The Wrist (midterm)

Question 1

Patient complains of dropping objects, trouble gripping, and tingling in digits 1, 2, and 3. Which provocative test would you perform to confirm your suspicion?

A. Finkelstein’s
B. Phalen’s
C. Cozen’s
D. Reverse mill’s

Answer 1

Answer: B – carpal tunnel syndrome

A – dequervain’s
C – extensor/lateral epicondylitis
D – flexors/medial epicondylitis

Question 2

How would you splint your patient with carpal tunnel?

A. Wrist in flexion; fingers in neutral
B. Wrist in neutral; fingers in flexion
C. Wrist in neutral; fingers in neutral
D. Wrist in extension; fingers in flexion

Answer 2

Answer: C

A + B – wrist flexion impinges median nerve, finger flexion draws lumbricals into carpal tunnel
D – wrist extension impinges median nerve (see above)

Question 3

You are fabricating a splint for a distal radius fracture. To what distal landmark should your splint go?

A. DIPs
B. MCPs
C. CMCs
D. DPC

Answer 3

Answer: D – distal palmar crease

A + B – you want the fingers free
C – you want the CMCs included

Question 4

A distal radius fracture results in a volarlly displaced fragment. This is known as what kind of fracture?

A. Barton’s
B. Colles
C. Chauffer’s
D. Smith’s

Answer 4

Answer: D

A – DRF on volar side with dislocation of radiocarpal joint
B – dorsally displaced fragment
C – radial styloid fracture

Question 5

Which of the following is not a part of OT management for a distal radius fracture?

A. Strengthening
B. Forearm supination
C. MP Blocking
D. Power gripping

Answer 5

Answer: A – not the most ideal, especially first 6 weeks

Question 6

Avascular necrosis is common with which fracture?

A. Colles
B. Scaphoid
C. Distal humerus
D. PIP

Answer 6

Answer: B – only gets blood supply from one aspect of the bone… it can die quickly if untreated

Question 7

Order the protocol for carpal fractures

__ A. PROM
__ B. Orthosis
__ C. Edema Management
__ D. Strength

Answer 7

Answer:
B
C
A
D

Question 8

In a perilunate wrist dislocation, its important to continually assess which nerve?

A. Ulnar
B. Radial
C. Median

Answer 8

Answer: C – in this injury the lunate can displace into the carpal tunnel, causing an impingement on the median nerve

Question 9

Which of the following is not a top priority of OT management for most wrist injuries?

A. Rest (splinting)
B. Activity modification
C. Progressive resistive exercises
D. Avoidance of aggravating activities

Answer 9

Answer: C – if anything, gentle PROM and AAROM