The Hand Flashcards
Which of the following tasks would not be okay for a post-op carpal tunnel patient to do?
A. Open a jar of peanut butter
B. Wash his hair
C. Tuck in his t-shirt
D. Wipe down his kitchen table
The answer is A (Open a jar of peanut butter). No gripping!
Your patient just had a surgical procedure for osteoarthritis of the CMC of the thumb joint. What is the proper & most functional splinting position? (Their thumb IP was not affected).
A. Splint from DRUJ to above IP of thumb
B. Splint from DRUJ to below IP of thumb
C. Splint from MID-forearm to above IP of thumb
D. Splint from MID-forearm to below IP of thumb
The answer is B (Splint from DRUJ to below IP of thumb). You want as much function as possible in the hand. it would go to the DPC & leave digits free.
Your patient just had a surgical procedure for osteoarthritis of the CMC of the thumb joint. (Their thumb IP was not affected).
Which position would you splint the thumb in?
A. Radial abduction
B. Flexion
C. Palmar abduction
D. Adduction
The answer is C (Palmar abduction). Most natural
Explanation:
A. Radial abduction -> never splint the thumb in plane with the palm
B. Flexion -> we’ll call this the “ouch” position
D. Adduction -> we’ll call this the “ouch” position
Your patient just had a surgical procedure for osteoarthritis of the CMC of the thumb joint. (Their thumb IP was not affected).
Let’s say you were the one to see the patient before surgery & you suspected osteoarthritis of the thumb. Which two tests could you do to evaluate?
A. Lateral pinch
B. Grind test
C. Moeberg’s test
D. Mill’s test
The answer is A (Lateral pinch -> adduction will produce pain) and B (Grind test -> That’ll produce crepitus).
Explanation:
C. Moeberg’s test -> could help, but not the BEST test
D. Mill’s test -> Lateral epicondylitis/tennis elbow
The 3 most important considerations in OT management for the hand does not include:
A. Position of immobilization
B. Edema control
C. Prevention of tendon adhesions
D. Strengthening of thenar muscles
The answer is D (Strengthening of thenar muscles).
Whenever possible, the MP’s should be splinted in about _____ degrees, & the IP’s in about _____ degrees.
A. 30; 60
B. 50; 15
C. 70; 0
D. 90; 25
The answer is C (70; 0). Near intrinsic plus to prevent contracture.
What is the difference in OT management between a post-op meta carpal fracture - CRPP verses ORIFF?
A. CRPP: MP motion after 4 weeks, ORIF: motion right away
B. CRPP: MP motion right away, ORIF: after 4 weeks
C. CRPP: No MP motion for 4 weeks, ORIF: motion right away
D. CRPP: No MP motion for 4 weeks, ORIF: after 4 weeks
The answer is A (CRPP: MP motion after 4 weeks, ORIF: motion right away). ORIF you can start right away; with CRPP , you can move IPs right away. but MPs need 4 weeks to heal before movement.
Early mobilization post-op (hand injury) can…
A. Increase strength
B. Increase ROM
C. Prevent adhesion
D. Increase sensitivity
The answer is C (Prevent adhesion).
Blocking is an important intervention to:
A. Protect surgical sites
B. Limit ROM
C. Modify specific activities
D. Mobilized individual joints
The answer is D (Mobilized individual joints. You “block” a joint you don’t want to move to mobilize one you do.
Ex: Block MP of index to engage extrinsic to flex PIP & DIP.
Unique consideration for managing distal phalanx fractures is:
A. Heat therapy
B. Desensitization
C. The progression of ROM
D. Increased risk for edema
The answer is B (Desensitization). Start early!
You cannot begin motion with a post-op thumb dislocation patient with an internal brace for 4-6 weeks.
A. True
B. False
The answer is B (False). As early as 1-2 weeks. No valgus stress (aka no pinch off the bat!)
A post-op volar dislocation treatment should focus on MP blocking for full extension.
A. True
B. False
The answer is A (True). The patient is in an extension blocking splint initially so it’s even more important to get the joint moving to prevent further flexion contracture.
Desensitization is most critical in which of the following conditions?
A. PIP dislocation
B. Chronic regional pain syndrome
C. Trigger finger
D. Carpal tunnel
The answer is B (Chronic regional pain syndrome). Extreme hypersensitivity to pain!
