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35 Cards in this Set
- Front
- Back
- 3rd side (hint)
Intrinsic muscles of the hand innervated by MEDIAN Nerve |
-Abductor pollicis brevis (palmar Abduction) |
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Median nerve damage at the wrist will cause difficulty with: |
Abduction, opposition & MCP flexion of the thumb *Pinch, 3 jaw chuck |
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Extrinsic flexor hand muscles innervated by the median nerve |
-(FDS) Flexor digitorum superficialis (PIP flexion) |
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Median Nerve damage at the elbow will cause difficulty with: |
Finger PIP and DIP flexion, thumb IP flexion *Hook Grasp *Fine motor precision *Gross grasp |
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Intrinsic hand muscles innervated by ulnar nerve |
* Abductor digiti minimi (little finger ABduction) * Opponens digiti minimi (Little finger opposition) * Flexor digiti minimi (Little finger MCP flexion, opposition) * Adductor (adducts thumb CMC) * Lumbricals - Ulnar side(LF and RF MCP flexion & IP extension * Palmar interossei (Digits 2-5 adduction, MCP flexion, IP extension *Dorsal Interossei (Digits 2-5 ABduction, MCP flexion, IP extension) |
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Extrinsic hand flexors innervated by Ulnar nerve |
* FDP Flexor digitorum profundus (LF and RF DIP flexion)
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Extrinsic hand extensors innervated by Radial nerve |
* EDC Extensor digitorum communis (Extension of MCPs, helps with extension of IPs) * EDM Extensor digiti minimi (LF MCP extension, helps with IP extension * EIP Extensor indicis proprius (IF MCP & IP extension) * EPL Extensor pollicis longus (Thumb IP extension) * EPB Extensor pollicis brevis (thumb MCP, CMC extension) * APL ABductor pollicis longus (Thumb CMC abduction & extension) |
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Which wrist extensor crosses two joints?
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ECRL extensor carpi radialus longus
Radial nerve *all wrist extensors innervated by radial nerve (ECRB, ECU) |
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If musculocutaneous nerve to UE damaged which muscle could be used for elbow flexion?
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Brachioradialus is innervated by radial nerve
Biceps & brachialis are elbow flexor innervated by musculocutaneous |
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OT intervention for Dupytren's
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Post sx wound care & edema control
Extension splint A/PROM progress to strengthening when wounds are healed Scar management Emphasize gripping/flexion & release/extension |
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OT intervention for skiers thumb
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Conservative: thumb splint 4-6wks, AROM, pinch strengthening 6 wks, ADL requiring opposition & pinch strength
Post op: Thumb splint 6 wks AROM PROM at 8 wks strengthening at 10 wks |
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What interventions are contraindicated for CRPS?
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PROM
Passive stretching Joint mobilization Dynamic splinting Casting |
Passive and complete immobilization
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What interventions are contraindicated for CRPS?
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PROM
Passive stretching Joint mobilization Dynamic splinting Casting |
Passive and complete immobilization
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Indicated interventions for CRPS
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Modalities to ⬇️ pain
Edema management AROM to involved joints ADL to encourage active pain free use Stress loading (WB & joint distraction) Splinting to prevent contracture promote engagement Self management |
Pain and Active intervention
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What splint would you use for a boxers fracture?
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Ulnar gutter splint
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Fracture of the 5th MC
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Common complication in proximal phalanx fractures
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A/PROM in PIP
Most common in thumb & index finger |
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Mallet finger
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Terminal extensor tendon damage associated with Distal phalanx fracture - most common type of finger fracture
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Elbow fracture with limited FA rotation suggests involvement of the
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Radial head
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Wrist drop after humerus fracture suggests
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Humeral shaft fracture with damage to the radial nerve
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Elbow fracture with damage to greater tuberosity
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May result in rotator cuff injury
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Etiology of humoral fractures
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Fall on outstretched upper extremity
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OT evaluation for UE fractures
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Hx - Mechanism of injury & fracture management
Test results - X-ray, MRI, CT scan Edema Pain AROM -DO NOT assess PROM & strength until ordered by MD except -humerus fractures fractures often begin with PROM or AAROM Sensation Roles occupations ADL activities related to roles |
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OT evaluation for UE fractures
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Hx - Mechanism of injury & fracture management
Test results - X-ray, MRI, CT scan Edema Pain AROM -DO NOT assess PROM & strength until ordered by MD except -humerus fractures fractures often begin with PROM or AAROM Sensation Roles occupations ADL activities related to roles |
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Intervention for UE fractures during immobilization phase
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Goals are stabilization & healing
-AROM of joints above & below stabilized part -Edema control *elevation *retrograde massage * compression garments -light ADL with NO resistance progress as tolerated |
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OT evaluation for UE fractures
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Hx - Mechanism of injury & fracture management
Test results - X-ray, MRI, CT scan Edema Pain AROM -DO NOT assess PROM & strength until ordered by MD except -humerus fractures fractures often begin with PROM or AAROM Sensation Roles occupations ADL activities related to roles |
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Intervention for UE fractures during immobilization phase
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Goals are stabilization & healing
-AROM of joints above & below stabilized part -Edema control *elevation *retrograde massage * compression garments -light ADL with NO resistance progress as tolerated |
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Intervention for UE fractures during mobilization phase
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Consolidation is the goal
-Edema control add contrast baths -AROM Progress to PROM with MD approval (4-8 wks) except w/humerus fractures which often begin w/PROM or AAROM -light purposeful or OB activities -Pain management: positioning, PAMs -strengthening Begin with isometrics w/MD approval |
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Cumulative trauma injury risk factors
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Repetition
Static position Awkward postures Forceful exertions Vibration |
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Cumulative trauma injury risk factors
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Repetition
Static position Awkward postures Forceful exertions Vibration |
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Common types of cumulative trauma injuries: De Quervain' s
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S&S: pain, swelling over radial styloid
Positive finklestein's test Conservative: Thumb spica splint , activity/work modification, ice massage, gentle AROM of wrist, thumb to prevent stiffness Post op tx: *Thumb spica splint Gentle AROM (0-2 weeks) *Strengthening, ADL, role activities (2-6 weeks) *unrestricted activities (6 weeks) |
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Lateral epicondylitis etiology
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Overuse of wrist extensors especially ECRB
= tennis elbow |
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Lateral epicondylitis etiology
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Overuse of wrist extensors especially ECRB
= tennis elbow |
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Etiology of medial epicondylitis
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Overuse of wrist flexors
= golfers elbow |
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Conservative intervention for lateral & medial epicondylitis
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- Elbow strap, wrist splint
- Ice & deep friction massage - Stretching - Activity/ work modification - add strengthening as pain decreases *begin with isometric *progress to isotonic & eccentric |
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Trigger finger conservative treatment
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-Hand based trigger finger splint (MP extended, IPs free)
-scar massage -edema control -tendon gliding -activity/work modification: avoid repetitive gripping activities & using tools with handles too far apart |
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