1.
When performing a clinical examination, you should observe and inspect for the following (choose all that apply)
Correct Answer(s)
A. AtropHy
B. Edema
C. Redness
D. Skin integrity
E. pHysical defects/anomolies
Explanation
During a clinical examination, it is important to observe and inspect for various signs and conditions. Atrophy refers to the wasting or shrinkage of tissues or muscles, which may indicate underlying health issues. Edema is the accumulation of fluid in tissues, often causing swelling, and it can be a sign of inflammation or other medical conditions. Redness can be a sign of inflammation, infection, or irritation. Skin integrity refers to the condition of the skin, looking for any abnormalities, lesions, or wounds. Physical defects or anomalies are important to note as they may indicate congenital conditions or acquired injuries.
2.
A volumeter is used to test for
Correct Answer
C. Edema
Explanation
A volumeter is a device used to measure the volume of a body part, such as a limb. Edema refers to the accumulation of excess fluid in the tissues, leading to swelling. By using a volumeter, healthcare professionals can accurately measure the volume of edematous body parts, helping to monitor the progression or regression of edema. Therefore, a volumeter is used to test for edema.
3.
Clinical examination includes
Correct Answer
E. All of the above
Explanation
The correct answer is "All of the above". Clinical examination includes observation, palpation, active range of motion (AROM), and muscle testing. Observation involves visually assessing the patient's appearance, posture, and movements. Palpation involves using touch to feel for abnormalities such as swelling, tenderness, or muscle tone. AROM refers to the patient's ability to move their joints actively. Muscle testing evaluates the strength and function of specific muscles. Therefore, all of these techniques are part of a comprehensive clinical examination.
4.
Intrinsic muscles consist of
Correct Answer
D. A&B only
Explanation
The correct answer is A&B only. Intrinsic muscles refer to the muscles that are located within a specific body part or organ. In this case, the interossei and lumbricals are examples of intrinsic muscles as they are found within the hand. Superficialis, on the other hand, is not an intrinsic muscle but rather a superficial muscle that is located closer to the surface of the body. Therefore, the correct answer is A&B only.
5.
The device used to measure grip strength is a
Correct Answer
B. Dynamometer
Explanation
A dynamometer is a device used to measure grip strength. It is specifically designed to measure the force exerted by the muscles of the hand and forearm when gripping an object. This device provides an accurate and standardized measurement of grip strength, which is important in various fields such as sports medicine, rehabilitation, and ergonomics. Unlike a goniometer, which measures angles, or other unrelated devices like a sphagmometer or volumeter, a dynamometer is specifically designed for grip strength measurement. A kilometer is a unit of distance and is not relevant to measuring grip strength.
6.
The following are standardized tools for functional assessment of the hand except:
Correct Answer
D. Bay Area Functional Performance Test
Explanation
The Bay Area Functional Performance Test is not a standardized tool for functional assessment of the hand. The other three options, Jebsen's Test of Hand Function, Minnesota Rate of Manipulation Test, and Purdue Pegboard Test, are commonly used and recognized assessments for evaluating hand function.
7.
The sensibility test that consists of using a monofilament applied to the patient's skin with increasing pressure until the patient feels the touch
Correct Answer
A. Semmes-Weinstein
Explanation
The Semmes-Weinstein test is a sensibility test that assesses the patient's ability to feel touch. It involves using a monofilament, which is a thin strand of nylon, and applying it to the patient's skin with increasing pressure. The test is performed by applying the monofilament to various areas of the body, such as the fingertips or the soles of the feet, and the patient is asked to indicate when they feel the touch. The Semmes-Weinstein test is commonly used in clinical settings to evaluate sensory function and can help identify areas of decreased or absent sensation.
8.
Using the Semmes Weinstein Monofilament Test, a therapist may test up to ______ times in the same area, except for monofilaments of 4.08 or higher.
