Upper Extremity Orthoses

Question 1

An orthotic device that crosses a joint is considered ________, while one that does not cross a joint is called ________.

Answer 1

Articular, Nonarticular

Question 2

Which of the following is not a direction of applied forces for orthotic devices?
A) Flexion
B) Extension
C) Radial Deviation
D) Rotation

Answer 2

Rotation

Question 3

Orthotic devices can be classified by their

Answer 3

Location

Question 4

What is the purpose of immobilization in upper extremity (UE) orthoses?

Answer 4

Immobilization helps stabilize joints or tissues by:

Preventing excessive or abnormal movements
Managing deformities by preventing contractures
Protecting structures from harmful or excessive loads

Question 5

Mobilization orthoses are used to assist with _______ and manage deformities by applying corrective force.

Answer 5

Movement

Question 6

What is the primary purpose of mobilization in UE orthoses?

Answer 6

Mobilization orthoses assist with movement and help manage deformities by applying corrective forces.

Example: Assist with lost movement from nerve injuries or elongate shortened tissues.

Question 7

Which of the following is not a purpose of restriction in UE orthoses?

A) Prevent joints from unsafe movements
B) Elongate shortened tissues
C) Protect structures from harmful or excessive loads
D) Limit joint movement

Answer 7

B) Elongate shortened tissue

Question 8

One of the main goals of immobilization is to reduce _______ in injured tissues.

Answer 8

Inflammation

Question 9

What is the purpose of UE orthoses designed to substitute hand grip or dexterity?

-Example:

Answer 9

provide support for individuals with limited hand function, allowing them to perform tasks like holding utensils.

Patients with C5-C6 spinal cord injuries (SCI).

Question 10

UE orthoses can be used as an exercise or therapy tool to assist function, such as using a ________ to enhance the movement of an impaired digit.

Answer 10

Budding Tapping

Question 11

What is the function of a blocking splint in UE rehabilitation?

A) To substitute hand grip
B) To assist with active range of motion (AROM) by blocking movement of more mobile joints
C) To provide stabilization for painful joints
D) To prevent contractures

Answer 11

B) To assist with active range of motion (AROM) by blocking movement of more mobile joints

Question 12

The anti-deformity position of the shoulder includes ________ degrees of abduction with external rotation.

Answer 12

90

Question 13

What is the recommended position for the elbow in an anti-deformity posture?
A) Flexion
B) Extension
C) Hyperextension
D) Slight flexion

Answer 13

Extension

Question 14

The forearm should be positioned in ________ to slight supination in an anti-deformity posture.

Answer 14

Neutral

Question 15

What is the recommended wrist position in an anti-deformity posture?

Answer 15

20-30 degrees of extension to prevent flexion contractures.

Question 16

In the anti-deformity position, the metacarpophalangel (MCP) joints should be flexed to ________ degrees.

Answer 16

70-90

Question 17

Label A, B, C
-name
-location
-position

Answer 17

A) HFO, MCP and IP immobilization

B) MCP flexion mobilization splint + resist ext, free movement of IP joint

C) MCP ext restriction splint (move more vs. A)

Question 18

In the anti-deformity position, the interphalangeal (IP) joints should be in:
A) Flexion
B) Extension
C) Abduction
D) Adduction

Answer 18

B) Extension

Question 19

The thumb should be positioned in ________ abduction in the anti-deformity posture.

Answer 19

palmar

Question 20

Why is the anti-deformity position important, especially in burn cases?

Answer 20

prevent contractures and preserve functional range of motion in the affected areas following burns.

Question 21

What does the wear time of an orthosis depend on?

Answer 21

purpose of the orthosis,

Question 22

Longer splints are generally more ________ for patients.

Answer 22

Comfortable

Question 23

Why are wider straps preferred in UE orthosis design?
A) They are easier to apply
B) They distribute force more evenly
C) They look better
D) They are less expensive

Answer 23

B) They distribute force more evenly

Question 24

What is the purpose of using contoured edges in orthosis design?

Answer 24

enhance patient comfort by reducing irritation and pressure

Question 25

When designing an orthosis, it is important to avoid pressure over ________.

Answer 25

Bony prominences (i.e. ulnar head)

Question 26

In dynamic braces, the angle of pull should ideally be: A) 45° B) 90° C) 180° D) 135°

Answer 26

B) 90°

Question 27

Static splints are commonly prescribed for ________.

Answer 27

Immobilization

Question 28

Static splints primarily provide ________ support to joints or limbs.

Answer 28

passive

Question 29

The resting position of a static splint holds tissues in ________ positions but not at end range.

Answer 29

elongated

Question 30

What is the functional position of the hand and wrist in a static splint? A) 10° wrist extension, 90° MCP flexion B) 20° - 30° wrist extension, 40° - 45° MCP flexion C) 45° wrist extension, 20° MCP flexion D) 30° wrist flexion, 45° PIP extension

Answer 30

B) 20° - 30° wrist extension, 40° - 45° MCP flexion

Question 31

Hand & Wrist Static Splint Pos: In the functional position of the hand, the PIP joints should be in ________ degrees of flexion.

