hand and upper extremity disorders and injuries Flashcards

Question

guyon's canal syndrome

Answer 1

-wrist splint in neutral, immobilization splint, wrist cock-up splint

Answer 2

-People who cannot move the thumb away from the rest of the hand. It is an inability to abduct the thumb. High median nerve injury at the elbow or proximal forearm. Sensory loss in index, middle, and radial side of finger; loss of pinch, thumb opposition, index finger MCP and PIP flexion; and decreased pronation.

Answer 3

-Fracture of the first metacarpal base -Orthotics are used for immobilization as needed. ROM is begun early, within 1 week if medically cleared. A sling is used for type 1 fractures or comfort if the client has pain and is nervous in public places.

Answer 4

``` -A boxer’s fracture is the result of a clenched fist hitting an object with enough force to break the metacarpophalangeal neck, most commonly seen in the fourth and fifth digits. ``` -Ulnar gutter splint

Answer 5

``` -Probable recovery, with additional upward movement of the wrist, as well as straightening of thumb and fingers an even stronger indicator of excellent spontaneous improvement. Gentle range of motion exercises. ``` ``` -Flail arm splint provides the needed stability at both the shoulder and elbow for functional positioning of the hand. ``` ``` -Any motion beyond 90° abduction may induce added stress to the brachial plexus and its roots. ```

Answer 6

most common in post-menopasul women may stem from RA or Gout -hand based thumb splint

Answer 7

fracture to the carpal bone associated with keinbocks disease

Answer 8

pain on either side of the carpal tunnel release surgery

Answer 9

splinting and activity modification | -thermoplastic splint and neoprene wrap

Answer 10

``` Occurs when a peripheral nerve is entrapped in more than one location. Symptoms: Intermittent diffuse arm pain and paresthesias ``` ``` -Nerve gliding exercises, and exercises for scapular stability, posture, and core trunk strengthening. ```

Answer 11

-involvement of radial head -Orthotics are used for immobilization as needed ROM begins early, withinin 1 week if medically cleared. A sling is used for Type 1 fracture (nondisplaced) or comfort if the client has pain and is nervous in public places.

Answer 12

``` -Paralysis of the arm caused by injury to the upper group of the arm’s main nerves, specifically the severing of the upper trunk C5–C6 nerves. atrophy/paralysis of arm muscles ``` ``` -resolve on its own over a period of months, necessitate rehabilitative therapy, or require surgery ``` ``` -Elbow lock splint stabilizes the elbow to enable the individual to position the hand closer to or away from his/her body for funcational use. ```

Answer 13

-extensor digitorum communis, extensor indicis proprius (EIP ``` -Modalities include heat, to gradually prepare the tissue for motion, and NMES to promote tendon excusion and activation. ``` - tendon gliding - strengthening is initiated 8-12 weeks after surgery

Answer 14

``` Support the user’s wrist in 10 to 20 degrees of extension to prevent contracture, but allows digits to function ``` -wrist cock up splint

Answer 15

-A deep cut on the palm side of your fingers, hand, wrist, or forearm can damage your flexor tendons, -intervention klienhert or Duran Protocol -Passive extension of the distal interphalangeal joint if the metacarpal and proximal phalangeal joints are flexed. -A tendon repair is typically at its weakest 10–12 days postsurgery during the fibroplasia phase, in which collagen is just beginning to be laid down to strengthen the repair. -dorsal blocking splint -no mans land because excessive scarring makes it difficult to get good results from a repair.

Answer 16

``` -AROM and PROM in splint for digits and thumb, tendon gliding exercises, scar massage, discontinue splint at 6 weeks and begin strengthening exercises. ``` Duran protocol Non-operative treatment: Static thenar web spacer splint. Operative treatment: dorsal wrist blocking splint worn for 4-6 weeks.

Answer 17

Excess pressure placed on a neurovascular bundle passing between the anterior scalene and middle scalene muscles

Answer 18

Inflammation of a tendon Treatment is largely conservative with rest, and gradual return to exercise is a common therapy. ``` -Rest, Ice, compression and elevation. Initial recovery is typically within 2 to 3 days and full recovery is within 4 to 6 weeks. Treatment of tendinitis helps reduce some of the risks of developing tendonosis, which takes longer to heal. ``` ``` -Duran /dorsal protection splint, -volar splint with wrist in neutral ```

Answer 19

``` Injury to both the median and ulnar nerves results in an impairment of function. Can be caused by car accidents and glass injuries. ``` -Figure of eight splint to prevent MP hyperextension or -dynamic MCP flexion splint

Answer 20

``` It tests for palsy of the ulnar nerve at the wrist, specifically, the action of adductor pollicis. Occurs when the flexor pollicis longus compensates for a weak or paralyzed adductor pollicis and flexor pollicis brevis. When a client attempts to pinch, the interphalangeal joint of the thumb flexes more than usual. To perform the test, a patient is asked to hold an object, usually a flat object such as a piece of paper, between their thumb and index finger (pinch grip). The OT then attempts to pull the object out of the subject’s hands. A normal individual will be able to maintain a hold on the object without difficulty. However, with ulnar nerve palsy, the patient will experience difficulty maintaining a hold and will compensate by flexing the FPL (flexor pollicis longus) of the thumb to maintain grip pressure causing a pinching effect. The compensation of the affected hand results in a weak pinch grip with the tips of the thumb and index finger, therefore, with the thumb in obvious flexion. ```

Answer 21

``` The correct angle of pull for a finger loop is 90°. This angle of pull distributes the pressure most evenly to the proximal phalanx. ```

Answer 22

Elbow splint at 90° (forearm in neutral),

Answer 23

fist contractures

Answer 24

``` Compression of the radial nerve in the proximal forearm resulting in a dull ache and burning sensation along the lateral forearm. ``` ``` -Operative treatment: long arm splint, elbow flexed, forearm supinated, wrist neutral for 2 weeks, the -wrist cock up for 2 more weeks, passive and active pronation and supination, hand strengthening exercise at 3 weeks, resistive exercise at 6 weeks. ``` ``` Non-operative: Long arm splint, elbow flexed, forearm supinated, wrist neutral, massage or TENS for pain management, pain free ROM, nerve gliding, activity modification ``` -Avoid foreceful wrist extension and supination.

Answer 25

A prefabricated dynamic PIP extension ``` - splint will improve PIP extension and takes less therapy time to fit than to custom make this splint. ```

Answer 26

``` -strap incorporating the index and middle fingers provides passive rom to the index finger ```

Answer 27

paralysis of the lower brachial plexus paralysis of the hand and wrist with ipsilateral horners syndrome (miosis, ptosis, and facial anhidrosis)

Answer 28

``` -Orthotics are used for immobilization as needed. ROM is begun early, within 1 week if medically cleared. A sling is used for type 1 fractures or comfort if the client has pain and is nervous in public places. ``` ``` -Ulnar nerve injury splint, dynamic/static splint to position MP’s in flexion. MCP block splint. If it is a low level ulnar nerve injury, then a splint that prevents hyperextension of the MCP joints and allows MCP flexion. -dorsal blocking splint with wrist in 20-30 degrees flexion ```

Answer 29

median nerve

Answer 30

radial nerve/radial tunnel syndrom

hand and upper extremity disorders and injuries Flashcards

(54 cards)