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Adults Spring 2015 > Orthotics > Flashcards

Orthotics Flashcards

1
Q

Name the carpal bones

A

Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate

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2
Q

Can you identify all the joints and where they are?

A

Radio-carpal joint; carpometacarpal (CMC); Metacarpal phalangeal (MCP); Interphalangeal (IP); Metacarpal phalangeal (MCP); Proximal interphalangeal (PIP); Distal interphalangeal (DIP)

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3
Q

This hand position preserves the length of the collateral ligaments. It is when MCP is in full flexion and PIP/DIP in full extension. Thumb is relaxed

A

“Safe Position”

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4
Q

This type of pinch is also called a tripod or 3 Jaw Chuck; 60% of prehension uses this pattern; i.e. picking up a block

A

3 point pinch

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5
Q

This type of pinch is also called a tip pinch or tip-to-tip pinch; it is the most precise prehension; i.e. picking up a pin

A

2 point pinch

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6
Q

This type of pinch is also known as a key pinch

A

lateral pinch

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7
Q

This type of prehension is for holding a pencil or make up brush

A

pencil prehension

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8
Q

This type of grip occurs when holding a cigarette between two fingers

A

Lateral grip

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9
Q

This type of grip is when you are holding a ball; it uses all 3 arches

A

Spherical grasp

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10
Q

This type of grip is when you are holding a book or sandwich; also called the intrinsic plus grasp

A

lumbrical grasp –> also “safe position”

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11
Q

This is a power grip for holding a baseball bat or hammer

A

cylindrical grasp

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12
Q

Step one in splint naming: In regards to splint or orthotic classification, this is the term for when the splint crosses a joint.

A

Articular

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13
Q

Step one in splint naming: In regards to splint or orthotic classification, this is term for when the splint does not cross a joint

A

Nonarticular

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14
Q

Step two in splint naming: After you determine if your splint is going to be articular or nonarticular, you should then identify the _____ of the splint - (Articular examples - shoulder, elbow, forearm, wrist, etc.) (Nonarticular examples - humerus, radius, ulna, etc.)

A

Location

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15
Q

Step three in splint naming: After you determine the location of your splint, you should identify the ______. Examples are flexion/extension, pronation/supination, abduction/adduction, etc.

A

Direction

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16
Q

Step four in orthosis naming: Identifying the ____ of the splint

A

Purpose

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17
Q

Step four in orthosis naming: Identifying the purpose of the splint –> this is when the splint is used to immobilize and rest healing tissue

A

Immobilization

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18
Q

Step four in orthosis naming: Identifying the purpose of the splint –> this is when you mobilize tissues using an applied force; static progressive, serial static, and dynamic

A

Mobilization

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19
Q

Step four in orthosis naming: Identifying the purpose of the splint –> this is when you limit motion; provide or improve joint stability

A

Restriction

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20
Q

One of the orthoses we made in lab was called the “wrist extension immobilization orthosis” or the wrist “cock up”. This is the splint where we cut out the hole for the thumb. What diagnoses is this splint used for?

A

Diatal radius fracture (main one listed on powerpoint so I would know this diagnosis for sure); carpal tunnel syndrome; post wrist surgery; OA/RA; wrist fractures; ganglion cyst

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21
Q

This orthosis that we made has flaps that wrap around the thumb and is called the “wrist/thumb CMC immobilization orthosis” (thumb spica). What diagnoses is this splint used for?

A

deQuervain’s tenosynovitis; Scaphoid fracture; OA/RA; CMC arthroplasty

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22
Q

This orthosis that we made puts the hand in “safe position” and is called the “wrist/hand immobilization orthosis” or resting hand splint. What diagnoses is this splint used for?

A

Crush injury left wrist and hand; burns; infection; RA; hand trauma; hand fractures; spasticity; contracture; edema

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23
Q

What are some purposes for a mobilization orthoses?

