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OT165 physical rehab > Quiz 4 Splinting and Fine Motor > Flashcards

Quiz 4 Splinting and Fine Motor Flashcards

1
Q

Low temp thermoplastic temperature & characteristics

A

Aprox. 160 degrees -used for upper extremity -placed on skin to mould -non weightbearing

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2
Q

High temp Thermoplastics temperature & characteristics

A

above 160 degrees -mold made on client first then heated -lower extremity/ back braces/ orthotics -weightbearing

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3
Q

splinting characteristic: Ability to return to its preheated shape and size when reheated

A

Memory

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4
Q

splinting characteristic: splints need to be remolded

A

serial static

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5
Q

splinting characteristic: Resistant to repeated stress Thicker material more rigid

A

rigidity

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6
Q

splinting characteristic: Degree to which material will stick to itself when properly heated

A

Bonding

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7
Q

splinting characteristic: coated

A

-does not bond to itself Temporary bond can be popped apart -For more permanent bond, coating can be scraped off or removed with solvent

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8
Q

splinting characteristic: Thickness for -adult -child or finger splint

A

1/8” for adult 1/16” for child or finger splint (or some hand based)

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9
Q

splinting characteristic: How long material takes to cool average time?

A

working time 3-5 min

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10
Q

splinting characteristic: Degree to which material resists stretching

A

Degree of resistance/Elasticity

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11
Q

splinting characteristic- what level resistance: o Easy to stretch o Provides intimate detail with gentle handling o Use with gravity o Edges trim and smooth easily What type of splints? what type of materials?

A

• Minimum resistance Finger/hand splints Polyform, Orfit

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12
Q

splinting characteristic- what level resistance: o Used for medium sized splints o Hand splints, wrist splints elbow splints what type of material?

A

Moderate resistance Polyflex II, Aquaplast

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13
Q

splinting characteristic- what level resistance: -Maximum resistance to stretch -Tolerates aggressive handling what are they used for? what type of material?

A

maximal resistance Used for foot drop splint, elbow splint, spasticity splint o Ezeform, Synergy

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14
Q

length of splint should be _____ of fore arm. width should be _____. why does fit matter?

A

2/3rds 1/2 Too high can dig into skin, too small could be uncomfortable, too wide could mobilize immobilize wrong areas etc.

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15
Q

why curl the edges of a splint?

A

For comfort, pressure relief

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16
Q

When to use padding for splints?

A

-can improve fit if area needs extra space (not to cushion “tight” area b/c it would increase pressure) -used to lessen pressure -can put pad on bony prominces 1/st then make splint to “bubble out”

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17
Q

Bony prominences to know for splinting?

A

3 CMC joint,

4 Dorsal MP joints

IP joints -wrist Ulnar styloid, radial styloid

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18
Q

what is this position

A

intrinsinc plus position

19
Q

land marks to know palmar

A
  1. pisiform
  2. IP
  3. MCP
  4. thenar crease (thumb CNC)
  5. DIP crease
  6. PIP crease
  7. distal palmar crease
  8. proximal palmar crease
  9. wrist crease
20
Q

Splinting straps:

common sizes, where to use them

parts of velcro?

A
  • Variety of sized ½ in, 1.5”, 2” etc. larger near forearm smaller near digits
  • Velcro, hooks and loops
21
Q

Arches of hands:

Longitudinal arch:

transverse arches:

A

Longitudinal arch: spans length of rays and carpus

transverse arches: proximal (lines up with carpal bones) and distal (lines with metacarpal heads)

22
Q
  • Provide support, protection
    • Also used to rest ligament that are potentially irritated/inflamed. Pain. stroke patients prevent contracture
  • Restrict motion
  • No movable parts
A
  • Static Splints
23
Q
  • Provide a low load, prolonged stretch to lengthen soft tissue, assist tendon gliding exercises and enhance function
  • Increases passive ROM
  • Client needs to be compliant and fully understand concept.
A

Static Progressive Splints

24
Q
  • Force applied by dynamic structure such as a rubber band or elastic
  • Permits active motion
  • Can have motion blocking component
A

Dynamic Splints

25
Q
  • Static splint that is reheated and remolded
  • Similar to serial casting but able to remove splint for hygiene
  • Worn for long periods of time
  • Low load, long stretch. No movable parts
A

Serial Static Splints

26
Q

name and Purposes of Splint:

A
  • Support and protect healing or inflamed structures
  • Restrain and immobilize
  • Position and maintain alignment
  • Prevent and/or correct deformity
  • Substitute for weak or absent muscle function
  • Enhance functional use of hand – increase ADL independence
  • Exercise
  • Enhance positioning and functional performance in clients with abnormal tone
27
Q

name type of splint

  • Purpose: Maintains wrist in extension; protection
    • -Can position wrist in neutral or extension depending on diagnosi
    • -Wrist in neutral extension or slight extension (20 or 30°)
    • -Carpal tunnel syndrome, wrist fracture, tendonitis
A

Wrist Cock-up Splint or Volar wrist splint, brace

28
Q

what type of splint?

  • Immobilize thumb and wrist
  • deQuervians tenosynovitis, post CMC arthroplasty surgery
A
  • Hand based thumb spica OR Long opponens splint
29
Q

what type of splint?

