Hand Therapy

Question 1

which 2 tendons make up the first dorsal compartment of the wrist

Answer 1

1. extensor pollicis brevis

2. abductor pollicis longus

Question 2

which 2 tendons make up the second dorsal compartment of the wrist

Answer 2

1. carpi radialis brevis

2. carpi radialis longus

Question 3

what tendon makes up the 3rd dorsal compartment of the wrist

Answer 3

1. extensor pollicis longus

Question 4

which 2 tendons make up the 4th dorsal compartment of the wrist

Answer 4

1. extensor digitorum

2. extensor Indias

Question 5

what tendon makes up the 5th dorsal compartment

Answer 5

extensor digiti minimi

Question 6

what tendon makes up the 6th dorsal compartment

Answer 6

extensor carpi ulnaris

Question 7

what are the 3 nerves of the hand

Answer 7

1. median
2. ulnar
3. radial

Question 8

what parts of the arm/hand is innervated by the median nerve

Answer 8

• lower part of upper arm
• elbow
• forearm
• carpal tunnel

Question 9

what parts of the arm/hand is innervated by the ulnar nerve

Answer 9

• lower part of upper arm
• outside of elbow
• inner forearm
• ring finger
• pinky finger

Question 10

what part of the arm/hand is innervated by the radial nerve

Answer 10

thumb side

Question 11

list the 3 assessments methods used for thumb pain

Answer 11

• The sign of O

- Step Deformity

Question 12

what does the sign of o assessment determine

Answer 12

will erect OA in thumb if it makes a D shape, rather than O

Question 13

what does a step deformity assessment determine

Answer 13

visible subluxations of the 1st metacarpal when thumb is extended

Question 14

list 3 different types of thermoplastics for orthosis construction

Answer 14

• polyform
• ezeform
• aquaplast

Question 15

list the characteristics of poly form

Answer 15

• low temperature
• minimum resistance to stretch
• lightweight
• ideal for acute trauma or joint irritation

Question 16

list the characteristics of ezeform

Answer 16

• maximum resistance to stretch
• superior drape for intimate fit
• bonds permanently once heated
• ideal for non compliant patients

Question 17

list the characterises of aquapalst

Answer 17

• perforated for ventilation
• controlled stretch
• transparent for observing pressure points and landmark whilst moulding

Question 18

list joint modalities to prevent swelling in the hand

Answer 18

• reducing repetitive movements
• joint protection techniques
• avoiding prolonged grip
• splinting

Question 19

symptoms of carpal tunnel syndrome

Answer 19

• pain on radial aspect of hand
• worse at night
• worse with repetitive force
• clumsiness or weakness
• proximal radiation of symptoms into forearm or elbow

Question 20

describe the anatomy/cause of carpal tunnel syndrome

Answer 20

- compression of the median nerve 
Tunnel contains: 
- ligaments 
- nerves 
- bones 
Any compression causes nerve to be compressed

Question 21

Assessment for Carpal Tunnel Syndrome

Answer 21

• positive tinels (tapping nerve at wrist)

- positive phanels (elbow extended and wrist flexed = altered sensation in fingers)

Question 22

list the causes of carpal tunnel syndrome

Answer 22

• anatomical e.g. fracture, tumor
• inflammatory diseases
• mechanical forces
• obesity

Question 23

list the symptoms of de quervains tenosynovitis

Answer 23

• raised swelling at radial styloid

- pain on tumb motion

Question 24

describe the anatomy of de quervains tenosynovitis

Answer 24

related to the EBP and APL tendons in 1st dorsal compartment
- inflammation of tendon sheath

Question 25

cause of de quervains tenosynovitis

Answer 25

EPB and APL not designed to be radial deviators and can cause dysfunction secondary to prolonged use in lifting

Question 26

assessment of de quervains tenosynovitis

Answer 26

finkelsteins test - thumb inside fingers and pulling down

Question 27

list the conservative treatment of de quervains tenosynovitis

Answer 27

- NSAIDS - orthosis - offloading - gentle AROM

Question 28

orthosis precautions for de quervains tenosynovitis

Answer 28

- joint immobilised for 6 weeks - radial gutter or entire hand - wrist in 20 degree extension - slight radial deviation - fingers and thumb IP free to mobilise

Question 29

symptoms of OA in the carbo-metacarpal joint of the thumb

Answer 29

- pain - swelling - nodules on joints - poor AROM - decreased function - referred pain

Question 30

define acute pain

Answer 30

- less than 3 months | - direct injury or illness that causes tissue damage

Question 31

describe chronic pain

Answer 31

- pain experienced beyond normal healing Time of 3-6 months | - persistent firing of pain signals within nervous system