Tendon & Nerve Injuries Flashcards
Which classification system describes neuropraxia, axonotmesis, and neurotmesis?
A) Sunderland
B) Seddon
C) Wilkes
D) Neer
B) Seddon
What percentage of elongation disrupts blood flow in a nerve?
A) 5%
B) 8%
C) 10%
D) 15%
B) 8%
At what pressure (in mmHg) does paresthesia occur due to compression of a nerve?
A) 10 mmHg
B) 30 mmHg
C) 50 mmHg
D) 70 mmHg
B) 30 mmHg
Which of the following best describes axonotmesis?
A) Conduction block without Wallerian degeneration
B) Complete nerve division
C) Axon & myelin sheath disruption
D) Axons and CT in continuity
C) Axon & myelin sheath disruption
Which of the following is NOT a common treatment method for neurotmesis?
A) Direct nerve repair
B) Nerve grafting
C) Tendon transfers
D) Physical therapy alone
D) Physical therapy alone
What is the typical recovery time for nerve axon migration after an injury?
A) 1 mm/day
B) 2 mm/day
C) 1 cm/day
D) 2 cm/day
A) 1 mm/day
Which condition involves pain, sensory disturbances, and sometimes upper extremity swelling due to compression of the brachial plexus?
A) Carpal Tunnel Syndrome
B) Cubital Tunnel Syndrome
C) Thoracic Outlet Syndrome
D) De Quervain’s Tenosynovitis
C) Thoracic Outlet Syndrome
What is the primary aim of sensory re-education after nerve repair or grafting?
A) To prevent contractures
B) To improve sensibility
C) To manage edema
D) To promote scar formation
B) To improve sensibility
Which nerve transfer involves moving the spinal accessory nerve to the suprascapular nerve?
A) Oberlin transfer
B) Spinal accessory nerve to suprascapular nerve
C) Radial nerve to axillary nerve
D) Median nerve to musculocutaneous nerve
B) Spinal accessory nerve to suprascapular nerve
What is the typical immobilization period after tendon transfer surgery?
A) 1 week
B) 2 weeks
C) 4 weeks
D) 6 weeks
C) 4 weeks
Which phase of tendon healing involves fibroblast activity and collagen production?
A) Inflammatory phase
B) Fibroplastic phase
C) Remodeling phase
D) Degenerative phase
B) Fibroplastic phase
In flexor tendon injuries, what is the main concern when managing injuries in Zone II?
A) Fractures
B) Adhesions
C) Neurovascular compromise
D) Tendon elongation
B) Adhesions
What type of flexion is emphasized during the early active motion protocol for flexor tendon repairs?
A) Composite flexion
B) Hook fist
C) PIP/DIP blocking
D) Straight fist
A) Composite flexion
Which splinting method is commonly used for closed mallet finger injuries?
A) Dorsal block splint
B) Finger gutter splint
C) Stack splint
D) Volar splint
C) Stack splint
For Zone I extensor tendon injuries, what is the primary management strategy?
A) Dynamic splinting
B) Immobilization
C) Early active motion
D) Early passive motion
B) Immobilization
Which nerve injury management technique aims to prevent neuroma formation?
A) Sensory re-education
B) Nerve grafting
C) Tendon transfer
D) Contracture prevention
B) Nerve grafting
What is the hallmark diagnostic test for neurogenic thoracic outlet syndrome?
A) EAST (Elevated Arm Stress Test)
B) Spurling’s Test
C) Tinel’s Sign
D) Phalen’s Test
A) EAST (Elevated Arm Stress Test)
What is the first step in managing peripheral nerve injuries in occupational therapy?
A) Strengthening exercises
B) Sensory re-education
C) Contracture prevention
D) Scar mobilization
C) Contracture prevention
Which tendon transfer is commonly used to address radial nerve injuries?
A) FCR/U to EDC
B) PT to ECRB
C) PL to EPL
D) All of the above
D) All of the above
In tendon healing, what type of healing is primarily responsible for adhesion formation?
A) Extrinsic healing
B) Intrinsic healing
C) Primary healing
D) Secondary healing
A) Extrinsic healing
Which type of nerve injury involves complete nerve division and disruption of all connective tissues?
A) Neuropraxia
B) Axonotmesis
C) Neurotmesis
D) None of the above
C) Neurotmesis
What is the primary goal during the early phase of OT management for nerve repair/graft?
A) Full range of motion exercises
B) Aggressive strengthening
C) Contracture prevention and protected motion
D) Sensory re-education
C) Contracture prevention and protected motion
Which of the following is a common complication after nerve injury repair?
A) Tendon elongation
B) Adhesion formation
C) Scar tissue reduction
D) Increased sensation
B) Adhesion formation
What type of splinting is indicated for a patient with a flexor tendon injury in Zone I-II during the first 4 weeks?
A) Dynamic splinting
B) Dorsal block splint
C) Volar splint
D) Finger gutter splint
B) Dorsal block splint
For nerve transfer procedures, what is a critical component of OT management?
A) Early strengthening
B) Establishing new motor patterns
C) Aggressive stretching
D) Passive range of motion only
B) Establishing new motor patterns
Which phase of tendon healing can last from 3 weeks to over a year?