  • Purpose: protects thumb CMC joint from external forces and positioning CMC joint properly to avoid metacarpal subluxation into void where FCR is filling space.
A

Thumb spica and Comfort cool thumb spica

30
Q

what type of splint?

  • Positioning the wrist and fingers
  • CVA, TBI with hemiplegia
A

Resting hand splint

31
Q

What condition?

  • Abductor pollicis longus (APL) and Extensor pollicis brevis (EPB) become inflamed through 1st dorsal compartment
  • Repetitive thumb Abduction and ulnar deviation
    • Hair styling, texting thumb, lifting a pan, video games etc.

treatment?

A

De Quervain’s Tenosynovitis “Nursing Thumb”

Conservative: Forearm based thumb spica orthosis with IP free; cortisone injections, modifications to activity, etc

32
Q

What condition?

  • Very common, aching and pain at basal joint the thumb (between thumb metacarpal and trapezium (“trapezium” “thumb”)
  • when to splint?
A

CMC Arthritis

Conservative: short opponens orthosis for immobilization of the CMC and MP of thumb

Surgery: Followed by fabrication of orthosis at first therapy appointment!

33
Q

what condition?

  • Palmar fascia tightens and develops knots over time. surgery releives contracted tendons
  • when to use splints?
  • what kind of splint?
A
  • Duputryen’s Contracture
  • after surgery: orthotic fabricated immediately to prevent contracture reformation of the digits
  • HFO (hand finger orthosis) fabricated to maintain alignment and worn continuously and wean at 6 weeks
34
Q

Functional hand position?

A

30 degrees from wrist joint

45 degrees PIP joint

35
Q

resting hand position?

A

20 degrees wrist extension

36
Q

Doccumenting splints:

what to include?

A
  • Describe what joints are included
  • Static vs. dynamic vs. static progressive
  • Purpose of splint (don’t be afraid to write in more details)
37
Q

How to name splints:

A
  1. Where is the splint “based”?
    1. Hand based – splint does not cross the wrist.
    2. Forearm based – e.g. forearm based thumb spica
  2. What joints are included?
    1. E.g. forearm based thumb spica with IP joint included (or IP free)
  3. What are you mobilizing?
    1. E.g. forearm based dynamic index PIP flexion splint
38
Q

considerations for splinting:

A
  • Type of splint
  • Patient education
  • Wear schedule
  • Purpose of splint
  • Problems/concerns
  • Adjustments in future visits
39
Q

Patient education for splints:

A
  • Splint handout should always be issued with a splint
    • Wear schedule
    • Precautions
      • Pain, irritation, redness, etc.
      • What to look for
      • What to do if there are problems
    • Care/cleaning of splint
    • Precautions for care of splint
      • Don’t leave it in the car in the summer
      • Don’t leave it near the heater in the winter
      • Don’t put it in the dishwasher, microwave, etc.
40
Q

What are we using for splints inclass?

A
  • material we are using: Omega
    • Coated (does not stick to itself), Low temp, Memory
41
Q

Box and block test:

how do you do it?

instructions to client?

what is it testing?

A

How to perform:

  • Clients pick up and move 1 in blocks over a divider one at a time over a 1 min span per arm. they get 15 sec practice each hand.

instructions:

“I want to see how quickly you can pick up one block at a time with your right (or left) hand [the examiner pointed to the hand]. Carry it to the other side of the box and drop it. Make sure your fingertips cross the partition. Watch me while I show you how.”

demonstrate putting block over partition same direction asking client to

If you pick up two blocks at a time, they will count as one. If you drop one on the noor or table after you have carried it across, it will still be counted, so do not waste time picking it up. If you toss the blocks without your fingertips crossing the partition, they will not be counted. Before you start, you will have a chance to practice for 15 seconds. Do you have any questions? Place your hands on the sides of the box. When it is time to start, I will say “ready” and then “go.”

tests:

  • Unilateral dexterity
    • Gross movement horizontal abduction, flexion, elbow extension, focus, PNF diagonals, crossing/orientation of midline (trunk rotation/lateral flexion as compensation), dynamic balance, left/right side neglect. Look at Grasp. Speed, accuracy, coordination.
42
Q

9 hole peg test:

starting position?

procedure?

A

Cleint sits with peg board in front centered, dish on participants dominant side. then do again and switch to non dominant side. Dropped pin/ interuption = client stops and restarts

  1. Demonstrate for pt. first goes in farthest corner. First to come out is opposite corner.
  2. Timed
  3. Unaffected hand first. Pull pegs from far top corner 1st then across lines ending in bottom closest hole. Reverse order to take them out.
43
Q

Purdue pegboard:

whats it testing?

components included?

procedure?

A

Testing: measure unimanual and bimanual finger and hand dexterity

Material: board-two parallel rows of 25 holes each, Pins/pegs, collars, washers Procedure: To test the right hand, the subject must insert as many pins as possible in the holes, starting at the top of the right-hand row. The left-hand test uses the left row. Both hands then are used together to fill both rows top to bottom. In the fourth subtest, the subject uses both hands alternately to construct “assemblies,” which consist of a pin, a washer, a collar, and another washer. The subject must complete as many assemblies as possible within 1 minute.

OT165 physical rehab (4 decks)

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