Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Management of Special Populations > Upper Extremity Orthoses > Flashcards

Upper Extremity Orthoses Flashcards

1
Q

Uses for upper extremity orthoses

A
  • Stroke
  • TBI
  • SCI
  • CP
  • MS
  • Peripheral nerve injury
  • Trauma
  • Sporting
  • Arthritis
  • Work related injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why would you recommend on orthosis for a patient

A
  • Immobilize an extremity to help promote tissue healing (IMMOBILIZATION)
  • Increase range of motion (ROM) (MOBILIZATION)
  • Block unwanted movement of a joint (RESTRICTION)
  • Apply traction either to correct or prevent contractures
  • Assist in providing enhanced function
  • Help correct deformities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the purposes of an upper extremity orthosis

A
  • Immobilization: most common and simple; resting position, restrains the joint the orthosis crosses
  • Mobilization: move/stretch to facilitate change, facilitates tissue growth/”physiological creep”, serial, static progressive and dynamic orthoses
  • Restriction: restrict/block an aspect of targeted motion & allow motion to other areas; static, dynamic, taping techniques
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 4 types of UE orthotic designs

A
  • Static
  • Serial static
  • Static progressive
  • Dynamic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe a static orthosis

A
  • Most Common, rigid
  • Provides stabilization, protection and support to a body segment
  • Can be used as adjunctive treatment or exercise device by blocking a distal segment to increase glide of another joint or improve tendon excursion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe serial static orthoses

A
  • Applied to a lengthened tissue, typically at the end range of motion: Mechanical stretching principles
  • Allows for stretching of the tissue into the desired direction of correction
  • Can be removed during therapy session and adjusted daily, weekly or longer
  • Systematically remolded based on gains made during the therapy session
  • Non-removable versions are better choice for the young, cognitive or behavioral issue pts, or those who have variable tone and spasticity.
  • Worn for extended periods of time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe dynamic orthoses

A
  • Use of an elastic type force to mobilize specific tissues to achieve increases in ROM
  • Have a base with outriggers/components: Spring, rubber band, elastic cord loaded
  • Creep principle through constant load applied to tissue
  • The dynamic force applied is maintained as long as the elastic component can contract, even when the tissue reaches the end of its elastic boundary.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe static progressive orthoses

A
  • Used to mobilize tissue in one direction through the application of a low load long duration stretch for a long period of time
  • GOAL: tissue will accommodate to this new positon
  • Different than dynamic orthosis in that the force applied is static
  • Mobilization force is applied through a static line, non elastic strapping materials, hinges, turnbuckles or inelastic tape
  • When new joint position is achieved the device will not continue to stress the tissue
  • Patients may tolerate this method better than dynamic orthoses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What must a physical therapist consider when determining what type of orthosis is needed?

A
  • Immobilization
  • Mobilization
  • Restriction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What bony prominences are vulnerable to pressure

A
  • Olecranon process at the elbow
  • Lateral and medial epicondyles of the humerus
  • Ulnar and radial styloid processes at the wrist
  • Base of the first metacarpal
  • Dorsal thumb and digit metacarpophalangeal and interphalangeal joints
  • Pisiform bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Superficial nerves that are vulnerable to pressure

A
  • Radial nerve at the radial groove of the humerus
  • Ulnar nerve at the cubital tunnel
  • Superficial branches of the ulnar and radial nerves at the distal forearm
  • Median nerve at the carpal tunnel
  • Digital nerves on the volar aspect of the digits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the position of function for the hand

A
  • Wrist 20-30 deg ext
  • MP joints 35-45 deg flexion
  • PIP joint 45 deg flexion and DIP relaxed flexed position
  • Thumb in palmar abd
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the position of rest/anti-deformity/safe for the hand

A
  • Wrist in 30-40 deg ext
  • MP joints 60 to 90 deg flexion
  • PIP and DIP in extension
  • Thumb in palmar abd
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe UE orthoses levers

