Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHTY APPB > Hand Therapy: Diagnosis and management > Flashcards

Hand Therapy: Diagnosis and management Flashcards

1
Q

List the hand therapy intervention strategies?

A
  • Splinting
  • Oedema control
  • Wound and scar care
  • Desensitisation
  • Specific exercises
  • Patient education
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the arches you have to maintain when splinting?

A
  • Dorsal arch (MC arch)
  • Proximal transverse (carpal) arch
  • Longitudinal arch - allows MCPJ, PIPJ and DIPJ flexion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which hand creases to note when splinting?

A
  • Distal Palmar Crease
  • Proximal Palmar Crease
  • Thenar Crease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some construction principles of splinting?

A
  • Increase area of force application
  • Roll edges
  • Conforming fit
  • Round internal and external corners
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are positions of safe immobilisation for each joint

A

Wrist: 20-39 ext
MCP J: 70-90 flex
IP J: 0-10 Relative extension
Thumb: CMC J palmar abduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are ways to control oedema?

A

Coban, neoprene, compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What to do to manage a wound?

A

Silcon gel sheet, self massage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the purpose of desensitisation?

A

Reintroduction of different textures and sensations to familiarise sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the time frames for tissue healing?

A
  • Inflammation 4-6 days
  • Proliferation 4-24 days
  • Remodelling 21 days- 2 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the clinical presentations for Carpal tunnel syndrome?

A
  • Pain, P&N/ numbness in median nerve distribution
  • Worse at night
  • Common in pregnancy
  • Reduce grip and pinch strength
  • Loss of sensation median nerve
  • APB wasting
  • Sensory changes before motor loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the management of Carpal Tunnel Syndrome?

A
  • Provocation test: Tinnels, Phalens, Durkans
  • Differential Diagnosis: C/sp radiculopathy
  • Splint at night, median nerve glides, postural advice, ergonomic assessment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When do you refer to hand surgeon for CTS?

A

APB wasting, constant numbness, Failure to improve after 6/52 conservative management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is DeQuervains syndrome?

A
  • Denegerative Tenosynovitis

- APL and EPB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the clinical presentation of DeQuervains syndrome?

A
  • Pain and swelling radial aspect of wrist +/- crepitus
  • Positive finkelsteins test
  • Pain on active thumb extension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the clinical presentation of DeQuervains syndrome?

A
  • Pain and swelling radial aspect of wrist +/- crepitus
  • Positive finkelsteins test
  • Pain on active thumb extension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the management program for DeQuervains Syndrome?

A
  • Patient edu to avoid agg activities - adduction of thumb with wrist deviation
  • Long opponens splint to support thumb
  • Soft-neoprene splint
  • KTape
  • Radial nerve glides
17
Q

What is trigger finger and its clinical presentation?

A
  • Flexor tendon gets caught at thickened A1 pulley
  • Finger clicks or locks in flexion after making a fist
  • Snapping sensation when trying to straighten finger or thumb
  • Worse in morning
  • Painful lump in palm at DPC
18
Q

What is the management of trigger finger?

A
  • Splinting to prevent full flexion
  • Passive ex to maintain ROM
  • Avoid agg activities
  • Hand surgeon when failure of conservative management
19
Q

Describe mallet finger and its presentation

A
  • Forced DIP flexion while extensor tendon is contracting
  • Soft tissue mallet or avulsion fracture of distal phalanx

CP: extension lag, inability to fully extend DIP joint

20
Q

What is the management of mallet finger?

A
  • Splint with DIP in extension (8weeks for tendon, 6 weeks for avulsion)
  • Skin care
  • Allow PIP ROM
  • SLOW careful weaning
  • Gradual strengthening and return to ADL
21
Q

When to refer mallet finger to hand surgeon?

A
  • Delayed presentation
  • Open fracture
  • Large mallet fracture fragment > 30 % articular surface
  • Joint sublluxation
22
Q

Describe PIP dislocations and their clinical presentation

A
  • Dorsal 85%, Volar: central slip rupture, Lateral

Clinical presentation:

  • Painful swollen digit following hyperextension injury
  • Possible associated volar plate avulsion frature of base of middle phalanx
  • Often relocated at time of injury or ED
23
Q

What is the management of PIPJ dislocation?

A
  • Closed reduction and splinting (3-4 weeks if stable after reduction)
  • Dorsal blocking splint in neutral (or slight flexion) for dorsal dislation
  • AROM IPJ flexion/ext exercises in splint
24
Q

When to refer to hand surgeon for PIPJ dislocation

A
  • Avulsion fragment > 50% of articular surface

- Joint remains subluxed and unstable

25
Q

Describe Skier’s thumb

A

acute injury to UCL +/- bony avulsion
- forced abduction of MP joint

Stener lesion: complete UCL rupture, avulsed ligament flipped over adductor aponeurosis

26
Q

What is the management of Skier’s thumb?

A
  • Partial tears: conservative management, hand based thumb spica splint for 4-6/52
  • Complete tear: surgical management, hand based thumb spica splint following surgery
  • IP joint ROM exercises
27
Q

Describe boxers fracture and management

A
  • 5th MC neck fracture
  • Removable ulnar gutter splint, IPJs free 3-4/52 if stable + AROM exercises
  • Surgical management: rotational deformity/scissoring or angulation
28
Q

Describe OA of 1st CMC joint?

A

Degeneration of trapeziometacarpal joint

  • Painful ache, joint thickening, loss of web space
  • Difficulty opening jars, kkeys, writing etc

+ve grind test

29
Q

What is the conservative management of CMC OA?

A
  • joint protection, splinting, education, NSAIDs, adaptive equipment, strength training, heat/ice
30
Q

What are self management procedures for CMC OA?

A
  • web stretch
  • trigger point release
  • self-traction
31
Q

Describe splinting management of CMC OA

A
  • Pain relief, deformity minimise/correction, decrease inflammation
  • Short opponens splint (improvement in pain, strength or hand function)
32
Q

What are proprioception exercises?

A
  • joint position sense
  • neuromuscular activation: isokinetic, eccentric etc
  • unconscious neuromuscular activation
33
Q

Describe presentation of distal radius fractures

A
  • Undisplaced is stable and managed conservatively
  • Displaced and unstable - ORIF
  • Colles: dorsally displaced frature
  • Smiths: volarly displaced fracture fragment
34
Q

What is the management of distal radius fractures?

A
  • Conservative up to 6 weeks
  • AROM of other joints in cast
  • Scar massage
  • AROM ex after splint removal
  • Grip strength
  • wrist strength
35
Q

What are complications of distal radius fractures?

A
  • Wrist and hand stiffness
  • Ulnar sided wrist pain
  • Carpal tunnel syndrome
  • Tendon rupture
  • Osteoarthritis
  • Deformity
  • CRPS
36
Q

Describe scaphoid fractures?

A
  • Most common carpal frature, FOOSH
  • Pain and swelling, tender in snuff box
  • X-ray with scaphoid view
  • Complications: scapholunate instability/ non-union 97% OA in 5 years

PHTY APPB (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions