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(2) Musculoskeletal Examination > S2_L1: Examination of the Elbow, Wrist, and Hand Complex > Flashcards

S2_L1: Examination of the Elbow, Wrist, and Hand Complex Flashcards

1
Q

modified T/F

Muscular strain are usually group of muscle since same origin

Ligamentous sprain are collateral ligamental injuries

A

TT

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2
Q

modified T/F on OLECRANON BURSITIS

Aka student elbow, thinker’s elbow, in which there’s an inflammation of the olecranon bursa

There are as many as 10 bursae around the elbow complex but the olecranon bursa is the most commonly injured

A

TT

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3
Q
  1. Golfer’s, Pitcher’s, Little Leaguer’s elbow
  2. Affects the pronator teres and flexor carpi radialis
  3. Tennis elbow
  4. 7x more common than medial epicondylitis
  5. Affects the extensor carpi radialis brevis, extensor carpi radialis longus, extensor digitorum

A. MEDIAL EPICONDYLITIS
B. LATERAL EPICONDYLITIS

A
  1. A
  2. A
  3. B
  4. B
  5. B
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4
Q

which of the ff are true about PULLED ELBOW AKA Nursemaid’s elbow

A. Common in children 2-5 years old

B. Locking of the forearm in pronation or neutral rotation when a segment of the annular ligament is pulled over the edge of the radial head

C. Happens in extended and pronated elbow by sudden direct pull

D. Traction force is applied in the elbow,
dislocating the radial head

E. All movements normal except: PRONATION

A

E. All movements normal except: SUPINATION

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5
Q

T/F

the most common mechanism of injury of Flexor tendon laceration is trauma due to sharp objects, Ex: Hold-up incidents

A

T

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6
Q

which of the ff are true about Extensor tendon laceration

A. More common than flexor tendon laceration

B. Extensor tendons are more superficial

C. Found on the dorsum aspect of the hand

D. MOI: trauma d/t sharp objects

E. All of the above

A

E

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7
Q

the ff are true about Rupture of extensor pollicis longus tendon, EXCEPT:

A. Passes through the IP joint of the thumb and crosses the wrist joint towards the radius

B. Rarely happens spontaneously d/t trauma

C. More commonly caused by a long standing non-displaced fracture of the radius

D. Commonly occurs at the site of the Lister’s tubercle due to the friction of nondisplaced fracture that causes the
rupture of the EPL tendon

E. None of the above

A

E

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8
Q

which are true about Central slip rupture

A. Ligamentous expansion comes from the extensor muscles and tapers down at the level of the PIP

B. Central slip is found right on top of the PIP

C. Wings at the sides of the PIP are the lateral bands

D. Rupture of central slip causes the default position of PIP flexed (Boutonniere deformity)

E. All of the above

A

E

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9
Q

the ff are true about Avulsion of flexor digitorum profundus tendon, EXCEPT:

A. FDP tendon is located beneath the digit of the ventral/palmar aspect of the digits

B. Rupture of FDP causes the inability to flex the DIP

C. Special test to be done is Empty Can test

D. Most commonly affected is the 4th / ring finger

E. Results from a hyperextension injury

A

C. Special test to be done is Jersey Finger

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10
Q

modified T/F

MALLET/BASEBALL/DROPPED/CRICKET FINGER’s Mechanism of injury is when a heavy object hits the tip of your finger while it is extended & causes the inability to extend DIP

RUPTURE OF ULNAR COLLATERAL LIGAMENT AKA Gamekeeper’s thumb has a Mechanism of injury of valgus injury or hyperabduction force on the thumb like when falling on a hyperabducted thumb

A

TT

Grade 1: stretching of ligament but still in tacked
Grade 2: partial tear of the ligament
Grade 3: complete tear

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11
Q

which of the ff are true about DE QUERVAIN’S TENOSYNOVITIS

A. Aka washer woman’s syndrome is d/t friction at the side of the hand during
handwashing

B. Inflammation of the tendons of the hand like Abductor pollicis longus and extensor pollicis brevis (Apolo ExPoBre)

C. Swelling, redness, and inflammation on the wrist area d/t overuse or trauma

D. All of the above

A

D

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12
Q

the ff are true about TRIGGER FINGER/STENOSING TENOSYNOVITIS, EXCEPT:

A. A1 pulley at the MCP area; A2 pulley at the PIP area; A3 pulley at the DIP area

B. Thickening of ligaments/nodules at the level of A1pulley that causes the trigger finger

C. Moving finger towards extension creates a clicking sensation wherein the nodule is forcing its way through the sheath at the MCP area

D. Commonly d/t overuse of the hands & affects the third and fourth fingers which may worsen with pain and can lock the finger in extension

E. None of the above

A

E.

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13
Q

match the CONTRACTURES/DEFORMITIES
(can have multiple answers)

  1. Result of weak extrinsic muscles and strong intrinsic muscles
  2. May be result of neurologic conditions
  3. Weak intrinsics and strong extrinsics
  4. Characteristic hyperextension of the PIP and flexion of the DIP
  5. Hyperextended MCP, flexed PIP, and extended DIP
  6. Starts off as a simple nodule on the hand that worsens over time and results in a contracture or inability of patient to straighten or extend the hand & most commonly affects the 3rd & 4th fingers

A. INTRINSIC PLUS
B. INTRINSIC MINUS
C. SWAN NECK DEFORMITY
D. BOUTONNAIRE DEFORMITY
E. CLAW HAND DEFORMITY
F. DUPUYTEN’S CONTRACTURE

A
  1. A
  2. A
  3. B, E
  4. C
  5. D
  6. F
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14
Q

modified T/F

Extrinsic muscles are only located in the hand area

Intrinsic muscles can have origins or
insertions beyond the hand area

A

FF

Intrinsic muscles are only located in the hand area

Extrinsic muscles can have origins or
insertions beyond the hand area

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15
Q

match the BONE: OSTEONECROSIS (Avascular necrosis)

necrosis:
1. scaphoid bone
2. distal ulna
3. capitulum of the humerus
4. vertebral body
5. lunate bone

A. Preiser’s
B. Kienbock’s:
C. Burn’s
D. Panner’s
E. Calve

A
  1. A
  2. C
  3. D
  4. E
  5. B
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16
Q

match the BONE: OSTEONECROSIS (Avascular necrosis)

necrosis:
1. vertebral cartilage resulting to abnormal kyphotic posture in the adults

  1. metatarsals
  2. navicular bone
  3. femoral head in children
  4. femoral head in adults

A. Scheurmann’s
B. Legg-Calve-Perthes Disease (LCPD)
C. Chandler’s
D. Kohler’s
E. Freiberg’s

A
  1. A
  2. E
  3. D
  4. B
  5. C
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17
Q

modified T/F on SCAPULOLUNATE ADVANCE COLLAPES

Complication of chronic wrist arthritis or chronic radiocarpal RA

Collapse in the junction between the lunate and the scaphoid bones

A

TT

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18
Q

which of the ff are true about MADELUNG’S DEFORMITY, EXCEPT:

A. Autosomal recessive disorder

B. Dorsal prominence of lower end of ulna

C. Instability of distal radioulnar articulation

D. Can be AD, F>M, more commonly bilateral

E. Findings: LOM of wrist extensor,
pronation/supination

A

A. Autosomal dominant disorder

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19
Q

the ff are true about Triangular fibrocartilage complex (TFCC) INJURY

A. ligament that connects the radius and ulna, right at the junction of the radius and ulna and the carpal bones

B. Mechanism of injury is fall on an extended wrist with the forearm
pronated or traction force on the ulnar side of the wrist Ex: tug of war

C. Wrist pain during pronation/supination, Ex: turning a door knob

D. All of the above

A

D.

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20
Q

modified T/F

Combination of proximal & distal symptoms is called double crush syndrome

Course of symptoms in Acute is 48-72 hrs, Subacute is more than 2 wks, Chronic is 2-6 months

A

TT

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21
Q

the ff are true about FOOSH INJURY, EXCEPT:

A. Most common mechanism of injury for elbow, wrist and hand complex

B. Impact of fall is absorbed by hand and travels along the forearm, humerus, and is absorbed by the clavicle

C. Angulation in the elbow (cubital angle) wherein the force will be concentrated more on one side

D. Compressive force on the lateral side of the elbow and traction force on the medial aspect of the elbow

E. None of the above

A

E.

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22
Q

modified T/F

Cyanotic means decrease blood supply & Redness/erythema means persistent
inflammation

Dry and scaly skin means decreased sympathetic activity while Smooth, shiny, glossy means increased
sympathetic activity

A

TT

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23
Q

modified T/F

Bouchard’s is the swelling at DIP while Herberden’s is swelling at PIP

Syndactyly is the union of two/three digits while Polydactyly means there’s extra fingers

A

FT

Bouchard’s is the swelling at PIP while Herberden’s is swelling at DIP

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24
Q

match the ff grade of Tenderness

  1. pt winces and withdraws the joint
  2. pt complains of pain
  3. pt will not allow palpation of the joint
  4. pain and winces

A. Grade 1
B. Grade 2
C. Grade 3
D. Grade 4

A
  1. C
  2. A
  3. D
  4. B
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25
Q

modified T/F on Anthropometric measurements

Limb girth measurement is used to compare muscle bulk & identify a body landmark then measure a few cm above and below this landmark

Volumetric measurement is used to confirm swelling of distal body parts
(hands and feet)

A

TT

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26
Q

the ff are important to take note of in Range of motion, EXCEPT:

A. AROM first before PROM, & don’t have to measure all

B. Movements that are painful are done last

C. Overpressure is applied with caution to determine whether a painful arc exists

D. Watch out for trick movements & note for capsular patterns

E. None of the above

A

E

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27
Q

match the ff myotomes

  1. finger flexors (distal phalangx of middle finger)
  2. elbow flexors
  3. wrist extensors
  4. finger abductors
  5. elbow extensors

A. C5
B. C6
C. C7
D. C8
E. T1

A
  1. D
  2. A
  3. B
  4. E
  5. C
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28
Q

identify the wrong matching of Dermatomes

o C2: occipital protuberance
o C3: supraclavicular fossa
o C4: top of acromioclavicular joint
o C5: lateral elbow
o C6: thumb
o C7: index finger
o T1: medial elbow
o T2: apex of axilla

A

C7: middle finger

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29
Q

identify the wrong matching of DTR

  • Biceps = C5-C6
  • Triceps = C7-C8
  • Brachioradialis = C6-C8
  • 0 = absent
    • = hyporeflexive
  • ++ = normoreflexive
  • +++ = hyperreflexive
  • ++++ = clonus
A

Brachioradialis = C5-C6

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30
Q

match the special tests
(can have multiple answers)

  1. lateral epicondylalgia
  2. sprain in MCL or LCL of the elbow
  3. medial epicondylalgia

A. Varus/valgus stress test
B. Cozen’s test
C. Mill’s test
D. Middle finger test/Maudsley’s test
E. Medial epicondylitis test

A
  1. B,C,D
  2. A
  3. E
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31
Q

which of the ff are Test for pronator teres syndrome

A. Wartenberg’s test
B. Elbow flexion test
C. Pinch grip test
D. Tinel’s sign
E. All of the above

A

E

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32
Q

T/F

Tests for ligament, capsule and joint instability include:

Ligamentous instability tests for the fingers

Thumb ulnar collateral ligament laxity or instability test

A

T

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33
Q

the ff are Test for tight retinacular (collateral) ligament, EXCEPT:
A. Lunotriquetral ballotment test
B. Murphy’s sign
C. Watson’s test
D. Piano keys test
E. Allen’s test

A

E

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34
Q

the ff are Tests for tendons and muscles, EXCEPT:

A. Finkelstein test
B. Hand volume test
C. Sweater finger sign
D. Bunnel-litter sign

A

B

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35
Q

the ff are Tests for circulation and swelling, EXCEPT:

A. Watson’s test
B. Hand volume test
C. Digital blood flow
D. Allen’s test

A

A. Watson’s test

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36
Q

the ff are Tests for neurological dysfunction, EXCEPT:
A. Tine’s sign
B. Phalen’s test
C. Lunotriquetral ballotment test
D. Froment’s sign
E. Weber’s 2-point discrimination
F.Prayer’s test

A

C. Lunotriquetral ballotment test

37
Q

which of the ff are true about VALGUS/UCL SPRAIN

A. to put valgus stress on the elbow, one hand is holding the lateral aspect of distal humerus while other hand is holding the proximal aspect of the medial aspect of forearm

B. Apply laterally translated force on the
forearm

C. MOI is single traumatic episode/Repetitive microtrauma (throwing)

D. S/Sx is medial elbow pain exacerbated by the late cocking and acceleration

E. All of the above

A

E.

38
Q

which of the ff are true about LIGAMENTOUS VALGUS INSTABILITY

A. To test for the medial collateral ligament

B. Humerus must be in full ER

C. (+) = excessive laxity compared to the unaffected side

D. PT can feel mobility of medial aspect of elbow

E. All of the above

A

E

39
Q

which of the ff are true about LIGAMENTOUS VARUS INSTABILITY

A. Test for the lateral collateral ligament

B. Full IR of the shoulder

C. (+) = excessive laxity or soft end feel

D. Diagnosis of ligamental injury or third degree may cause posterolateral
instability

E. All of the above

A

E

40
Q

the ff are true about MOVING VALGUS STRESS TEST, EXCEPT:

A. Pt’s shoulder at 90 deg abd and elbow is bent to 90 deg

B. Move the elbow from extension to flexion then apply valgus force

C. (+) = pain between 120-70 degrees/shear angle zone

D. Diagnosis partial tear of LCL

E. None of the above

A

D. Diagnosis partial tear of MCL

41
Q

the ff are true about LATERAL EPICONYLALGIA, EXCEPT:

A. AKA Tennis elbow/extensor tendinopathy & the most commonly affected tendon is ECRB

B. Common in >45 yo age, F>M

C. MOI: repetitive wrist motion (especially towards extension)

D. S/sx: Pain on resisted wrist extension and on passive wrist flexion as well as gripping/forearm pronation

E. None of the above

A

B. Common in >35 yo age, M>F

42
Q

the ff are true about COZEN’S TEST, EXCEPT:

A. An active test wherein the pt does all the work

B. Procedure: Make a fist, Pronate the forearm, Radially deviate and extend wrist then the PT will resist wrist extension and radial deviation

C. (+) = pain on the medial epicondyle area

D. Diagnosis: lateral epiconylalgia

E. None of the above

A

C. (+) = pain on the LATERAL epicondyle area

43
Q

..

A

.

44
Q

which of the ff are true of MAUDLEY’S TEST, EXCEPT:

A. Ask pt to lift the middle finger while whole hand is supported on a surface/table

B. Resist extension of the third digit distal to the PIP joint

C. Puts stress on the ED tendon

D. (+) = pain over the medial epicondyle

A

D. (+) = pain over the LATERAL epicondyle

45
Q

which of the ff are true about GOLFER’S ELBOW TEST, EXCEPT:

A. Test for Medial epiconylalgia

B. An active test that pronates FA & flex the elbow and wrist

C. (+) = pain over the medial epicondyle

D. Diagnosis: medial epicondylitis

A

B. A PASSIVE test that SUPINATES FA & EXTEND the elbow and wrist

46
Q

which of the ff are true about ELBOW FLEXION TEST, EXCEPT:

A. Initial pt position is elbow fully flexed, shoulder abducted and depressed 90 degrees, then wrist extended

B. Hold position for 10 mins

C. (+) = tingling or paresthesia on the ulnar nerve distribution (medial aspect of forearm)

D. Diagnosis: possible cubital tunnel syndrome

A

B. Hold position for 3-5 min

47
Q

modified T/F on SHOULDER MEDIAL ROTATION ELBOW FLEXION TEST

A modification of the elbow flexion test.

Procedure: Medial rotation of the shoulder, maximum elbow flexion, maximum forearm supination, and maximum wrist extension

A

TT

48
Q

which the ff are true about PINCH GRIP TEST AKA OK sign test

A. Pinch tips of index finger and thumb

B. Normal is tip to tip

C. (+) findings if pulp to pulp (Kiloh-Nevin Syndrome)

D. Diagnosis: entrapment of the anterior interosseous nerve AIN

E. All of the above

A

E
*[AIN] is purely motor, No tingling sensation is felt
▪ The only physical manifestation of
AIN impingement is muscle
weakness

49
Q

which of the ff are true about TEST FOR PRONATOR TERES SYNDROME

A. Actively done (with pt participation)

B. Ask pt to pronate elbow while elbow is extending & the PT will resist this while extending the elbow

C. (+) = tingling or parasthesia in the median nerve distribution in the forearm and hand

D. All of the above

A

D

50
Q

which of the ff are true about TINEL SIGN (ELBOW)

A. Tapping of the ulnar nerve at the cubital tunnel

B. Test for regeneration

C. (+) = tingling sensation in the ulnar nerve distribution

D. All of the above

A

D

51
Q

which of the ff are true about WARTENBERG SIGN

A. Pt’s hand is resting on the table while PT passively spreads the finger, then ask the patient to bring them together again

B. (+) = inability to squeeze little finger

C. Diagnosis: ulnar neuropathy

D. All of the above

A

D

52
Q

which of the ff are true about AXIAL LOAD

A. Stabilize hand of pt, grab thumb and apply axial compression

B. (+) = pain or crepitation

C. Diagnosis is fracture of metacarpal or adjacent carpal bones as well as Joint arthrosis/arthritis

D. All of the above

A

D

53
Q

modified T/F on CATCH UP-CLUNK TEST

With forearm pronated, PT will radially and ulnarly deviate the wrist while the other hand of PT will palpate for clunking

(-) findings means there’s clunk

A

TF
(+) = clunk

54
Q

which of the ff are true about SHUCK TEST

A. AKA Finger extension test

B.Procedure: Wrist flexed while finger extension is resisted

C. (+) = pain

D. Diagnosis can be Radiocarpal or midcarpal instability, Scaphoid instability, Inflammation, Kienbock disease (osteonecrosis of lunate)

E. All of the above

A

E

55
Q

which of the ff are true about REAGAN TEST

A. Check for the integrity of the lunotriquetral ligament

B. One thumb of PT will palpate for the triquetrum while other thumb will palpate for the lunate & apply pressure on the lunotriquetral junction

C. (+) = pain, crepitus, and laxity

D. All of the above

A

D

56
Q

which of the ff are true about LUNOTRIQUETRAL SHEAR TEST

A. For the integrity of the lunotriquetral ligament

B. Procedure: Press on the two bones then one thumb of PT will palpate for the triquetrum while other thumb will palpate for the lunate & apply pressure on the lunotriquetral junction

C. (+) = pain, crepitus, and abnormal movement

D. All of the above

A

D

57
Q

which of the ff are true about MURPHY SIGN

A. Ask pt to make a fist then observe the height of the head of the third metacarpal that should be the highest

B. (+) sign if the head of third metacarpal is level with the second and the fourth metacarpal

C. Diagnosis: lunate dislocation

D. All of the above

A

D

58
Q

which of the ff are true about PIANO KEYS TEST, EXCEPT:

A. With forearm pronated, PT will push down on the distal ulna

B. (+) means there’s difference in the mobility, Pain and/or tenderness

C. Diagnosis: instability of the PRUJ

D. None of the above

A

C. Diagnosis: instability of the PRUJ

59
Q

which of the ff are true about WATSON TEST (AKA Scaphoid shift test)

A. Passive test wherein the Pt should be seated, test arm should be rested with
the elbow on the table & the examiner should sit across the table facing
the pt

B. Examiner places his thumb on the palmar side of the scaphoid while his other fingers are wrapped on the back of the wrist & will create a subluxation stress on the scaphoid

C. (+) = pain and thunk

D. Diagnosis: Scaphoid instability, Scaphoid fracture

E. All of the above

A

E

60
Q

which of the ff are true about SCAPHOID STRESS TEST, EXCEPT:

A. Modification of the Watson test

B. Passive test

C. (+) = clunk and pain

D. Diagnosis: Scapholunate instability, Scaphoid fracture

A

B. Active test
*If done passively —> scaphoid shift test
(watson)

61
Q

which of the ff are true about

A

.

62
Q

modified T/F on TRIANGULAR FIBROCARTILAGE COMPLEX

Found on ulnar side

The articular disk between the ulna, pisiform, and lunate is the TFCC

A

TT

63
Q

which of the ff are true about TFCC PATHOLOGY

A. TFCC is the primary stabilizer of the DRUJ

B. Causes Wrist catching and locking or crepitations

C. MOI: FOOSH, axial load to wrist

D. All of the above

A

D

64
Q

which of the ff are true about SUPINATION LIFT TEST

A. Position: Elbow 90 deg. and forearm supinated, Hands of pt are located on the underside of the table then ask pt to lift the table

B. (+) = localized pain on the ulnar side of the wrist

C. Diagnosis: dorsal TFCC tear

D. All of the above

A

D

65
Q

modified T/F on TFCC LOAD TEST

Axially load and ulnarly deviate the wrist while moving it dorsally or palmarly & while the PT ulnarly deviates the wrist,
compress the ulnar side of the wrist

(+) = pain, clicking, or crepitus

A

TT

66
Q

which of the ff are true about ULNOMENISCOTRIQUETRAL DORSAL GLIDE TEST

A. Stabilize ulna using the thumb while index finger pushes on the pisotriquetral complex (apply upward force)

B. (+) = pain and excessive laxity

C. Diagnosis: TFCC pathology

D. All of the above

A

D

67
Q

which of the ff are true about HAINES-ZANCOLLI TEST

A. a passive test for tight retinacular ligament or capsular tightness around the interphalangeal joints

B. To test for structures around PIP

C. Hold PIP joint in neutral, flex DIP, If (-) DIP flexion = tight retinauclar ligament/capsule

D. Flex the PIP and then flex the DIP, If (-) DIP flexion = tight capsule, If (+) DIP flexion = tight retinacular ligament

E. All of the above

A

E

68
Q

which of the ff are true about THUMB GRIND TEST

A. Axial compression and rotation on the MCP joint

B. (+) = pain

C. Diagnosis: degenerative joint disease in the metacarpophalangeal or metacarpotrapezial joint

D. All of the above

A

D

69
Q

which of the ff are true about THUMB ULNAR COLLATERAL LAXITY TEST, EXCEPT:

A. AKA Gamekeeper’s or skier’s thumb

B. Thumb in extension while applying valgus

C. (+) = hypermobile thumb

D. Normal laxity is 20 deg

E. To test for the UCL in isolation, flex CMC to 30 deg then valgus

A

D. Normal laxity is 15 deg

  • Valgus is > 30-35 deg = complete tear of the UCL and accessory ligaments
  • Valgus is < 30 deg = partial tear
70
Q

which of the ff are true about BOYES TEST, EXCEPT:

A. Test for the central slip of the flexorhood

B. Hold finger in slight extension at PIP then ask to DIP flex

C. (+) = unable or difficult to flex

D. None of the above

A

A. Test for the central slip of the extensorhood

71
Q

which of the ff are true about BUNNEL-LITTLER

A. AKA Finochietto-Bunnel Test/Intrinsic-Plus Test

B. To check for integrity of structures around MCP

C. Position MCP in slight extension, flex PIP, If (-) PIP flexion = tight intrinsic or tight capsule

D. Slightly flex MCP and then flex PIP
- (+) PIP flexion = tight intrinsic muscles
- (-) PIP flexion = capsular tightness

E. All of the above

A

E

72
Q

which of the ff are true about FINKELSTEIN TEST

A. Ask patient to make a fist with the thumb inside the finger then the examiner will passively radially deviate the wrist then compare on the affected side

B. (+) = pain over the APL and EPB tendons

C. Diagnosis: Paratenonitis of APL and EPB tendon

D. AKA De Quervain or Hoffman disease or washer woman disease

E. All of the above

A

E
* This test is painful on normal individuals
* (+) if one side is more painful than the other

73
Q

which of the ff are true about LINBURG SIGN

A. Actively done by asking pt to flex thumb such that it crosses the palm of
the hand pointing towards the little finger while extending index finger

B. (+) = limited index finger extension and pain

C. Diagnosis: paratenonitis at the interconnection of the FPL and flexor indices

D. All of the above

A

D

74
Q

which of the ff are true about SWEATER FINGER SIGN, EXCEPT:

A. Ask the pt to make a fist

B. (+) = distal phalanx of one finger does not flex

C. Diagnosis: ruptured FDP

D. Most commonly affected site: middle finger

A

D. Most commonly affected site: ring finger

75
Q

which of the ff are true about TEST FOR EXTENSORHOOD RUPTURE, EXCEPT:

A. Flex PIP at edge of table such that the proximal phalanx, hand, and forearm rests on the table

B. Patient carefully flexes PIP while examiner palpates the middle phalanx

C. (+) = pressure is felt at the middle phalanx

D. Diagnosis: torn central extensorhood

A

B. Patient carefully EXTENDS PIP while examiner palpates the middle phalanx

76
Q

which of the ff are true about EGAWA SIGN

A. Ask pt to flex middle digit

B. Alternately deviate radially and ulnarly

C. (+) = inability to do the test

D. Diagnosis: ulnar nerve palsy

E. All of the above

A

E

77
Q

match the ff diagnosis
(can have multiple answers)

  1. ulnar nerve paralysis
  2. CTS
  3. median nerve pathology

A. Flick Maneuver
B. Froment’s paper sign
C. Hand Elevation test
D. Phalen’s test
E. Reverse phalen’s

A
  1. B
  2. A, D
  3. E
78
Q

match the ff if there’s a (+) sign

  1. resolution of symptoms
  2. Terminal phalanx of the thumb flexes or MCP joint hyperextends (Jeanne’s Sign)
  3. sx along the median nerve are reproduced in less than 2 mins
  4. tingling in the thumb, index finger, and middle and lateral half of the ring finger
  5. tingling in the thumb, index, and middle and lateral half of the ring finger

A. Flick Maneuver
B. Froment’s paper sign
C. Hand Elevation test
D. Phalen’s test
E. Reverse phalen’s

A
  1. A
  2. B
  3. C
  4. D
  5. E
79
Q

match the ff procedures

  1. pt vigorously shake the hands or flick the wrist
  2. Pt grasp a piece of paper between thumb and index finger while the examiner attempts to pull away the paper
  3. Patient raises both hands over the head and maintain position for at least 3 minutes
  4. Examiner flexes the wrist maximally against each other. Hold the position for 1 min
  5. AKA Prayer test wherein the wrist is in extended position then hold for 1 minute

A. Flick Maneuver
B. Froment’s paper sign
C. Hand Elevation test
D. Phalen’s test
E. Reverse phalen’s

A
  1. A
  2. B
  3. C
  4. D
  5. E
80
Q

which of the ff are true about CARPAL COMPRESSION TEST

A. Apply direct pressure on the median nerve at the wrist for 30 seconds (at the carpal tunnel site) then flex wrist 60 degrees before application of
pressure

B. Modification of the reverse phalen’s

C. (+) = reproduction of the pt’s symptoms

D. Diagnosis: CTS

E. All of the above

A

E

81
Q

which of the ff are true about TETHERED MEDIAN NERVE STRESS TEST

A. Elbow flexed and FA supinated with slight wrist extension then hyperextend the index finger

B. (+) = anterior radiating pain on the forearm

C. Diagnosis: median nerve pathology – usually for chronic cases

D. All of the above

A

D

82
Q

which of the ff are true about TINEL’S SIGN (WRIST)

A. Tapping of the median nerve at the wrist

B. (+) = tingling or paresthesia into the thumb, index (forefinger), and middle and lateral half of the ring finger (median nerve distribution)

C. Diagnosis: CTS

D. Test for regeneration

E. All of the above

A

E

83
Q

modified T/F on WEBER’S TWO POINT DISCRIMINATION TEST (AKA Moberg’s test)

Uses paper clip, two point discriminator or calipers

Find the minimum distance at which the patient can distinguish between two stimuli/ threshold for discrimination

A

TT

84
Q

match the Two-point Discrimination Normal Values to its Discrimination Distances Required for Certain Tasks

  1. Less than 6 mm
  2. 6 to 10 mm
  3. 11 to 15 mm
  4. 1 point perceived
  5. 0 points perceived

A. Normal
B. Fair
C. Poor
D. Protective
E. Anesthetic

A
  1. A
  2. B
  3. C
  4. D
  5. E
85
Q

match the Two-point Discrimination Normal Values to its Discrimination Distances Required for Certain Tasks

  1. 6 mm
  2. 6 to 8 mm
  3. 12 mm
  4. Greater than 15 mm

A. Winding a watch
B. Sewing
C. Handling precision tools
D. Gross tool handling

A
  1. A
  2. B
  3. C
  4. D
86
Q

which of the ff are true about ALLEN TEST

A. Determines the patency of the radial and ulnar artery & which artery provides the major blood supply

B. One finger compresses ulnar artery while another compresses the radial artery

C. While PT applies compression on both arteries, ask pt to do close-open the hand

D. When PT releases pressure on the artery, area should immediately become red

E. All of the above

A

E

87
Q

which of the ff are true about DIGIT BLOOD FLOW, EXCEPT:

A. Compress the nail bed and then release the compression

B. Take note of the time taken for the color to return

C. Normal is 5 seconds

D. Abnormal if it takes longer before the color returns

A

C. Normal is 3 seconds

88
Q

which of the ff are true about FIGURE OF EIGHT MEASUREMENT

A. For swelling

B. Starting point: distal aspect of ulnar styloid process

C. Points: PIP (individually) & MCP as a group

D. All of the above

A

D

89
Q

which of the ff are true about HAND VOLUME TEST

A. Volumeter is only applicable when assessing swelling of distal areas (hands and feet)

B. Assess change in hand size d/t localized swelling, generalized edema, or atrophy

C. (+) Swelling if the difference between 2 hands is 30-50 mL

D. Normal difference between two hands is 10 mL

E. All of the above

A

E

(2) Musculoskeletal Examination (11 decks)

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