Hands and UE Flashcards
What kind of treatment does the Duran protocol recommend
Early passive range of motion
What kind of treatment does the kleinert protocol recommend
Active extension of digits with passive flexion via traction
What is a benefit to early active motion
Prevent adhesions and promote tendon gliding
When would you immobilize a joint
For people incapable of caring for self like children or people with a low cognitive cognitive ability
Name six effects of cryotherapy
Decreased edema decrease muscle spasm decrease inflammation decrease metabolic activity decreased nerve conduction velocity
What are the contraindications and precautions for use of cryotherapy
Impaired circulation peripheral vascular disease hypersensitivity to cold impaired sensation open wounds or infections
What are the effects for thermotherapy
Increase blood flow
decrease muscle spasm
decreased pain
What are the precautions and contraindications for use of thermotherapy
acute inflammation edema sensory impairment cancer blood clots infection cardiac problems impaired cognition
Misty effects of using continuous ultrasound
Increase tissue extensibility increase blood flow decrease pain decrease joint stiffness decreased muscle spasm decreased chronic inflammation
Name the effects of pulsed ultrasound
Increase protein synthesis
increase bone healing
decrease inflammation
What is phonophoresis
Use of ultrasound to promote absorption of topically Applied medication to accelerate to to repair and decrease inflammation
What are the precautions and contraindications for use of ultrasound
Pregnancy used over the eyes used over a pacemaker bleeding infection cancer blood clots and use over the growth plate of a children child
What are the effects of the use of NMES
promote wound healing maintains muscle mass increased range of motion facilitates voluntary muscle control decreases edema increases muscle spasms decreases muscle spasticity
Name the effects of use of a TENS unit
Controls pain
What are the contraindications and precautions for use of electrical stimulation
Don't place over pacemaker for carotid sinus or pregnant uterus or eyes. epilepsy cancer infection cardiac disease history of stroke decreased sensation
Describe the splint used for carpal tunnel syndrome
Wrist in neutral to 10 degrees of extension
Name the splint used for ulnar nerve injury at the wrist
Block MCP of fingers 4 + 5 to 30-45 degrees of flexion in order to prevent hyperextension
Type of splint used for radial nerve injury
Wrist cock up splint
Type of splint for pronator syndrome
Forearm and wrist in neutral elbow in 90 degrees of flexion
Type of splint for radial tunnel syndrome
position the wrist in 30 degrees of flexion supinate the forearm and have the elbow in 90 degrees of flexion
What is the purpose of a dynamic splint
To correct contractures increase passive range of motion and protect recent surgery
When evaluating range of motion on a brachial plexus injury how high can you abduct the shoulder
90 degrees
What kind of splint is used for a flexor tendon injury
Dorsal blocking splint
what is a resting hand splint used for
To prevent deformities like with rheumatoid arthritis
What is a boutonniere deformity
Pip flexion and D IP hyperextension
What is a swan neck deformity
PIP hyperextension and dip flexion
What is a Smith’s fracture
Complete fracture of distal radius with Palmar displacement
what are the symptoms of a radial nerve injury
Wrist drop lack of finger and thumb extension
Name two assessments for upper extremity sensation
Semmes Weinstein monofilament used for nerve compression
two point discrimination used for nerve laceration and Recovery
Name the symptoms of an ulnar nerve injury
Ulnar claw claw deformity numbness of ulnar side of hands generalized weakness with owner side of hand and pain
What is a Colles fracture
Complete fracture of distal radius with dorsal displacement
What are the symptoms of radial tunnel syndrome
Burning pain in the lateral forearm caused by entrapment of radial nerve between Radiohead and supinateor muscle
What is De Quervain’s syndrome
It is a cumulative trauma resulting in tenosynovitis of the thumb and tendons in the first dorsal compartment of the wrist. It is caused by the forceful repetition of thumb abduction
How should the elbow be splinted for cubital tunnel syndrome
between 30-90 degrees of flexion
What is phalen’s test
Hold the wrist in full flexion for 1 minute to elicit changes in sensation to test for CTS
What is tinel’s sign
Tap on the median nerve at the wrist or tap over cubital tunnel to elicit symptoms of carpal tunnel syndrome or cubital tunnel syndrome
What are the symptoms of complex regional pain syndrome
Allodynia hyper algia hyperpathia edema contractures bluish or red shiny skin abnormal sweating and hair growth muscle spasms decreased strength low activity tolerance
What is wartenberg sign
V finger is held abducted from the ring finger this shows entrapment of the radial nerve radial tunnel syndrome
What is mallet finger
Avulsion of the terminal tendon
What is mallet finger
Avulsion of the terminal tendon. Splint in full extension for 6 weeks
What is the Finkelstein test
Place your thumb in your fist and ulnar deviate to test for dequervain’s syndrome
what splint is used for dequervain’s syndrome
Forearm based thumb Spica
What are the symptoms of cubital tunnel syndrome
Decreased sensation in the little finger and on our half of the ring finger decreased grip and pinch strength
what is cubital tunnel syndrome
Proximal ulnar nerve compression at elbow between the medial epicondyle and olecranon. Common causes of fracture at the elbow osteoarthritis rheumatoid arthritis diabetes
What is froment’s sign
Flexion of the IP joints of the thumb when lateral pinch is attempted
What are the interventions for complex regional pain syndrome
Gentle active range of motion for short periods stress loading pain control edema control desensitization and tendon gliding. Avoid passive range of motion
what are the symptoms of a median nerve injury
Ape hand deformity sensory loss in the index middle and radio half of ring finger loss of pinch thumb opposition and decrease pronation
when do you begin active range of motion for post fracture?
3-6 weeks post
what is a Bennett’s FX?
intra-articular FX of thumb metacarpal bone
what is Keinbock’s Disease?
necrosis of lunate bone
what is a Boxer’s fx
FX of MCP of 4th and 5th digits
what does a positive Froment’s sign indicate?
weak adductor policis and flexor policis
What are two tests for Cubital Tunnel Syndrome?
(compressed upper ulnar nerve
- Wartenburg (5th finger abducted from 4th)
2. Froment (Flexed IP of the thumb with lateral pinch)
What type of splint would benefit someone with OA of thumb CMC joint?
Hand-based thumb spica splint
The splint will support thumb as a functional post.
Describe the purpose of a Dynamic MCP flexion splint
Provides correct angle of pull for finger loop = 90 degrees.
Distributes pressure more evenly to proximal phalanx
What is the proper intervention for a nondisplaced humeral neck fracture?
Support with sling and supervised ROM
When is MILD HEAT best used?
Before or during passive stretching to increase ROM, circulation, decrease discomfort
When is DEEP HEAT best used?
Contractures
Scarring
Pain
Muscle spasms
What is the focus of intervention for CRPS Type 1 (traumatic stage)?
Focus on pain and edema management with AROM
Include stress loading program