A) Inflammatory phase
B) Fibroplastic phase
C) Remodeling phase
D) Degenerative phase
C) Remodeling phaseC) Remodeling phase
What is the preferred method for treating a Zone I closed mallet finger injury?
A) Dynamic splinting
B) Early active motion
C) Stack splint for 6-8 weeks
D) Immediate surgery
C) Stack splint for 6-8 weeks
Which intervention is critical for the management of thoracic outlet syndrome?
A) Immediate surgery
B) Postural remediation
C) Strengthening exercises
D) High-intensity interval training
B) Postural remediation
What is the primary focus during the intermediate/late phase of OT management for nerve repair/graft?
A) Immobilization
B) Diligent contracture prevention and functional return
C) Edema management
D) Passive range of motion
B) Diligent contracture prevention and functional return
Which nerve injury classification predicts complete recovery without Wallerian degeneration?
A) Neuropraxia
B) Axonotmesis
C) Neurotmesis
D) Neuro
A.) Neuropraxia
A 45-year-old patient presents with a wrist drop following a humeral fracture. What is the most likely nerve involved?
A) Median nerve
B) Ulnar nerve
C) Radial nerve
D) Axillary nerve
C) Radial nerve
During the evaluation of a patient with carpal tunnel syndrome, what is the most appropriate test to confirm the diagnosis?
A) Phalen’s Test
B) Tinel’s Sign
C) Finkelstein’s Test
D) Spurling’s Test
A) Phalen’s Test
A patient with a repaired flexor tendon injury in Zone II is in the early phase of rehabilitation. What is the most appropriate intervention?
A) Early active motion
B) Strengthening exercises
C) Dorsal block splint and PROM
D) Unrestricted AROM
C) Dorsal block splint and PROM
A patient complains of numbness and tingling in the ring and little fingers, especially when the elbow is flexed. Which condition is most likely?
A) Carpal Tunnel Syndrome
B) Cubital Tunnel Syndrome
C) Thoracic Outlet Syndrome
D) De Quervain’s Tenosynovitis
B) Cubital Tunnel Syndrome
Following a radial nerve injury, which tendon transfer could be used to restore wrist extension?
A) FCR to EDC
B) PT to ECRB
C) PL to EPL
D) BR to FPL
B) PT to ECRB
A patient has undergone a nerve graft procedure for a brachial plexus injury. During the intermediate phase of OT management, what is a key focus?
A) Immobilization
B) Sensory re-education
C) Contracture prevention and progressive challenge
D) Strengthening exercises
C) Contracture prevention and progressive challenge
In managing a patient with a Zone III extensor tendon injury, what is a critical early intervention?
A) Full unrestricted motion
B) Immobilization with a PIP extension splint
C) Dynamic splinting
D) Strengthening exercises
B) Immobilization with a PIP extension splint
A patient with thoracic outlet syndrome presents with pain and numbness in the arm, particularly when performing overhead activities. What is the primary OT intervention?
A) Postural remediation and nerve glides
B) Strengthening exercises for the shoulder
C) High-intensity interval training
D) Immediate surgical referral
A) Postural remediation and nerve glides
A 30-year-old patient presents with a claw hand deformity following an ulnar nerve injury. Which tendon transfer is most appropriate?
A) FCR to EDC
B) FDS to A1 pulleys (IV/V)
C) PT to ECRB
D) PL to EPL
B) FDS to A1 pulleys (IV/V)
After a flexor tendon repair in Zone I, a patient is advised to follow the early active motion protocol. What is the main rationale for this approach?
A) Prevents tendon elongation
B) Increases tensile strength and reduces adhesions
C) Allows for unrestricted AROM
D) Minimizes risk of infection
B) Increases tensile strength and reduces adhesions
A patient with a history of diabetes presents with a laceration to the median nerve at the wrist. Which sensory re-education technique is most appropriate in the early phase?
A) Localization and discrimination
B) Strengthening exercises
C) Visual/audio-tactile cueing and mirror imagery
D) Full unrestricted motion
C) Visual/audio-tactile cueing and mirror imagery
A patient is recovering from a Zone II flexor tendon repair and exhibits significant swelling and stiffness. What intervention should be prioritized?
A) High-intensity strengthening
B) Edema management and passive stretching
C) Full unrestricted AROM
D) Dynamic splinting
B) Edema management and passive stretching
A patient with radial nerve palsy is being considered for a tendon transfer. Which muscle is typically used to restore thumb extension?
A) FCR
B) PT
C) PL
D) ECRB
C) PL
During the rehabilitation of a patient with a repaired nerve injury, the OT focuses on preventing the formation of painful neuromas. Which strategy is most effective?
A) Early active motion
B) Contracture prevention
C) Proper surgical repair and sensory re-education
D) Strengthening exercises
C) Proper surgical repair and sensory re-education
A patient presents with signs of thoracic outlet syndrome and reports worsening symptoms with overhead activities. What specific physical test would be most appropriate to confirm the diagnosis?
A) Phalen’s Test
B) Tinel’s Sign
C) Elevated Arm Stress Test (EAST)
D) Finkelstein’s Test
C) Elevated Arm Stress Test (EAST)
