Upper Extremity

Question 1

What nerve is affected with ape hand deformity?

Answer 1

Median

Question 2

What nerve is affected with wrist drop?

Answer 2

Radial

Question 3

What is normal position for the wrist and arm in a WHO?

Answer 3

15-30* dorsiflexion, no ulnar or radial deviation, neutral pronation - supination

Question 4

What residual function would you expect with a complete C-6 Cervical lesion?

Answer 4

Wrist Extension

Question 5

What is your orthotic recommendation for above?

Answer 5

wrist driven flexor hinge splint

Question 6

How does a wrist driven function?

Answer 6

tenodesis action from wrist extension to cause grasp

Question 7

Name 6 prehension patterns.

Answer 7

Spherical
Tip
Palmer
Cylindrical
Hook
Lateral

Question 8

A thumb post should hold the thumb in what position?

Answer 8

in opposition to index and 2nd finger

Question 9

What type of orthosis would you use for an intrinsic minus hand? RX rational?

Answer 9

HO

Question 10

What type of orthotic devices would you use for a patient with a complete C-5 lesion?

Answer 10

static WHO, mobile arm supports

Question 11

What is clonus?

Answer 11

A rapid alternating involuntary movement elicited by stretch

Question 12

How many cervical neural segments are there?

Answer 12

8

Question 13

True/False: At the neural segmental level of the spinal cord lesion there will always be a return reflex action.

Answer 13

False

Question 14

Describe a rotator cuff injury

Answer 14

Damage to the SITS muscles in the shoulder

Question 15

What is your orthotic recommendation for rotator cuff

Answer 15

Immobilize shoulder in slight abduction - airplane splint

Question 16

Describe Erb’s palsy and make orthotic recommendations

Answer 16

Avulsion of C5-6 roots resulting in a flail arm (finger flexors & extensors intact)
“gunslinger” orthosis to position hand and support shoulder

Question 17

What type of neural injury normally results in flaccid paralysis (upper motor, CNS, peripheral)

Answer 17

Peripheral nervous system injuries

Question 18

What muscles flexes, abducts, extends and supports the shoulder joint?

Answer 18

Deltoid

Question 19

What should 1 of your primary concerns be in upper extremity orthotics for spinal injury?

Answer 19

Insensate skin sensitive to pressure

Question 20

What orthosis would you recommend for a hand with lumbricales, interossei & thumb abduction out? Why?

Answer 20

HO with C-bar & MP extension stop to maintain thumb web space, flex MPs allowing long extensors to extend IPs DIPS

Question 21

Describe the etiology of carpal tunnel syndrome

Answer 21

compression of the medial nerve in the carpal canal caused by edema, synovitis, & fibrosis of the tendon sheath

Question 22

how long would you treat a mid-humeral fracture with radial nerve lesion?

Answer 22

humeral fracture brace with positional cock up splint and sling

Question 23

How do you position for carpal tunnel syndrome?

Answer 23

immobilize in neutral

Question 24

radial nerve injury

Answer 24

lose extensors of wrist and elbow, supinator & thumb abduction

Question 25

median nerve injury

Answer 25

lose lumbricales 1 & 2, opponens policies, flexor pollicis braves, & palmar sensation “ape hand”

Question 26

ulnar nerve injury

Answer 26

lose of most intrinsics of the hand “claw hand”