Orthotics Test Flashcards by Amanda Harris

What is the function of the lumbricals

Flex at the MCP joint, and extend at the IP joints of each finger.

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What is the function of the interossei?

Palmar Interossei = ADDuct at the MCP

Dorsal Interossei = ABDuct at the MCP

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What is the function of the Flexor Digitorum Superficialis and how do you test its function?

It Flexes the MCP and PIP Joints

To test hold down all fingers except the one being tested and have them bend that finger only at the PIP.

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What is the function of the Flexor Digitorum Profundus and how do you test its function?

It flexes the DIP

To test block the MCP and PIP joints and have the person bend only the tip of their finger

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What is a static splint and what are some uses for it?

Static splints have no moving parts. Is used for:

Immobilization
Prevent soft tissue contractures
Substitute for loss of motor function
Protection
Decrease Tone

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What is a serial static splint and what are some uses for it?

It allows for slow progressive increases in ROM by repeated molding of the splint. Is adjusted by the therapist. Used for:

Increasing ROM

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What is a dynamic splint and what are some uses for it?

Has moving components of it and allows for movement. Used for:

Substitute for loss of motor function
Correct existing deformity
Provide controlled motion
Decrease tone

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What are some negative qualities about padding inside orthotics?

Causes skin breakdown

Makes skin sweat which can cause skin breakdown.

Can cause skin irritation

Can be odorous

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What are some tips to improve comfort in an orthotic?

Use stockinet
Use powder under splint
Round edges to reduce irritation
Flare edges of splint

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What are some characteristics of thick low temperature material?

More Strength
More Durability
Requires more working time
Less Flexibility

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What are some characteristics of thin low temperature material?

Less Strength
Less Durability
Less Working Time
More Flexibility

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What are some characteristics of rubber material?

Less Stretch
Less risk of fingerprinting
Less drapability

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What are some characteristics of plastic material?

Stretchy
More risk of fingerprinting
Drapes well

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What is the definition of memory in orthotics?

Memory is the ability to conform back to the original shape once the material has been reheated.

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What is a way to decrease the negative effects of stress from an orthosis?

Straps should be placed on the orthosis in order to disperse pressure over an area and reduce stress.

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What is a static progressive splint and what is it used for?

It is a splint that can be adjusted over time and is adjusted by the patient.

It is good for increasing passive ROM

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What are some disadvantages of a prefabricated splint?

Poor fit
Decreased ability to adjust
May not exactly address the goal of the splint
May be delayed if not in stock or size.

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What would be some components of client education with a splint?

Why is the splint helpful and why use it
When to wear it (schedule)
Precautions
How to care for the splint

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What is the function of a drop-out splint?

It allows for elbow extension but blocks elbow flexion.

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How many pressure systems are needed to articular orthosis compared to non-articular orthosis?

Articular Orthoses: Three-point pressure systems

Non-Articular Orthoses: Two-Point Pressure Systems

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What is drapability?

The degree of ease with which a material conforms to the underlying shape without manual assistance.

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What is elasticity?

The materials resistance to stretch and its tendency to return to its original shape after stretch.

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Do you need more mobility or stability in the shoulder complex?

You need more mobility because without mobility you severely limit function.

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Which is an unforgiving joint and it gets stiff quickly?

Elbow, you have to move it right away

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What is "stiffness"

When the ligaments are tight

What motion is harder to get pronation or supination?

Supination and you cannot compensate for this motion.

What is more important at the wrist, stability or mobility?

Stability is more important because you need the stability in order to grasp and hold things.

If I want mobility at the wrist, which is more important: wrist extension or flexion?

Extension is more important, the tendonisis grasp. Also you have more grip strength in extension than flexion. Flexion is only important for toileting.

Collateral Ligaments are very important for this?

Stability

What is the position of safety?

MP's are in flexion and the IP's are in extension

You use this splint when you are unsure about recovery and do not think they can recover to 100%

Resting Hand Splint

Is safety position different than intrinsic plus? If so how?

Safety position is different than Intrinsic Plus because Intrinsic plus talks about position of muscles and safety position has to do with the ligaments and joints.

What are the primary extensors of the metacarpals?

Extensor Digitorum (EDC)

What is extrinsic plus?

Bear Claw - Superficialis and Profundus are working

You should splint below what area to ensure that you have and maintain MP flexion?

Below the distal palmar crease

You should splint below what area to ensure that you have and maintain thumb opposition?

Below the Thenar Crease

What are the three stages of wound healing?

