Upper Extremity Oral Questions

Question 1

What nerve is affected with ape hand deformity?

Answer 1

Median nerve

Question 2

What nerve is affected with wrist drop?

Answer 2

Radial nerve

Question 3

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

Answer 3

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

Question 4

What residual function would you expect with a complete C6 cervical lesion?

Answer 4

Wrist extension

Question 5

What is your orthotic recommendation for a C6 cervical lesion?

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 4 of the 6 prehension patterns.

Answer 7

1. spherical
2. tip
3. palmer
4. cylindrical
5. hook
6. lateral

Question 8

A thumb post should hold the thumb in what position?

Answer 8

In opposition to index and second fingers

Question 9

What type of orthotic device(s) would you use for a patient with a complete C5 lesion?

Answer 9

*Static WHO
*mobile arm supports

Question 10

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

Answer 10

Hand Orthosis (HO)

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

eight

Question 13

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

Answer 13

False

Question 14

Describe a rotary cuff surgery?

Answer 14

Damage to the SITS muscles in the shoulder *Supraspinatus – abducts arm
*Infraspinatus – externally rotates arm
*Teres Minor – externally rotates arm
*Subscapular – internally rotates arm

Question 15

What is your orthotic recommendation for rotator cuff?

Answer 15

Immobilize shoulder in slight abduction – airplane splint

Question 16

Describe Erbs’s palsy and make orthotic recommendations?

Answer 16

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

Question 17

What type of neural injury normally results in flaccid paralysis (upper motor, central nervous system, peripheral)?

Answer 17

Peripheral nervous system injuries

Question 18

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

Answer 18

Deltoid

Question 19

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

Answer 19

Insensate skin sensitve to pressure

Question 20

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

Answer 20

HO with C-bar and M-P extension stop to maintain thumb web space, flex M-Ps allowing long extensors to extend I-Ps and D-I-Ps

Question 21

Describe the etiology of carpal tunnel syndrome.

Answer 21

Compression of the median nerve in the carpal canal caused by edema, synovitis, and fibrosis of the tendon sheath

Question 22

How 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

Describe the muscle picture for:
1. radial nerve injury
2. median nerve injury
3. ulnar nerve injury

Answer 24

1. Lose extensors of wrist and elbow, supinator, and thumb abduction
2. lose lumbricales 1&2, opponens polling, flexure pollicis brevis, and palmer sensation “ape hand”
3. Lose of most intrinsics of the hand “claw hand”