Correct Answer
C. 3
Explanation
Using the Semmes Weinstein Monofilament Test, a therapist may test up to 3 times in the same area, except for monofilaments of 4.08 or higher. This is because the test involves applying the monofilament to specific areas of the body to assess the patient's ability to perceive touch and pressure. Testing multiple times helps to ensure accurate results and allows the therapist to determine the patient's threshold for detecting stimuli. However, monofilaments of 4.08 or higher are typically used to test for deep pressure sensation, and testing more than once in the same area may not provide additional useful information.
9.
Carpal Tunnel Syndrome is a neuropathy of the radial nerve
Correct Answer
B. False
Explanation
Median Nerve
10.
Evaluation for carpal tunnel syndrome may include (choose all that apply)
Correct Answer(s)
B. Tinel's Sign
D. pHalen's Test
Explanation
The evaluation for carpal tunnel syndrome may include Tinel's Sign and Phalen's Test. Tinel's Sign is a test where the healthcare provider taps on the median nerve at the wrist to check for any tingling or electric shock-like sensations, which can indicate carpal tunnel syndrome. Phalen's Test involves flexing the wrist for a minute to see if any numbness or tingling occurs, which is also a common symptom of carpal tunnel syndrome. The other tests listed, Finkelstein's Test, Mill's Test, and Drop Arm Test, are not typically used to evaluate carpal tunnel syndrome.
11.
When splinting for carpal tunnel syndrom, the wrist should be at 90 degrees of flexion
Correct Answer
B. False
Explanation
Neutral
12.
A carpal tunnel splint should be worn
Correct Answer
C. While sleeping
Explanation
A carpal tunnel splint should be worn while sleeping because it helps to keep the wrist in a neutral position, reducing pressure on the median nerve and alleviating symptoms of carpal tunnel syndrome. Wearing the splint during sleep ensures that the wrist is properly supported and immobilized throughout the night, allowing for better rest and healing.
13.
To avoid adhesions in carpal tunnel, a patient should be instructed to perform
Correct Answer
D. A&B only
Explanation
To avoid adhesions in carpal tunnel, a patient should be instructed to perform nerve gliding exercises and tendon gliding exercises. Nerve gliding exercises involve moving the nerves within their sheaths to prevent them from becoming trapped or compressed. Tendon gliding exercises involve moving the tendons within their sheaths to maintain their flexibility and prevent adhesions from forming. PROM exercises, which stands for passive range of motion exercises, involve moving the affected joint with the assistance of another person or device. However, PROM exercises alone may not be sufficient to prevent adhesions in the carpal tunnel. Therefore, the correct answer is A&B only.
14.
Tendon gliding exercises for carpal tunnel include the following positions:Straight, hook, table top, partial fist, and full fist
Correct Answer
A. True
Explanation
The statement is true because tendon gliding exercises are commonly used to improve the flexibility and mobility of the tendons in the hand and wrist. These exercises involve moving the fingers and wrist through various positions, such as straight, hook, table top, partial fist, and full fist, to stretch and strengthen the tendons. These exercises are often recommended as part of the treatment for carpal tunnel syndrome, a condition that causes compression of the median nerve in the wrist. By regularly performing these exercises, individuals can help alleviate symptoms and improve their hand and wrist function.
15.
Hand conditioning treatment for carpal tunnel syndrome includes (choose all that apply)
Correct Answer(s)
B. Avoid gripping exercises
C. Avoid external pressure
D. Functional intrinsic acts
E. Functional in hand manipulation acts
Explanation
The correct answer includes avoiding gripping exercises, avoiding external pressure, performing functional intrinsic acts, and performing functional in hand manipulation acts. These recommendations for hand conditioning treatment are based on the understanding that excessive gripping and external pressure can exacerbate symptoms of carpal tunnel syndrome. Instead, focusing on functional intrinsic acts and functional in hand manipulation acts can help to strengthen the hand and improve overall hand function without putting additional strain on the affected area.
16.
Pain management for carpal tunnel syndrome includes icing, fluidotherapy, and rest
Correct Answer
B. False
Explanation
Heat packs, not ice!
17.
Post operative treatment of carpal tunnel syndrome includes
Correct Answer(s)
A. Scar management
B. Edema Management
C. Hand conditioning
D. Return to work discharge plans
Explanation
The post-operative treatment of carpal tunnel syndrome includes scar management, edema management, hand conditioning, and return to work discharge plans. Scar management is important to minimize the appearance and discomfort of scars after surgery. Edema management helps reduce swelling and promote healing. Hand conditioning exercises improve strength and flexibility in the hand and wrist. Return to work discharge plans involve assessing the patient's ability to resume work activities and providing recommendations or accommodations if needed.
18.
Guyon's Tunnel Syndrome is a neuropathy of the ______ nerve
Correct Answer
A. Ulnar nerve
Explanation
Guyon's Tunnel Syndrome is a neuropathy that affects the Ulnar nerve. This condition occurs when the Ulnar nerve, which runs from the neck down to the hand, becomes compressed or irritated at the wrist. Symptoms of Guyon's Tunnel Syndrome include pain, numbness, and weakness in the hand and fingers. It is important to note that this condition specifically affects the Ulnar nerve and not the Radial or Median nerves. Therefore, the correct answer is "Ulnar nerve."
19.
Symptoms of Guyon's tunnel syndrome include all of the following except:
Correct Answer
B. Pins and needles in the 2nd and 3rd digit
Explanation
The symptoms of Guyon's tunnel syndrome include pins and needles in the 4th and 5th digit, burning pain in the wrist and hand, decreased sensation, and intrinsic weakness. However, pins and needles in the 2nd and 3rd digit are not typically associated with Guyon's tunnel syndrome.
20.
Treatment for guyon's tunnel syndrome includes the following:
Correct Answer(s)
A. Avoiding repetitive hand motions, heavy grasping, and working with wrist flexed
B. Splinting
C. Work ergonomics
D. Fine motor skills training
Explanation
The correct answer includes a combination of different treatments for guyon's tunnel syndrome. Avoiding repetitive hand motions, heavy grasping, and working with the wrist flexed helps to reduce further irritation and compression of the ulnar nerve. Splinting can provide support and immobilization to the wrist, relieving pressure on the nerve. Work ergonomics involves making adjustments to the workspace to ensure proper posture and minimize strain on the wrist. Fine motor skills training helps to improve hand coordination and dexterity. Repetitive hand motion exercises can help to strengthen the muscles and improve flexibility.
21.
De-Quervain's Tendonitis involves the abductor pollicis longus (APL) and extensor pollicis brevis (EPB)
Correct Answer
A. True
Explanation
De Quervain's Tendonitis is a condition that affects the tendons of the thumb. The two tendons involved in this condition are the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB). These tendons are responsible for the movement of the thumb away from the palm and extension of the thumb, respectively. Therefore, the statement that De Quervain's Tendonitis involves the APL and EPB tendons is true.
22.
De-Quervain's tendonitis is diagnosed using this test
Correct Answer
D. Finkelstein's Test
Explanation
Finkelstein's Test is used to diagnose De-Quervain's tendonitis. This test involves the patient making a fist with the thumb tucked inside the fingers, and then bending the wrist towards the little finger. If this causes pain on the thumb side of the wrist, it is a positive Finkelstein's Test and indicates De-Quervain's tendonitis. This test helps to identify inflammation of the tendons in the thumb and wrist, which is a common symptom of De-Quervain's tendonitis.
23.
Therapist management of De-Quervain's tendonitis includes
Correct Answer(s)
A. Pain control
C. Edema control
D. Splinting
E. Cross friction massage
Explanation
The correct answer includes various methods for managing De-Quervain's tendonitis. Pain control is important to alleviate discomfort, while edema control helps reduce swelling. Splinting is used to immobilize the affected area and provide support. Cross friction massage can help improve blood flow and promote healing. These techniques combined can effectively manage the symptoms and aid in the recovery of De-Quervain's tendonitis.
24.
Trigger finger is caused by a nodule at the A2 pulley that causes the the pulley to "catch" during MCP and IP flexion due to inflammation.
Correct Answer
B. False
Explanation
A1 Pulley
25.
Ice is used to treat chronic trigger finger
Correct Answer
B. False
Explanation
Acute is treated with ice. Chronic is treated with heat.
26.
Treatments fro trigger finger include (choose all that apply)
Correct Answer(s)
A. Cross friction massage
C. Splinting
D. Hook fist/tendon gliding exercises
Explanation
The correct answer is cross friction massage, splinting, and hook fist/tendon gliding exercises. These treatments are commonly used for trigger finger. Cross friction massage involves applying pressure to the affected area to break up scar tissue and promote healing. Splinting is used to immobilize the finger and reduce inflammation. Hook fist/tendon gliding exercises help to improve finger mobility and reduce stiffness. Coban wrap is not a recommended treatment for trigger finger.
27.
Dupuytren's Contractures initially presents with palpable
Correct Answer
B. Palmar nodules at the ulnar side
Explanation
Dupuytren's Contractures initially presents with palpable palmar nodules at the ulnar side. This condition is characterized by the thickening and tightening of the connective tissue in the palm, causing the fingers to bend inward towards the palm. The nodules typically form on the ulnar side of the palm, which is the side closer to the little finger. Over time, the contracture may progress, leading to the formation of cords and contractures that can limit finger movement.
28.
Dupuytren's contractures eventually result in a flexion posturing of the ulnar digits.
Correct Answer
A. True
Explanation
Dupuytren's contractures is a condition that causes the fingers to bend towards the palm of the hand, resulting in a flexion posturing of the ulnar digits. This means that the fingers on the ulnar side of the hand (little finger and ring finger) become permanently flexed or bent. Therefore, the statement "Dupuytren's contractures eventually result in a flexion posturing of the ulnar digits" is true.
29.
Indication for treatment of Dupuytren's contracture are (choose all that apply)
Correct Answer(s)
A. Painful nodules
B. Skin involvement
D. Joint flexion contracture
Explanation
The indication for treatment of Dupuytren's contracture includes painful nodules, skin involvement, and joint flexion contracture. Painful nodules are a common symptom of Dupuytren's contracture and may require treatment to alleviate discomfort. Skin involvement refers to the thickening and tightening of the skin in the affected area, which can also be a sign that treatment is necessary. Joint flexion contracture refers to the inability to fully straighten the affected finger or fingers, which can significantly impact hand function and may require intervention.
30.
Preoperative treatment for Dupuytren's contractures are
Correct Answer
D. All of the above
Explanation
The correct answer is "all of the above" because preoperative treatment for Dupuytren's contractures can include ultrasound, splinting, and other physical agent modalities (PAMs) such as fluidotherapy. These treatments are often used to reduce pain, improve range of motion, and potentially slow down the progression of the condition before surgery.
31.
The preoperative treatment focus for dupuytren's contractures includes (choose all that apply)
Correct Answer(s)
A. Pain management
B. Maximizing ROM
C. Maximizing function
Explanation
The preoperative treatment focus for Dupuytren's contractures includes pain management, maximizing range of motion (ROM), and maximizing function. Pain management is important to ensure the patient's comfort and improve their overall well-being. Maximizing ROM aims to prevent further contracture and maintain or improve hand function. Maximizing function involves optimizing the patient's ability to perform daily activities and tasks. These treatment goals are essential in preparing the patient for surgery and maximizing their postoperative outcomes.
32.
Assessment for dupuytren's contractures includes ROM, Pain, Edema, Vascular Status, Sensory Thresholds, Wound Status
Correct Answer
A. True
Explanation
The given statement is true. Assessment for Dupuytren's contractures includes evaluating various factors such as range of motion (ROM) of the affected fingers, pain levels, presence of edema (swelling), vascular status (blood flow to the hand), sensory thresholds (ability to feel sensation), and wound status (if any wounds are present). These assessments help in determining the severity and progression of the condition, as well as guiding the appropriate treatment plan.
33.
Splinting for Duypuytren's contractures places the wrist, MCP and IP in the maximum "safe" extension and the splints are commonly dorsal based.
Correct Answer
A. True
Explanation
The statement is true because splinting for Duypuytren's contractures involves placing the wrist, MCP (metacarpophalangeal) joints, and IP (interphalangeal) joints in maximum "safe" extension. This helps to prevent further contracture and promote gradual improvement in hand function. Additionally, the splints used for Duypuytren's contractures are commonly dorsal based, meaning they are applied to the back of the hand.
34.
AROM exercises for duypuytren's contractures begins at 4-5 days post-op
Correct Answer
B. False
Explanation
1-2 days
35.
Initial contact for flexor tendon injuries is 1 week post-op
Correct Answer
B. False
Explanation
Immediately
36.
When evaluating flexor tenon injuries (choose all that apply)
Correct Answer(s)
A. Remove cast and clean the area
B. Check integrity of stitches
C. Look for edema
D. Passive flexion and active extension
Explanation
The correct answer options for evaluating flexor tenon injuries include removing the cast and cleaning the area, checking the integrity of stitches, looking for edema, and assessing passive flexion and active extension. These steps are important in assessing the condition of the injury, ensuring proper healing, and monitoring any potential complications such as infection or swelling.
37.
With flexor tendon injuries, complete immobilization of repair is
Correct Answer
C. 3-4 weeks
Explanation
In the case of flexor tendon injuries, complete immobilization of repair is typically required for a period of 3-4 weeks. This allows for proper healing and minimizes the risk of complications such as tendon adhesions or ruptures. During this time, the injured tendon needs to be protected from any excessive movement or stress to ensure successful recovery. After the immobilization period, controlled movement and rehabilitation exercises may be gradually introduced to restore full function and strength to the affected area.
38.
Immobilization is the treatment of choice for
Correct Answer(s)
B. Children younger than 10 years
C. Individuals with cognitive deficits
D. Individuals who are unable or unwiling to follow instructions
Explanation
Immobilization is the treatment of choice for children younger than 10 years because they may not fully understand instructions or be able to cooperate during medical procedures. It is also the treatment of choice for individuals with cognitive deficits who may have difficulty understanding or following instructions. Additionally, immobilization may be necessary for individuals who are unable or unwilling to follow instructions, regardless of their age or cognitive abilities. Therefore, the correct answer includes all three options: children younger than 10 years, individuals with cognitive deficits, and individuals who are unable or unwilling to follow instructions.
39.
When following the immobilization protocol for flexor tendon injuries, which splint would be appropriate
Correct Answer
D. Dorsal hood splint
Explanation
The dorsal hood splint would be appropriate when following the immobilization protocol for flexor tendon injuries. This splint is designed to support the fingers while allowing the thumb to move freely. It helps to maintain the proper alignment of the fingers and prevents excessive movement that could disrupt the healing process. By immobilizing the fingers in a neutral position, the dorsal hood splint helps to protect the injured flexor tendons and promote healing.
40.
When following the early controlled motion protocol for flexor tendon injuries, what type of splint would be used 1-2 days post-op?
Correct Answer
B. Dorsal block splint with dynamic flexion traction
41.
Treatment considerations for a boxer's fracture include
Correct Answer(s)
A. Edema control and scar management
B. AROM & PROM
C. Splinting and buddy taping
D. Vigorous exercise at 6 weeks
Explanation
The treatment considerations for a boxer's fracture include edema control and scar management, AROM & PROM (active range of motion and passive range of motion exercises), splinting and buddy taping, and initiating vigorous exercise at 6 weeks. These interventions aim to reduce swelling and promote healing, restore joint mobility and function, provide support and stability to the fractured area, and gradually increase the strength and flexibility of the hand and wrist. This comprehensive approach helps in the recovery and rehabilitation process of a boxer's fracture.
42.
The most commonly fractured carpal bone is the
Correct Answer
D. ScapHoid
Explanation
The scaphoid bone is the most commonly fractured carpal bone. It is located on the thumb side of the wrist and is prone to fractures due to its location and shape. Fractures of the scaphoid bone often occur during falls or when the hand is extended to break a fall. Delayed diagnosis or improper treatment of scaphoid fractures can lead to complications such as nonunion or avascular necrosis, making it important to promptly identify and treat these fractures.
43.
A scaphoid fracture often results from the patient punching another individual.
Correct Answer
B. False
Explanation
FOOSH! Fall on outstretched hand.
44.
The scaphoid bone heals easily and quickly
Correct Answer
B. False
Explanation
Poor healing due to poor circulation
45.
Choose the correct treatments for scaphoid fracture (choose all that apply)
Correct Answer(s)
A. Distal fracture- 8-10 wks in short thumb spica
B. Waist fracture- 6 weeks long arm spica, 6 weeks short arm
C. Proximal fracture- 6 wks long arm spica, 6 wks-6mos short arm spica
Explanation
The correct treatments for scaphoid fracture are as follows: for distal fractures, the patient should wear a short thumb spica for 8-10 weeks; for waist fractures, a long arm spica should be worn for 6 weeks, followed by a short arm spica for another 6 weeks; for proximal fractures, a long arm spica should be worn for 6 weeks, and then a short arm spica for 6 weeks to 6 months.
46.
Colles fracture is a proximal radius fracture that results from fall on outstretched hand
Correct Answer
B. False
Explanation
Distal!
47.
Colles fracture is caused by
Correct Answer
A. Increased volar tension and dorsal compression
Explanation
Colles fracture is caused by increased volar tension and dorsal compression. This means that there is increased force on the volar (palmar) side of the wrist and compression on the dorsal (back) side of the wrist. This can occur when a person falls onto an outstretched hand, causing the wrist to be forced back and compressed. The fracture typically results in the distal radius bone breaking and displacing towards the dorsal side.
48.
A smith's fracture is a reversed colles fracture
Correct Answer
A. True
Explanation
A smith's fracture is indeed a reversed Colles fracture. A Colles fracture is a type of fracture that occurs in the distal radius bone of the forearm, where the bone breaks and is displaced backward. In contrast, a Smith's fracture is also a fracture of the distal radius bone, but it is displaced in the opposite direction, towards the palm. Therefore, a Smith's fracture can be considered a reversed or opposite version of a Colles fracture.
49.
Reduction with cast immobilization is an appropriate non-surgical management for a distal radius fracture
Correct Answer
A. True
Explanation
Reduction with cast immobilization is considered an appropriate non-surgical management for a distal radius fracture. This means that using a cast to immobilize the fractured area can help in realigning the broken bone and promoting proper healing without the need for surgery. This approach is often effective in cases where the fracture is stable and the bones can be properly aligned with the help of a cast. However, it is important to note that the appropriateness of this management option may vary depending on the specific characteristics of the fracture and the individual patient.
50.
Therapy goals fro distal radius fractures are (choose all that apply)
Correct Answer(s)
A. Decrease/eliminate pain
B. Decrease edema
D. Maximize wrist and forearm ROM
E. Full ROM of shoulder, elbow, and hand
Explanation
The therapy goals for distal radius fractures include decreasing or eliminating pain, decreasing edema, maximizing wrist and forearm range of motion (ROM), and achieving full range of motion of the shoulder, elbow, and hand. These goals are important in the rehabilitation process to restore function and mobility to the affected area. By addressing pain and edema, the patient's comfort can be improved, while maximizing ROM helps regain normal movement and strength in the wrist, forearm, and surrounding joints. Achieving full ROM of the shoulder, elbow, and hand ensures that the entire upper extremity is functioning properly and able to perform daily activities.