Inflammation: 0 - 3 days Fibroplasias: 4 days - 2-4 Weeks Scar Maturation: 2-4 weeks to 6 months

Which is a handling charateristic of low temp splinting materials? A. Dissolvability B. Durability C. Drapability

C. Drapability - How well does it drape when it's warm.

Which is a performance characteristic of low temp splinting material? A. Bonding B. Perforations C. Dissolvability

B. Perforations - a performance characteristic when someone is wearing it.

Which splint would you use for a crush injury? A. Resting Hand B. Position of Safety

B. Position of Safety - You want to protect damage to the ligaments (collateral ligaments) You place in this splint in case you cannot recover use to that the position is functional.

``` Which tissues are you most concerned with getting stiff? A. Bone B. Muscle C. Skin D. Ligaments E. Fat ```

D. Ligaments

If your client had a colles fracture (wrist fracture) and has inability to straighten their digits, which type of orthosis would you fabricate? A. Hand based extension orthosis for those unforgiving PIP joints B. Cock up orthosis to support the wrist C. Resting Hand Orthosis D. Position of safety orthosis E. Some other design

B. Cock up orthosis to support the wrist - used to stabilize the wrist. If it's a muscle weakness you use this to elongate the muscle and then remove while strengthening. Strengthen EDC and Lumbricals to strengthen extensors.

Which is more important? A. Extrinsic Plus B. Intrinsic Plus

A. Extrinsic Plus - Because grip is most important in function so if in this position you can preserve grip. Also because MP flexion will be taken care of by Flexor Digitorum Sup/Prof

What would be the best splint for the scaphoid fracture?

Forearm Based Thumb Spica Orthosis to immobilize the wrist.

``` What test would you do to determine what structure was involved and needed to be immobilize during tightness? A. Sensory Test B. AROM C. PROM D. Provocative Nerve Test E. Strength Testing ```

B. AROM - You get to observe the patient do activity, observe pain and compensation.

What is the difference between a STrain and a SPrain?

Strain = tendon (muscle) Sprain = ligament

What is the difference between an low profile and high profile outrigger?

High Profile means that the pull goes directly to the outrigger Low Profile means that the pull goes directly to a pulley then connects to the outrigger. Gives you more control

Should you use a dynamic splint with someone with rheumatoid arthritis?

NO! They already have abnormal joint mechanics.

What will happen if you do not TERT Total, End, Range, Time

They will REVERT!

What are reasons for using orthotics?

Protection Block Movement Prevent Deformity Maintain range of motion Stabilize unstable joint or bone Protect healing structures Provide controlled motion Exert Traction to allow for healing Decrease Tone

What is the position of the wrist in order to promote functional hand patterns?

0 - 30 degrees of wrist extension

What is the best wrist position for someone with Carpal Tunnel Syndrome?

Neutral so as not to put and pressure on the median nerve.

What is the best wrist position for someone with a radial nerve injury?

30-45 degrees of extension because it facilitates optimum grip and pinch.

What is the best wrist position for someone with RA?

0 - 30 degrees of wrist extension.

How do orthoses help people with CMC arthritis?

Manage pain Preserve webspace Protect Joints Provide Stability for intrinsic weakness of the capsular structures. Prevents dorsoradial subluxation of base of metacarpal.

What are the 3 purposes of a resting hand orthosis?

1. Immobilize 2. Position in Functional Alignment 3. To slow further deformity

This joint, with Dupuytren, is the hardest to correct and release?

The PIP joint of the little finger because it has 4 cords.

What is the cause of boutonniere deformity and what is its presentation?

It's caused by the rupture of the central slip. The presentation is PIP flexion and DIP hyperextension.

What is the cause of swan neck deformity and what is its presentation?

The presentation is PIP hyperextension and DIP flexion. Caused by displacement of the lateral bands.

What is the optimum angle of pull of an outrigger?

90 degrees of pull

Name the 4 handling characteristics of orthotic materials?

Memory Drapability Elasticity Bonding

What are the 5 performance characteristics of orthotic materials?

Conformability Flexibility Durability Rigidity Perforations

Name the 3 arches of the hand

Longitudinal arch from finger to wrist Distal Transverse Arch Proximal Transverse Arch

Name the 5 main Creases of the hand and wrist

Distal Palmar Crease Proximal Palmar Crease Thenar Crease Distal Wrist Crease Proximal Wrist Crease

What is RICE and when is it used?

For acute injuries and edema R - Rest I - Ice C - Compression E - Elevation

What does it tell you when the passive range of motion but client cannot actively move it?

Tendon Glide Issue.

A client has no active or passive range of motion. This is indicative of what condition?

Joint Contracture

What are the implications of having less or more than 90 degrees angle in the outrigger?

90+ = Traction of the joint | 90 - = Compression of the joint

Describe the Finklestein Test and what it tests for?

Tests De Queverain Tendonytis (woman's washer syndrome) Done by having client perform hammering motion with thumb tucked into palm. If painful test is positive.

How to test for scaphoid fracture?

Press on snuffbox to illicit pain

What is the best splint for an individual with Carpal Tunnel Syndrome?

Wrist Cock-Up

Why is the position of safety good?

All of the ligaments are long and taut. It prevents the ligaments from becoming stiff in the shortened position.

What is the position of the ligaments in MP flexion/extension?

Flexion MP = Long and Taut | Extension MP = Short and Fat

What is the position of the ligaments in IP flexion/extension?

Flexion IP = Short and Fat | Extension IP = Long and Taut

What is tennis elbow and what motions are painful?

Lateral Epicondylitis, inflammation of ligaments originating from the lateral epicondyle. Wrist Flexion is painful because Extensor Carpi Ulnaris orginates from the lateral epicondyle and in flexion this muscle is lengthened.

Orthotics Test Flashcards

(75 cards)