A

remodel scar tissue; elongate soft tissue contractors; realign or preserve ligament length; substitute for weak or absent motion; provide resistance for exercise; increase PROM

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24
Q

This type of mobilization orthosis is when the therapist or patient sets the resistance; can use elastic traction such as rubber bands; wearing time depends on purpose; assist weak muscles; mobilize joints; prevent or correct contractures

A

dynamic orthoses

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25
Q

This type of mobilization orthosis has no traction; non-mobile; applied at maximum tissue length; worn for long periods of time; remolded periodically to increase stretch

A

serial static (progressive)

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26
Q

This type of mobilization orthosis uses inelastic traction (fishing line or nylon); correct contractors; used for lengthening soft tissue; mobilize specific joints; low load, prolonged stress

A

static progressive

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27
Q

This type of orthosis provides or improves joint stability and alignment; assists in functional use of the hand; limit motion after nerve injury or repair, tendon injury or repair, or bone or ligament injury or repair

A

restriction orthoses

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28
Q

What does occupation based orthotic intervention mean to us?

A

Promote the client’s ability to participate in meaningful occupations

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29
Q

What are some considerations for occupation based orthotic intervention?

A

cultural background, physical environment, social context, personal factors, spiritual, temporal, virtual

30
Q

What are some specific outcomes of orthotic intervention?

A

occupational performance, client satisfaction, role competence, adaptation, health and wellness, prevention, quality of life

31
Q

What are some things to ask about during a patient interview in hand therapy?

A

Medical/surgical history (including medications and allergies); social/work history (living situation, children or pets, hobbies, support network); subjective findings (hand dominance, primary complaints or concerns, pain, ADL status, goals for therapy)

32
Q

What are some observations you should make during an appointment with a client?

A

Appearance of the upper extremity (skin condition, trophic changes, atrophy, asymmetry, swelling); Affect (facial expression, tone of voice, emotional lability); Mobility (mode of ambulation, wheelchair, walker, cane, stretcher)

33
Q

What are the 3 phases of healing?

A
  1. Acute
  2. Proliferative
  3. Chronic
34
Q

What are some orthotics you would make during the acute phase of healing?

A

Static and serial static

35
Q

What are some orthotics you would make during the proliferative phase of healing?

A

serial static, static progressive, dynamic

36
Q

What are some orthotics you would make during the chronic phase of healing?

A

serial static and static progressive

37
Q

T/F: Memory, drapability, elasticity, bonding, and rigidity are some characteristics of low temperature thermoplastics?

A

True

38
Q

T/F: Heating the adhesive side of the velcro will help it adhere better to the thermoplastic material?

A

True

39
Q

What are some common conditions where they might use “soft” orthoses (prefabricated?)

A

carpal tunnel syndrome, deQuervain’s tenosynovitis, CMC arthritis, rheumatoid arthritis

40
Q

When fabricating a splint, you want to have how many points of pressure?

A

Three

41
Q

This is the term used when the splint wraps all the way around the surface (instead of 2/3)

A

Circumferential

42
Q

What is more stable - a flat surface or a contoured surface?

A

Contoured

43
Q

What are some considerations for designing an orthosis? (There are a ton!)

A

Age, occupation, ADL’s, patients motivation, cognitive status, leisure activities, length of time for orthosis.
What will the orthosis be used for? Where will the orthosis be worn? Will the orthosis be worn at extreme temperatures?

44
Q

What does the acronym “P.R.O.C.E.S.S.” stand for?

A

P: Pattern
R: Refine pattern
O: Options (select splinting materials and trace pattern)
C: Cut and Heat (really heat and then cut though)
E: Evaluate and Fit (mold and fit)
S: Straps and padding
S: Splint finishing touches (smooth edges, clean up the splint)

45
Q

What are some things you should educate your patient about before they leave with their orthosis?

A

Donning/doffing splint; wear/care schedule; precautions like redness, swelling, pressure areas; contact information for you in case they have any problems

46
Q

What are some important considerations when molding a splint?

A

Clear prominences, clear the creases, and preserve the arches

47
Q

For all of the orthoses we made, they should extend how much of the length of the forearm?