Answer 31

45

Question 32

Hand & Wrist Static Splint Pos: What is the recommended position for the distal interphalangeal (DIP) joints in a functional splint position?

Answer 32

relaxed flexion

Question 33

Hand & Wrist Static Splint Pos: In the functional position of the hand, the thumb should be ________ and in opposition to the fingers.

Answer 33

Abducted

Question 33

These are functional positioning for what type of splint? Wrist Extension: 20° - 30° MCP Flexion: 40° - 45° PIP Flexion: 45° DIP Position: Relaxed flexion Thumb Position: Abducted and opposed to fingers

Answer 33

static splint of hand and wrist

Question 34

When may static splints be worn to manage elbow flexor spasticity? A) Only during physical therapy sessions B) During the day to assist with activities C) At night to maintain elbow extension ROM D) Throughout all waking hours

Answer 34

C) At night to maintain elbow extension ROM

Question 35

What is the primary purpose of an airplane splint?

Answer 35

immobilization of the shoulder and arm.

Question 36

In an airplane splint, the positioning of the arm is in ________.

Answer 36

Abduction

Question 37

Which of the following is NOT an indication for using an airplane splint? A) Axillary burns B) Contracture prevention C) Wrist fracture D) Brachial plexus injury

Answer 37

C) Wrist fracture

Question 38

Which of the following is NOT an indication for using an abduction-external rotation shoulder brace? A) After shoulder dislocation B) s/p shoulder arthrodesis C) s/p total knee replacement D) s/p rotator cuff repair

Answer 38

s/p total knee replacement

Question 39

The most comfortable position for the shoulder in the abduction-external rotation brace is ________ degrees of abduction and ________ degrees of external rotation.

Answer 39

30°; 30°

Question 40

Which of the following is NOT an indication for using a shoulder sling? A) AC or GH dislocation B) Post-surgery C) Chronic shoulder pain D) Post-trauma

Answer 40

C) Chronic shoulder pain

Question 41

Long-term use of a shoulder sling may lead to ________ flexion contracture.

Answer 41

Elbow

Question 42

Which of the following is true regarding the cost effectiveness of a sling versus an abduction brace? A) The sling is generally more expensive. B) The abduction brace is more cost effective. C) The sling may be more cost effective. D) Both are equally expensive.

Answer 42

C) The sling may be more cost effective.

Question 43

What is the primary purpose of elbow-forearm wrist orthoses?

Answer 43

stabilize injuries of the forearm and wrist by preventing supination and pronation.

Question 44

Elbow-forearm wrist orthoses can be used for a terrible triad, which involves elbow dislocation with associated radial head and ________ fractures.

Answer 44

Coronoid

Question 45

Elbow-forearm wrist orthoses are typically positioned in a ________.

Answer 45

neutral position

Question 46

What is the primary purpose of a sugar tong splint?

Answer 46

limit forearm supination/pronation, elbow extension, and wrist motion.

Question 47

The sugar tong splint is indicated for ________ fractures, distal radius fractures, and distal ________ fractures.

Answer 47

Carpal; ulna

Question 48

What are the key indications for using a static wrist hand orthosis?

Answer 48

Burns Joint replacements Rheumatoid arthritis Peripheral nerve injuries Nerve and tendon repairs Carpal tunnel syndrome Wrist pain (prevention or management) Contracture prevention (e.g., CVA, SCI, burns)

Question 49

What is the primary purpose of a dorsal blocking splint?

Answer 49

block wrist and finger extension to protect repaired flexor tendons.

Question 50

The dorsal blocking splint is typically positioned in ________ degrees of wrist flexion.

Answer 50

0° or 30°

Question 51

What is a benefit of positioning the dorsal blocking splint in a neutral position? A) Increased wrist extension B) Less flexion deformities and complications C) Enhanced finger extension D) Longer recovery time

Answer 51

B) Less flexion deformities and complications

Question 52

Dorsal blocking splints are used to protect repaired ________ tendons during the healing process.

Answer 52

Flexor

Question 53

What is the primary purpose of a volar blocking splint?

Answer 53

block wrist and finger flexion.

Question 54

Which of the following is an indication for using a volar blocking splint? A) Shoulder dislocation B) Spasticity control C) Elbow fracture D) Carpal tunnel syndrome

Answer 54

B) Spasticity control

Question 55

What are the key indications for using a volar blocking splint?

Answer 55

Contracture prevention (e.g., burns to the hand, CVA, TBI, SCI) Spasticity control Distal radius fractures

Question 56

What is the primary purpose of ulnar gutter splints?

Answer 56

immobilize the 4th and 5th fingers

Question 57

Which of the following conditions is NOT an indication for using an ulnar gutter splint? A) Boxer's fracture B) 4th and 5th phalange fractures (extended) C) Scaphoid fracture D) Positioning for rheumatoid arthritis (RA)

Answer 57

C) Scaphoid fracture

Question 58

Which fingers are primarily indicated for Radial Gutter Splints?

Answer 58

The 2nd and 3rd fingers

Question 59

Only use HO when wrist motion can be restricted. True or False

Answer 59

False: unrestricted

Question 60

What is the special test used to diagnose DeQuervain’s Tenosynovitis?

Answer 60

Finkelstein Test

Question 61

What symptom might indicate DeQuervain’s Tenosynovitis when grasping an object?

Answer 61

Pain when grasping an object or making a fist.

Question 62

Where might the pain radiate in someone with DeQuervain’s Tenosynovitis?

Answer 62

Radiating pain to the forearm.

Question 63

An injury to the ulnar collateral ligament (UCL) of the thumb, often caused by sudden abduction of the first metacarpophalangeal (MCP) joint.

Answer 63

Gamekeeper’s or Skier’s Thumb?

Question 64

What difficulty might a person experience when handling objects with Gamekeeper's thumb injury?

Answer 64

gripping objects

Question 65

What is the primary function of a Thumb Spica Splint?

Answer 65

To immobilize the thumb and possibly the wrist.

Question 66

Is a Thumb Spica Splint considered standard care for carpal tunnel syndrome?

Answer 66

No, it is not the standard of care for carpal tunnel syndrome.

Question 67

What condition is indicated for using a Thumb Opponens Splint?

Answer 67

Spastic cerebral palsy (CP) CMC (carpometacarpal) osteoarthritis. Congenital deformity of the thumb.

Question 68

What is the recommendation for using hand orthoses in CMC Joint OA?

Answer 68

Strong recommendation for soft or rigid hand orthosis.

Question 69

List the finger deformities:

Answer 69

mallet finger boutonniere deformity swan neck

Question 70

What is Elson's test used to diagnose?

Answer 70

A laceration or injury to the central slip of the extensor tendon in the finger.

Question 71

What finger deformity can result from an untreated central slip laceration?

Answer 71

A boutonnière deformity.

Question 72

Finger Orthoses: mallet finger: boutonniere deformity: swan neck ring deformity:

Answer 72

stack splint, aluminum splint ring splint, dynamic splint swan neck splint, oval 8 finger splint

Question 73

A ___________ holds the affected finger in relative extension or relative flexion compared to adjacent fingers.

Answer 73

Relative Motion Orthosis

Question 74

How long is a Relative Motion Orthosis typically worn? What are the common designs of a Relative Motion Orthosis?

Answer 74

For 4-7 weeks Usually 3- or 4-finger designs.

Question 75

What type of orthosis is this? The affected finger is placed in 15-20 degrees of MCP flexion relative to the adjacent fingers. It provides laxity in the lumbricals while increasing tension on the extensor hood.

Answer 75

Relative Motion Flexor Orthosis

Question 76

How is the affected finger positioned in a Relative Motion Extensor Orthosis for long extensor tendon repairs?

Answer 76

10-15 degrees of relative metacarpophalangeal (MCP) joint extension.

Question 77

What degree of extension is recommended in a Relative Motion Extensor Orthosis for sagittal band injuries?

Answer 77

15-20 degrees of relative extension.

Question 78

What is the primary purpose of Serial Static Orthoses? What type of device is typically used in Serial Static Orthoses?

Answer 78

Mobilization through prolonged low load stretching of tissues. A cast or brace with range of motion (ROM) control.

Question 79

What is a common indication for using a Serial Static Splint?

Answer 79

PIP flexion contracture biceps tendon repair elbow fracture/contracture

Question 80

How does a Static Progressive Orthosis hold the joint? How often should a Static Progressive Orthosis be worn?

Answer 80

It holds the joint at its current end range and is readjusted with each wear. At least 30 minutes, 3 times per day.

Question 81

What is the primary purpose of a Dynamic Splint?

Answer 81

Mobilization through a low-load, prolonged duration stretch.

Question 82

Should a Dynamic Splint produce pain during use?

Answer 82

No, it should not produce pain.

Question 83

What specific motion is a Dynamic Splint commonly used to increase?

Answer 83

Increasing extension.

Question 84

What is a common indication for using a Dynamic Splint?

Answer 84

Post-surgery (s/p) Flexor Tendon Repair. radial nerve injury

Question 85

What specific splinting technique is used after flexor tendon repair?

Answer 85

A dorsal blocking splint to limit MCP extension.

Question 86

What is the primary purpose of a Tenodesis Splint? What type of patients is a Tenodesis Splint typically indicated for?

Answer 86

To act as a substitute for irreversible functional loss and enhance the tenodesis grip. Patients with C6-C7 quadriplegia.