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NBCOT > Upper Extremity > Flashcards

Upper Extremity Flashcards

1
Q

Most common carpal fractures is…

A

Scaphoid fracture

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2
Q

With scaphoid fractures, you need to be concerned about…

A

Blood supply/necrosis

Blood from distal to proximal

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3
Q

Colle’s vs Smith’s fracture

A

Both are distal radius fracture (fall on an outstretched hand)

Colle’s: dorsal displacement
Smith’s: volar displacement

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4
Q

Metacarpal fractures, common complication is…

A

Rotational deformities

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5
Q

Boxer’s fracture

A

Fifth metacarpal

Splint with an ulnar gutter splint

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6
Q

When middle phalanax is fractured, we are worried about mobility of the..

A

Flexor digitorum superficilias

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7
Q

When first assessing fractures, you should NOT…

A

Assess PROM until ordered by physician

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8
Q

OT intervention for…

Immobilization phase of fractures

A

Stabilizing and healing are the goals

  1. AROM of joints above and below the stabilized part
  2. Edema control: elevation, manual edema mobilization and compression garments
  3. Light ADLs and role activities with no resistance, progress as tolerated (if sling, shoulder immobilizer, LAC, fracture brace or ORIF…instruct on one-handed techniques)
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9
Q

OT intervention for…

Mobilization phase for fractures

A

Consolidation is the goal

  1. Edema control: elevation, manual edema mobilization, gentle retrograde massage, contrast baths, compression garments
  2. Splint for protection possibly
  3. AROM (progress to PROM when physician approved)
  4. Light purposeful occupation based activities
  5. Pain management: positioning and PAMs
  6. Strengthening when approved by physician
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10
Q

With elbow fractures, we are concerned with…

A

Involvement of radial head may result in limited rotation of the forearm

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11
Q

Wrist fracture injuring median nerve produces…

A

Carpal tunnel like symptoms

  1. Palmar numbness
  2. Numbness of the first digit to half of the fourth digit
  3. Generalized weakness
  4. Pain
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12
Q

Wrist fractures injuring the ulnar nerve results in…

A

Ulnar claw deformity
Numbness on ulnar side of hand (half of 4th and 5th digit)
Generalized weakness and pain on ulnar side

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13
Q

Avulsion injuries are…

A

Tendons separate from bone/insertion and removes bony material (swan necks, boutonniere, mallet)

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14
Q

Mallet finger injury…

A

Avulsion of terminal tendon

Splinted in full extension for 6 weeks

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15
Q

Boutonniere deformity…

A

Disruption of the central slip of the extensor tendon
Characterized by PIP flexion and DIP hyperextension

PIP splinted in extension
Isolated DIP extension exercises are performed

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16
Q

Swan neck deformity…

A

Injury to the MCP, PIP or DIP joints
Characterized by PIP hyperextension and DIP flexion

PIP splinted in slight flexion

17
Q

Cumulative Trauma Disorder

A

Trauma to soft tissue caused by repeated force

This is a mechanism of injury, not a diagnosis

Could be diagnosed as anything from rotator cuff tear to osteoarthritis to deQuervain syndrome

18
Q

OT intervention for Cumulative Trauma Disorder

A
  1. Acute phase: reduce inflammation and pain
  2. Subacute phase: Stretching, progressive resistive exercise, education, splinting
  3. Return to work: therapy as work simulator
  4. Functional capacity evaluation
  5. Work hardening
19
Q

What kind of splint do you need for flexor tendon injuries?

A

Dorsal Block Splint

Wrist: 20-30 (flexion?)
MCP: 50-70
IP: full extension

20
Q

Early mobilization for flexor tendon injuries should look like…

A

Duran: do it yourself, passively flex and extend your fingers

Kleinhart: rubberband passively flex, actively extend

Discharge splint around week 6
Strengthening does NOT occur until week 8

21
Q

Immobilization protocols for flexor tendon injuries should really only be used for…

A

Children
Patients without cognitive capacity
Those who will not be able to maintain safety and/or care for themselves safely

22
Q

Which zone of flexor tendons is considered “no man’s land” and why

A

Zone II: center portion of middle phalanx to distal palmar crease

Because of the difficulty of tendon gliding without scarring to surrounding tissues

23
Q

What are the tests for Carpal Tunnel Syndrome?

A

Tinel’s sign: tap on the median nerve at wrist to elicit symptoms

Phalen’s test: holding the wrist in full flexion for 1 minute to elicit changes in sensation

Moberg pick up test: timed test manipulating small objects to test function (typically for children and cognitively impaired adults)

24
Q

What type of splint would you use for Carpal Tunnel Syndrome?

A

Wrist cock up splint at 0-10 degrees extension

25
Q

Dupuytren’s Disease

A

Thickened and contracted fascia of the palms with developing cords/bands that extend into the digits

Results in flexion deformities of the involved digits

Remember that is fixes with the Z-plasty
Then splint in extension as advised by surgeon

26
Q

With Complex Regional Pain Syndrome, you should typically avoid/proceed with caution for…

A
  1. PROM
  2. Passive stretching
  3. Joint mobilization
  4. Dynamic splinting
  5. Casting
27
Q

Testing for DeQuervain’s Tenosynovitis

A

Finklestein’s Test

Place thumb in closed fist

Tilt hand down

Pain is felt in this position

28
Q

Splinting for DeQuevain’s

A

Thumb spica splint

NBCOT (13 decks)

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