Hand Therapy

Question 1

Tip to tip

Answer 1

fingernail to fingernail

Question 2

pad to pad

Answer 2

pad of finger to pad of finger

Question 3

tripod

Answer 3

D123 touch- use this for writing

Question 4

Lateral pinch

Answer 4

pad of D1 touches middle phalanx of D2- used for using a key

Question 5

Name all of the grasps:

Answer 5

Cylindrical
Spherical
Hook
Bilateral palmer grasp

Question 6

Division of the hand

Answer 6

• Radial side- manipulation
• Ulnar side- strength and stability

Question 7

Flexor tendon injuries:

Answer 7

• frequently caused by lacerations or crush/fracture injuries
• Zone 2- “no man’s land” most challenging)- unrepairable, tendon would get stuck- Zone 2

Question 8

TX for FTI’s:

Answer 8

• TX: -Early Active motion- NO AROM in flexion
• or
• -Controlled passive
• or
• • Immobilization

Question 9

• Extensor tendon injuries

Answer 9

• caused by laceration or crush/fracture injury
• 8 zones- different zones dictate different surgery and treatment approach

Question 10

TX for ETI’s

Answer 10

• focus is to prevent adhesions which cause extensor lag
• Treatment generally occurs splinting/immobilization followed by AROM and finally resisted exercise.

Question 11

What is extensor lag?

Answer 11

during active movement- where tendon is cut it gets stuck

Question 12

Neurapraxia

Answer 12

contusion or bruising of the nerve. Full recovery in days or weeks

Question 13

• Axontmesis:

Answer 13

nerve fibres distal to the injury degenerate, but nerve is still in continuity. No surgery required. Recovery usually good. Length of time depends upon location of injury.

Question 14

• Neurotmesis:

Answer 14

complete laceration of the nerve. Usually repaired micro surgically. Recovery is unpredictable.

Question 15

Radial nerve injury:

Answer 15

• most commonly injured in upper arm.
• Results in wrist drop and MP joint extension
• Rx with a wrist extension splint and ROM exercises.

Question 16

Median Nerve Injury

Answer 16

• Median nerve often called the eyes of the hand (provides sensation to much of the palmar hand surface)
• distal injuries- loss of thumb ABD and OPP. Wasting of thenar eminence.
• Rx- thumb opposition splint.

Question 17

Ulnar Nerve Injury

Answer 17

• Injury in the forearm results in hyperextension of the MCPJs of the ring and small finger (clawing).
• Rx- MCP extension block splint for D4 and D5.
• Educate client about risk of burns and injury.

Question 18

Cumulative Trauma Disorder

Answer 18

• AKA repetitive stress or strain, overuse syndromes.
• Common examples are tennis elbow, DeQuervain’s tenosynovitis, and carpal tunnel syndrome.

Question 19

Carpal Tunnel syndrome

Answer 19

• compression of the median nerve travelling through the carpal tunnel.
• Causes pain, paresthesias and sometimes weakness in the median nerve distribution.

Question 20

Causes of The stiff hand

Answer 20

• Immobilization
• Disease
• Injury
• Trauma
• Burn
• Crush
• Laceration
• Post Surgery

Question 21

Characteristics of stiff hand:

Answer 21

EDEMA
Immobility
Pain
Position of deformity

Question 22

Decrease stiff hand

Answer 22

1. Proper positioning- splinting. Hand and thumb,
2. Assure client involvement and understanding
3. Increase mobility- PROM, stretch, progressive splinting, AROM, activity
4. Control edema