Lunate,
  • Triquetrum

Top 5 left to Right:

  • Trapezium,
  • Trapezoid,
  • Capitate,
  • Hamate,
  • Pisiform.
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6
Q

What are the 9 creases of the hand

A
DIP crease,
PIP crease,
IP crease,
Palmar digital crease,
Distal palmar crease,
Proximal palmar crease,
Median crease,
Thenar crease,
Wrist crease.
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7
Q

What are the 3 main arches of the hand

A

1) Proximal transverse arch,
2) Distal transverse arch,
3) Longitudinal arch.

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8
Q

What is a tendon.

A

-A tendon is a fibrous connective tissue that attaches muscle to bone

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9
Q

What is the role of a ligament

A
  • Ligaments are bands of tissue that help connect bones, joints and organs and hold them in place,
  • Hold bones together,
  • Stabilise muscles and bones + strengthen joints.
  • Allow joint to move in direction it’s meant too.
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10
Q

What are the two sides of the hand

A

Palmar and dorsal

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11
Q

What is the role of the Volar plate

A
  • Volar plate is a small piece of ligament on the palm side of the middle phalanx on your finger.
  • Helps support middle joint of your finger and prevents it from being able to dislocate or over straighten.
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12
Q

What are the 3 main nerves in the hand

A

Ulnar nerve
Median nerve
Radial nerve

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13
Q

Key things about the median nerve

A
  • Originates at shoulder,
  • Controls the muscles we need to perform fine precision hand movements and pinching functions,
  • Enters through carpal tunnel,
  • controls sensation in the thumb, middle finger and one side of the ring finger.
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14
Q

Key things about ulnar nerve

A
  • Runs Through the arm into the hand
  • Largest unprotected nerve in the body,
  • Connects little finger and adjacent side of the ring finger,
  • Provides sensation to the palm side of the hand,
  • Enables us to grasp objects
  • Enters palm of the hand through Guyons canal
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15
Q

Key things about Radial nerve

A
  • Nerve Runs through our arm and controls our ability to extend our wrist and control the position of our hand.
  • Provides sensory feedback from the back of the little finger and adjacent side of the ring finger.
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16
Q

What does SOAP stand for

A

Subjective,
Objective,
Analysis,
Plan.

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17
Q

Things to include in an objective assessment

A
  • Your observation,
  • Patients wound and it’s condition,
  • Patients scar and it’s condition,
  • Palpation,
  • Tendons,
  • Oedema,
  • ROM, Grip, Sensation.
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18
Q

Key things about mallet finger injuries

A
  • It’s an injury to the end of your finger that causes it too bend inwards towards your palm.
  • Will not be able to straighten the end of your finger because tendon connecting muscle to finger bone is stretched or torn.
  • Finger will be painful and swollen.
  • Extensor tendon is affected.
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19
Q

What are collateral ligament injuries also known as?

A

Joint sprains.

20
Q

How is a collateral ligament injury graded?

A

Grade 1- Asymmetric swelling and tenderness,
Grade 2- Complete disruption of collateral ligament but Volar plate remains intact,
Grade 3- Total collateral ligament disruption and Volar plate rupture.

21
Q

What are the 3 types of dorsal dislocation (hyper-extension injuries)?

A

Type 1 hyperextension,
Type 2 Dorsal dislocation,
Type 3 Fracture- dislocation

22
Q

Why does a boutonierre deformity form?

A
  • Rupture of the central slip,
  • Lateral bands descend volarly around the PIPJ causing a flexion pull to the PIPJ and hyper-extension to the DIPJ.
  • Oblique retinacular and transverse retinacular ligaments tighten.
  • Triangular ligament tears,
  • Intrinsic muscles tighten causing proximal migration of central slip.
23
Q

What does the Elson’s test do?

A

It’s used for early detection of injuries to the central slip of the extensor tendon.

24
Q

List the 10 common classifications of fracture

A
  • Normal,
  • Transverse,
  • Open,
  • Oblique,
  • Commiuted/stress,
  • Segmental,
  • Avulsed,
  • Oblique non-displaced,
  • Taurus,
  • Greenstick
25
Q

What are the three stages of fracture healing.

A

Inflammatory phase,
Reparative (proliferative) phase,
Remodelling (maturation) phase.

26
Q

How long does it typically take for a fracture to heal

A

4-6 weeks.

27
Q

What are 5 common fracture fixations.

A
  • K-wires,
  • Lag screws,
  • Circulage wires,
  • plate/screw,
  • Traction.
28
Q

What is osteoarthritis?

A
  • Where cartilage that cushions the ends of bones in your joints deteriorates.
  • Causes joints to become painful and stiff it’s the most common type of arthritis.
29
Q

What are the 4 stages of osteoarthritis

A

Stage 1- minor,
Stage 2 -mild,
Stage 3 -moderate,
Stage 4-Severe

30
Q

What are the causes of osteoarthritis?

A
  • Joint injury,
  • Rheumatoid arthritis,
  • age,
  • family history,
  • obese,
  • being a woman
31
Q

What are the clinical symptoms of osteoarthritis

A
  • pain,
  • stiffness,
  • tenderness,
  • swelling,
  • bone spurs,
  • grating sensation,
  • loss of flexibility.
32
Q

How is osteoarthritis diagnosed?

A
  • Gp will ask questions about pain and examine joints affected,
  • X-Rays to rule out other possible causes such as rheumatoid arthritis.
33
Q

What are three deformities associated with osteoarthritis

A
  • Heberdens nodes,
  • Bouchards nodes,
  • Z-Deformity.
34
Q

What is Rheumatoid arthritis.

A
  • It’s a long term condition that causes pain, swelling and stiffness in the joints,
  • Caused by the immune system attacking healthy body tissue.
35
Q

How stages of Rheumatoid arthritis is there?

A

4 Stages

36
Q

What are the clinical symptoms of rheumatoid arthritis?

A
  • Pain in the joints usually a throbbing and aching pain.
  • Stiffness in the joints,
  • Swelling, warmth and redness around the joints caused by inflammation.
37
Q

How is Rheumatoid arthritis diagnosed?

A
  • GP will do physical examination of joints to examine swelling will ask about symptoms,
  • Blood tests,
  • Joint scans such as x-ray,
  • assessing physical activity.
  • Rheumatoid factor and anti-ccp anti bodies.
38
Q

What are the defomities associated with rheumatoid arthritis?

A
  • Boutanierre,
  • Swan neck,
  • Ulnar drift,
  • Z-Deformity.
39
Q

What are the main principles for joint protection?

A
  • Respect for pain,
  • Balance activity and rest,
  • Avoid activities which cannot be stopped,
  • Use longer stringer joints for activities
40
Q

What are the main principles of energy conservation?

A
  • Pace,
  • Plan,
  • Prioritise.
41
Q

What are 6 main principles of an exercise programme for a patient with with either type of arthritis?

A

1) Pain free movement,
2) Maintenance of joint range,
3) Protection of soft tissue structures,
4) Patient reproducibility,
5) Exercises that don’t reinforce patterns/positions of deformity,
6) Apprioate level of intensity to avoid flare ups and increased pain post excersise.

42
Q

What are the main functions of splinting?

A
  • Surgical protection,
  • Support, position or rest,
  • Immobilise a joint,
  • Fracture alignment,
  • Limit joint range of motion,
  • Substitute impaired muscle function,
  • Mobilise stiff joints,
  • Maintain gains in ROM,
  • Provide a prolonged stretch over soft tissue or adhesions,
  • Prevent or correct abnormality or deformity,
  • Control/modify scar formation.
43
Q

Things to include in a subjective assessment?

A
  • Patients medical history,
  • Treatment now to then,
  • How painful it is on scale 1-10,
  • What caused the pain,
  • What is their job and their leisure activities,
  • How are they coping,
  • If there anything they have tried before,
  • What is there dominant hand,
  • How do they deal with the pain,
  • What causes the pain to worsen,
  • what helps make the pain manageable.
44
Q

What are the 8 principles of hand therapy assessment.

A

1) Time,
2) Assess appropriately,
3) Environment,
4) positioning,
5) Patient- put them at ease,
6) Explanations and instructions,
7) Equipment,
8) Prioritise.

45
Q

What are the 6 pain assessment guidelines

A

1) Pain behaviour- type of pain,
2) Location of pain,
3) Irritability/alleviation,
4) Frequency,
5) Medication,
6) Quantitative assessment.

46
Q

What is the acronym to remember the 8 Carpal bones?

A
So. = Scaphold
Long = Lunate
To = Triquetrum,
Pinky = Pisiform,
Here = Hamate
Comes = Capitate
The = Trapezoid
Thumb = Trapezium.