A

2/3

48
Q

What is the position of the hand/joints in the “Safe position” or “resting hand” orthosis? (wrist/hand immobilization orthosis)

A

Wrist: 20-30 degrees extension
Fingers: MCP’s in 70-80 degrees of flexion; IP’s in 0 degrees extension
Thumb positioned midway between radial and palmar abduction

49
Q

For all of the orthoses we made, the material needed to extend ___ the circumference of the forearm.

A

1/2

50
Q

What is the position of the hand/joints in the Wrist/thumb spica orthosis (wrist/thumb immobilization orthosis)?

A

Wrist: 15-20 degrees extension
Thumb: MCP slightly flexed; IP free, thumb CMC mid-way between radial and palmar abduction
Fingers free with enough clearance at distal palmar crease to allow for full MCP flexion

51
Q

What is the position of the hand/joints in the Wrist “cock up” orthosis (wrist immobilization orthosis)?

A

Wrist: 0-15 degrees extension
Thumb hole “flared” out, away from the skin, and large enough to allow thumb to oppose middle finger tip
Fingers free with enough clearance at distal palmar crease to allow for full MCP flexion

52
Q

T/F: In the healing hand, a delicate balance between rest to reduce painful inflammation and exercise to maintain tissue glide can be accomplished by a removable splint

A

True

53
Q

T/F: Splints cannot provide defined limits to tissue glide or stress

A

False - they can provide defined limits

54
Q

T/F: In regards to scar formation, prolonged positioning of the scar at maximum length combined with positive pressure to minimize scar hypertrophy can often prevent the need for surgical release

A

True

55
Q

T/F: Static splints mobilize and dynamic splints immobilize

A

False - static splints immobilize and dynamic splints mobilize

56
Q

T/F: Static splints are used most often to rest tissues, provide external support, and intermittently gain or maintain motion which has little resistance

A

True

57
Q

T/F: Dynamic splints provide a constant force to the joints. The force is usually generated by either a stretched rubber band or wire spring coil

A

True

58
Q

What is the type of casting called that holds the body part in a certain position so that the tissue adapts. These types of casts are changed out frequently.

A

Serial casting

59
Q

T/F: Respect for the wrist as the keystone for hand positioning is the basis for all splinting, except isolated digital splinting.

A

True

60
Q

T/F: By positioning the wrist in slight extension, the thumb in abduction, and all finger joints in slight flexion, the hand will likely retain some pinch ability even if stiffened by infection

A

True

61
Q

What is the first stage of wound healing?

A

Inflammation

62
Q

What is the second stage of wound healing?

A

Fibroplasia

63
Q

What is the third stage of wound healing?

A

Scar maturation

64
Q

T/F: It is important for therapists who make orthoses to understand the stages of healing, however, there is still going to be a trial and error period because all patients are different. Therapists need to be knowledgable about the body’s response to issues with splinting.

A

True

65
Q

T/F: It is more important for an orthosis to have a large force for short periods of time than it is to apply a small force for longer periods of time.

A

False- it is more preferable to apply a small force that the patient can tolerate for longer. The goal should be to increase wear time before increasing force.

66
Q

T/F: Since every person varies, patients comfort remains the best way of deciding maximum effective force over time

A

True

67
Q

T/F: Any splint used to gain motion should be easy to remold, inexpensive to replace, and quick to adjust. The splint must be adaptable to the anticipated joint change

A

True

68
Q

T/F: It is most important for the doctor to relay a specific type of splint that he wants for a patient.

A

False - it is most important for the doctor to relay the function of the splint…an experienced therapist can use that information to decide what type of splint to use. It is also important for the doctor to provide a specific diagnosis

69
Q

T/F: Any splint applying a force or restricting motion can prove detrimental if applied incorrectly, used improperly, or worn too long or with excessive force

A

True

70
Q

All splints applying force to the hand should be worn in the clinic for about ___ minutes before the client leaves with the splint so it can be checked for pressure points and rough edges

A

15 minutes

71
Q

T/F: Splinting is a comprehensive treatment approach.

A

False - splinting should always be accompanied by an active home therapy program

Adults Spring 2015 (5 decks)

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