A
  • Rigid structures which a force can be applied to produce rotational motion about a fixed axis
  • Fulcrum corresponds with the anatomical axis of the target joint,
  • Effort arm is the segment of the orthosis that applies the effort force
  • Resistance arm is the segment of the limb that resists the effort force
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define stress on an UE orthoses

A
  • Concerns for compression, shear, bending and torsion (goal is to distribute)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define angle of force application on an UE orthoses

A
  • In mobilization splints, angle should be 90º to the body segment being mobilized to maximize therapeutic effect
17
Q

What are some signs of too much stress

A
  • Edema
  • Skin blanching
  • Vascular changes
  • Pain
18
Q

What are the mechanical principles of UE orthoses

A
  • Levers
  • Stress
  • Angle of force application
  • Force application = tolerable
  • Mobilization vs. stabilization
19
Q

What are the types of UE orthoses

A
  • Shoulder-elbow-wrist orthoses (SEWO)
  • Shoulder-elbow orthoses (SEO)
  • Elbow orthoses (EO)
  • Elbow-wrist-hand orthoses (EWHO)
  • Wrist-hand orthoses (WHO)
  • Hand orthoses (HdO)
20
Q

Indications for a SEWHO

A
  • Distal humeral fractures
  • Immobilization after surgery
  • Unconscious movement during sleep
  • Olecranon and Epicondyle fractures
  • Ligament injuries in the elbow joint
  • Instabilities or hyperextension
  • Injuries requiring limited ROM at the elbow
  • Elbow arthroplasty
  • Post-op conditions
  • Post-op cast
21
Q

Indications for an EO

A
  • Distal humeral fractures
  • Immobilization after surgery
  • Unconscious movement during sleep
  • Olecranon and Epicondyle fractures
  • Ligament injuries in the elbow joint
  • Instabilities or hyperextension
  • Injuries requiring limited ROM at the elbow
  • Elbow arthroplasty
  • Post-op conditions
  • Post-op cast
22
Q

Indications for a wrist-hand-thumb orthosis

A
  • Post cast fracture immobilization
  • Wrist fractures and sprains
  • Cumulative Trauma Disorder
  • Carpal Tunnel Syndrome
  • Post tendon transfer support
  • Postoperative support after removal of internal or external fixation devices
  • Gamekeeper’s thumb
  • DeQuervain’s Syndrome
23
Q

Indications for a thumb spica

A
  • Sprains
  • Fractures
  • Strains
  • Skier’s thumb
  • Gamekeeper’s thumb
  • Post-op rehab
24
Q

Describe a tenodesis orthosis

A
  • Used in SCI patients
  • Must have some wrist extension intact, specifically extensor carpi radialis
  • Allows pt to produce prehension through reciprocal wrist extension and finger flexion motion
  • Pt potentially can improve grasp, holding and releasing desired objects
25
Q

Describe a Bioness H200

A
  • Wireless
  • Low amplitude FES
  • Allows for functional training of reach, grasp, opening and closing of the hand
  • Can also be used as NMES unit
26
Q

Describe a Givmohr Sling

A
  • Developed by an OT and PT (Givler and Mohr)
  • Also available in bilateral sling form
  • Proposed benefits include: Reduction in subluxation and pain, Improved UE positioning for ambulation, Creates compressive forces throughout the UE
27
Q

For a functional hand orthosis to be worn during activity you need to check out

A
  • Distal trim lines do not interfere with metacarpophalangeal flexion
  • Palmar splint permits thumb opposition to index and long fingers
  • Thumb palmar abduction is maintained
28
Q

What should you check out for UE orthoses

A
  • Comfort and circulation are intact
  • Acceptable appearance
  • No excessive pressure, “gapping,” or migration
  • Splint base is properly contoured to provide total contact with the body
  • Joint position is accurate to prescription
  • Movement of the splinted joint is controlled as prescribed
  • Splint does not impede movements of the neighboring joints
  • Mechanical joints of aligned properly (example elbow joint and wrist joint)
  • No sharp edges on trim lines
  • Straps are snug and located properly to ensure total contact
  • Outriggers and splint components are securely and safely fastened to the base

Management of Special Populations (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions