The Hand (midterm)

Question 1

Which of the following tasks wouldn’t be okay for 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

Answer 1

Answer: A – no gripping

Question 2

Your patient just had a surgical procedure for osteoarthritis of the CMC of the thumb joint. What is the proper and most functional splinting position? (thumb IP not affected)

A. Splint from DRUJ to above IP of the thumb
B. Splint from DRUJ to below IP of the thumb
C. Splint from mid-forearm to above IP of thumb
D. Splint from mid-forearm to below IP of thumb

Answer 2

Answer: B – you want as much function as possible. In hand, it would go tot he DPC and leave digits free.

Question 3

What position would you splint a patient that had a surgical procedure for osteoarthritis of the CMC of the thumb joint and needed a splint from DRUJ to above IP of the thumb?

A. Radial abduction
B. Flexion
C. Palmar abduction
D. Adduction

Answer 3

Answer: C – most natural

A - never splint thumb in plane with palm
B - “ouch” position
D - “ouch” position

Question 4

What two tests can you do to evaluate a patient with suspected osteoarthritis of the thumb?

A. Lateral pinch
B. Grind test
C. Moeberg’s
D. Mill’s

Answer 4

Answer: A (adduction will produce pain) + B (produce crepitus)

C - could help but not the best
D - lateral epicondylitis/tennis elbow

Question 5

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

Answer 5

Answer: D – made up answer

Question 6

Whenever possible, MP’s should be splinted in about ___ degrees, + the IPs in about ___ degrees.

A. 30;60
B. 50; 15
C. 70; 0
D. 90; 25

Answer 6

Answer: C – near intrinsic plus to prevent contracture

Question 7

What is the difference in OT management between a post-op metacarpal fracture – CRPP vs 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

Answer 7

Answer: A – ORIF- you can start right away, CRPP - can move IPs right away, but MPs need 4 weeks to heal before movement

Question 8

Early mobilization post-op (hand injury) can..

A. Increase strength
B. Increase ROM
C. Prevent adhesion
D. Increase sensitivity

Answer 8

Answer; C

Question 9

Blocking is an important intervention to:

A. Protect surgical sites
B. Limit ROM
C. Modify specific activities
D. Mobilize individual joints

Answer 9

Answer: D – you “block” a joint you don’t want to move to mobilize one you do
ex. Block MP of index to engage extrinsics to flex PIP + DIP

Question 10

A unique consideration for managing distal phalanx fractures is:

A. Heat therapy
B. Desensitization
C. Progression of ROM
D. Increased risk for edema

Answer 10

Answer: D – start early!

Rest are made up

Question 11

T/F: You cannot begin motion with a post-op thumb dislocation patient with an internal brace for 4-6 weeks

Answer 11

FALSE – as early as 1-2 weeks (aka no pinch off the bat, no valgus stress.)

Question 12

T/F: A post-op volar dislocation treatment should focus on MP blocking for full extension

Answer 12

TRUE – patient is in an extension blocking splint initially so it’s even more important to get the joint moving to prevent further flexion

Question 13

Desensitization is most critical in which of the following conditions?

A. PIP Dislocation
B. Chronic regional pain syndrome
C. Trigger finger
D. Carpal tunnel

Answer 13

Answer: B – EXTREME hypersensitivity to pain!