1
Q
What splint should you use for a Flexor Tendon Injury?
A
Dorsal Block Splint:
- Blocks fingers from extending, prevents re-injury
- Keep it on for 6 weeks
2
Q
What splint should you use for a Jersey Finger injury?
A
Dorsal Block Splint
3
Q
Measurements for Dorsal Block Splint
A
Wrist: 20-30 degrees Flexion
MCP: 50-70 degrees Flexion
IPs: Full Extension
4
Q
What splint should you use for RA?
A
Dorsal Block Splint
-With RA, the tendons become weak over time and are more vulnerable to tear
5
Q
What is KEY to tendon healing? Why?
A
Early Immobilization !
-Prevents scar adhesion from forming and encourages excursion
6
Q
For which condition would you use a DIP extension splint?
A
Mallet Finger (Flexion of DIP)
- Splint for up to 6 weeks
- This is CRITICAL for EI
- DIP joint is Zone 1 FYI
7
Q
Which deformity describes a PIP joint flexion and DIP joint hyperextension?
A
Boutonniere
-Inability to extend PIP joint
8
Q
What splint should you use with a patient who has Boutonniere deformity resulting from RA?
A
- PIP extension splint for up to 6 weeks
- Splint ONLY goes over the PIP joint to keep DIP free for AROM
- PIP joint is Zone 3 and prox. phalanx is Zone 2 FYI
9
Q
What splint should you use if you have an injury in your MCPs or MCP joint?
A
Volar Wrist Splint for about 6 weeks.
- After a couple weeks, may shorten splint so the IPs can move
- After 4-5 weeks, move splint so pt can actively flex and extend MCP distally
10
Q
What are the degrees for a volar wrist splint?
A
Wrist: 20 degrees Extension
MCPs: 0-10 flexion
11
Q
What splint should you use if you have an injury in your carpal bones?
A
Volar wrist splint for about 6 weeks (same as with injuries at MCP joint/bones or carpals)
- After couple weeks, may shorter splint so IPs can move
- After 4-5 weeks, move splint distally so pt can actively flex and extend MCP
12
Q
What kind of splint should you provide a patient with swan neck deformity?
A
- Pt has hypertension hyperextension and DIP flexion
- PIP is splinted in slight flexion
13
Q
What splint should be worn for a radial tunnel injury as a nonoperative tx?
A
- Long arm splint with elbow flexed, forearm supinated, wrist neutral
- Along with massage or TENS for pain management, pain free ROM, nerve glides, activity modification avoid forceful wrist extension and supination
14
Q
What splint should be worn for a radial tunnel injury as an operative tx?
A
- Long arm splint with elbow flexed, forearm supinated, wrist neutral for 2 weeks
- Then wrist cock up for 2 more weeks with passive and active pronation and supination
- At 3 weeks, do hand strengthening exercise, then resistive exercise at 6 weeks
15
Q
What splint should be worn for a Radial nerve injury as a nonoperative treatment?
A
- Radial=wrist drop!
- Wrist cock-up splint with or without dynamic finger and thumb extension assist, passive and active ROM, isotonic strengthening exercises upon muscle reinnervation
16
Q
What splint should be worn for a Radial nerve injury as an operative treatment?
A
- Static wrist extension splint 30 degrees
- After 4 weeks, adjust to 10-20 degrees extension
17
Q
Splinting considerations for fractures of the hand
A
- Orthotic fabrications can be used as prescribed by the physician for safe splinting and functional splinting
- Materials should be chosen to fit the client and the condition
- Thermoplastic and casting orthoses are commonly used to provide support for healing structures
18
Q
What splints can be worn for Complex Regional Pain Syndrome?
A
- With CRPS, splints are worn as a pain control technique
- Begin with static splint, then change to dynamic
19
Q
Why is splinting used with Cumulative Trauma Disorder?
A
With CTD, there is trauma to the soft tissue caused by repeated force (overuse syndrome and repetitive strain injury). Static splinting can help with reduction of pain along with ice, contrast baths, ultrasound, iontophoresis, high-voltage electric and interferential stim. During the subacute phase, static splint can be used during activities that cause pain.
20
Q
What kind of splint is used for Pronator syndrome as nonoperative tx?
A
- Pronator syndrome is the entrapment of the proximal median nerve between the heads of the pronator muscles
- Splint with elbow 90 to 100 degrees flexion, forearm in neutral
- Along with TENS for pain, gentle prolonged stretching supination and elbow, wrist, and finger extension, activity mod. avoid repetitive forearm rotation with resistance and prolonged elbow flexion
21
Q
What kind of splint is used for Pronator syndrome as an operative tx?
A
-Half cast, AROM all UE joints while wearing cast, muscle strengthening in 1 week, full AROM gained by 8 weeks
22
Q
What kind of splint should be worn for Median nerve injury as a nonoperative tx?
A
- Median nerve injury causes ape hand.
- For nonoperative tx, use static thenar webspacer splint
23
Q
What kind of splint should be worn for Median nerve injury as an operative tx?
A
- Median nerve injury causes ape hand
- For operative tx, dorsal wrist blocking splint worn for 4-6 weeks
- AROM and PROM in splint for digits and thumb, tendon gliding, scar massage
- Discontinue splint at 6 weeks and begin strengthening
24
Q
Which splint should be used for double crush syndrome?
A
It depends. A double crush injury occurs when a peripheral nerve is entrapped in more than one location. Treatment varies according to each nerve injury or syndrome, avoid movements or postures and aggravate the symptoms, nerve gliding, exercises for scapular stability, posture, core trunk strengthening
25
Which splint should be used for Carpal tunnel syndrome as a nonoperative tx?
With carpal tunnel, the median nerve is trapped as it courses through the carpal tunnel. Nonoperative tx includes:
-A carpal tunnel syndrome splint or wrist cock-up splint at 0-10 wrist extension to relieve pressure on the median nerve in the carpal tunnel and control edema. A prefabricated wrist cock-up splint can be used if wrist position is adjustable.
26
When should splints be used for carpal tunnel syndrome after a carpal runnel release surgery or endoscopic release?
With carpal tunnel, the median nerve is trapped as it courses through the carpal tunnel. Nonoperative tx includes:
-Splinting is provided only to clients who sleep with the wrist flexed or who will engage in too much activity too soon e.g., immediate return to work
27
What splint position should be used as a nonoperative tx with cubital tunnel syndrome?
With cubital tunnel, proximal ulnar nerve compressed at the elbow between the medial epicondyle and the olecranon process. Nonoperative tx includes:
-Elbow splint or positioning at 30-60 degrees flexion for 3 weeks
28
What splint position should be used with cubital tunnel syndrome post-operation?
With cubital tunnel, proximal ulnar nerve is compressed at the elbow between the median epicondyle adn the olecranon process. Post-operation:
- During protection phase (1-3 weeks): splint elbow at 70-90 degree flexion. Wound care, edema, pain management, and AROM of uninvolved joints, teach one-handed ADL
- During active phase (beginning at 3 weeks): Discontinue elbow splint and anticlaw splint if used before surgery
29
Which splint should be used with de Quervain syndrome for nonoperative tx? After surgery?
- De Quervain syndrome is caused by cumulative microtrauma resulting in tenosynovitis of the thumb muscle tendon unit, the abductor pollicis longus and extensor pollicis brevis, and the tendons in the first dorsal compartment of the wrist
- Nonoperative tx: Forearm-based thumb spica splint with wrist in neutral and thumb radilaly abducted for 3 weeks
- Operative tx: forearm-based thumb spica splint with wrist at 20 degrees extension and thumb radialy abducted for 3 weeks
30
Which kind of splint should be used with claw deformity as a nonoperative tx?
Claw deformity is distal ulnar nerve compression or lesion at the wrist. As a nonoperative tx:
-An ulnar nerve palsy or anticlaw splint is used, and dynamic PIP extension assist may be added if PIP flexion contractures are present
31
Which kind of splint should be used with a claw deformity postoperative?
-A dorsal blocking splint is used to maintain the wrist at 20-30 degrees flexion and an MCP block to 45 degrees extension to protect nerve repair. Splint adjusted at 3-6 weeks to increase wrist position in neutral. Discontinue at 6 weeks. Preoperative splint continues until muscle function returns
32
What type of splint should be used with Digital stenosing tenosynovitis (trigger finger)?
Treatment of trigger finger includes splinting the MCP at 0 degrees for 3-6 weeks or surgically releasing the A1 pulley
33
```
Splints can help a body part with all of the following except which?
A. support
B. protect
C. gain muscle
D. immobilize
```
C. gain muscle
34
T/F: Splints should be comfortable and heavy, aesthetically pleasing, convenient to use, and should enable participation in valued occupations
FALSE! splints should be comfortable and LIGHT weight
35
```
Splinting evals may include chart or medical report review, interview and observation of the client, palpation, occupational assessment, and assessment of all of the following components EXCEPT which?
A. Pain and Edema
B. Sensation, ROM, and muscle strength
C. MET level
D. Coordination, functional use
E. Psychosocial issues
```
C. Splinting evals typically do not include an assessment of MET levels
36
When molding hand splints, it is important to maintain...
Arches! Longitudinal, distal, and proximal transverse arches of the hand should be maintained
37
When molding hand splints, it is important to maintain...
Arches! Longitudinal, distal, and proximal transverse arches of the hand should be maintained
38
After fitting a splint to a pt, the practitioner instructs the client and caregiver in all of the following EXCEPT which?
A. Wear and care of splint
B. Reshaping splint if necessary
C. Provides contact info for consultation if problems occur
D. Monitors client's responses to splint wear
B. Client's don't reshape, yo!
39
Which of the following measurements describe a resting hand splint:
A. Wrist at 20-30 degrees extension, thumb at 45 degree palmar abduction, MCPs at 35-45 flexion, and PIPs and DIPs in slight flexion
B. Wrist at 30-40 extension, thumb at 45 degree palmar abduction, MCPs at 70-90 degrees flexion, and PIPs and DIPs in full extension
C. PIP extension
D. Block fourth and fifth MCPs to 30-45 degree flexion to prevent hyperextension
A. With a resting hand splint, the wrist should be at 20-30 degrees of extension, thumb at 45 degrees palmar abduction, MCPs at 35-45 flexion, and PIPs and DIPs in slight flexion.
(B is Antideformity resting hand splint--burn intrinsic plus; C is boutonniere; D is for ulnar nerve injury at wrist)
40
Which of the following measurements describe a resting hand splint:
A. Wrist at 20-30 degrees extension, thumb at 45 degree palmar abduction, MCPs at 35-45 flexion, and PIPs and DIPs in slight flexion
B. Wrist at 30-40 extension, thumb at 45 degree palmar abduction, MCPs at 70-90 degrees flexion, and PIPs and DIPs in full extension
C. PIP extension
D. Block fourth and fifth MCPs to 30-45 degree flexion to prevent hyperextension
A. With a resting hand splint, the wrist should be at 20-30 degrees of extension, thumb at 45 degrees palmar abduction, MCPs at 35-45 flexion, and PIPs and DIPs in slight flexion.
(B is Antideformity resting hand splint--burn intrinsic plus; C is boutonniere; D is for ulnar nerve injury at wrist)
41
Which of the following measurements describes an antideformity resting hand splint (burn intrinsic plus)
A. Wrist at 20-30 degrees extension, thumb at 45 degree palmar abduction, MCPs at 35-45 flexion, and PIPs and DIPs in slight flexion
B. Wrist at 30-40 extension, thumb at 45 degree palmar abduction, MCPs at 70-90 degrees flexion, and PIPs and DIPs in full extension
C. PIP extension
D. Block fourth and fifth MCPs to 30-45 degree flexion to prevent hyperextension
B. With an antideformity resting hand splint for burn intrinsic plus, maintain wrist at 30-40 degrees extension, thumb at 45 degrees palmar abduction, MCPs at 70-90 degrees flexion, and PIPs and DIPs in full extension
(A is resting hand splint; C is boutonniere; D is ulnar nerve injury at wrist)
42
Which of the following splints is described here: ulnar or volar based and provide thumb palmar or radial abduction, a hard surface in contact with finger flexors, and serial casting for the wrist, elbow, knee, or ankle to decrease soft tissue contractures
Ball or cone antispasticity splint
43
```
Which splint immobilizes the dorsal or volar wrist, maintains hand arches, full thumb movement, and full MP flexion?
A. Thumb spica splint
B. Resting hand splint
C. Swan neck splint
D. Wrist cock-up splint
```
D. Wrist cock-up splint (dorsal or volar wrist immobilization)
44
Finger splints include all of the following EXCEPT which?
A. PIP extension (boutonniere) and extension splints
B. PIP hyperextension block (swan neck) splints
C. DIP extension (mallet) and flexion splints
D. Silver ring splints
E. Resting hand splint
E. Resting hand splint is not a finger splint
45
```
Elbow splints include:
A. Anterior elbow immobilization
B. Posterior elbow immobilization
C. Lateral elbow immobilization
D. Anterior and posterior elbow immobilization
```
D. Elbow splints include both anterior and posterior elbow immobilization
46
T/F: Knee extension splints provide posterior full knee extension to the fullest extent possible, even with pain
False! Knee extension splints provide posterior full knee extension to the extent that the pt can tolerate without pain
47
```
Ankle splints include antifoot drop splints to maintain how many degrees of ankle dorsiflexion?
A. 180 degrees
B. 90 degrees
C. 75 degrees
D. 30 degrees
```
B. Ankle splints include antifoot drop splints to maintain 90 degrees of ankle dorsiflexion.
Another type of ankle splint includes ankle foot orthoses
48
Which of the following describes the correct splinting procedure for carpal tunnel syndrome?
A. Wrist in neutral to 10 degrees flexion
B. Wrist in 90 degrees extension
C. Wrist in neutral to 10 degrees extension
D. Wrist in 90 degrees flexion
B. With carpal tunnel syndrome (entrapment of median nerve), a wrist cock up splint with 0 to ten degrees of wrist extension is used to relieve pressure on the median nerve in the carpal tunnel and control edema
49
Which of the following describes the correct splinting procedure for an ulnar nerve injury at the wrist?
A. Block thumb, second, third, and half of fourth MCPs to 30-45 flexion to prevent hyperextension
B. Wrist in neutral to 10 degrees extension
C. Block fourth and fifth MCPs to 30-45 degrees flexion to prevent hyperextension
D. Forearm and wrist neutral, elbow in 90 degrees flexion
C. With an ulnar nerve injury at the wrist (claw hand), the split should block the fourth and fifth MCPs to 30-45 degrees flexion to prevent hyperextension
B. this describes carpal tunnel splint
D. This describes Pronator syndrome splint
50
Which of the following describes the correct splinting procedure for pronator syndrome?
A. Forearm and wrist neutral, elbow in 90 degrees extension
B. DIP extension
C. Wrist in neutral to 10 degrees extension
D. Forearm and wrist neutral, elbow in 90 degrees extension
D. With pronator syndrome, the forearm and wrist should be help in neutral with the elbow in 90 degrees of extension
B. This is a mallet finger splint
C. This is a carpal tunnel splint or radial nerve injury splint
51
Which of the following describes the correct splinting procedure for anterior interosseous:
A. Forearm neutral, elbow in 90 degrees of flexion
B. Forearm neutral, elbow in 90 degrees of extension
C. PIP extension
D. Wrist cock-up splint
B. With anterior interosseous, splinting involves forearm in neutral and the elbow in 90 degrees of EXTENSION (results in motor loss involving flexor digitorum longus, flexor profundus to index finger, and pronator quadratus, so you need to EXTEND)
C. This is for boutonniere
D. This is for carpal tunnel syndrome
52
Which of the following describes the correct splinting procedure for radial tunnel syndrome?
A. Wrist in neutral to 10 degrees of extension
B. Cock-up splint with possible dynamic finger extension assist
C. Thumb spica splint
D. Wrist in 30 degrees extension, forearm supinated, elbow in 90 degrees flexion
D. With radial tunnel syndrome, the radial nerve is trapped in area extending from radial head to supinator muscle), the wrist should be held in 30 degrees extension, forearm supinated, and elbow in 90 degrees flexion
53
Special considerations for pediatric splinting involve all of the following EXCEPT:
A. Age
B. Child's Environment
C. Make appealing to child
D. Consider using a hard splint
E. limit fit time by using cold pack to set splint quicker
D. You should consider using a soft splint with pediatric splinting
54
```
Special considerations for geriatric splinting include all of the following EXCEPT which?
A. Existing medical issues
B. Use stockinette over splint
C. Cognitive or perceptual deficits
D. Low vision
E. Hearing impairments
```
B. You should use a stockinette UNDER splint.
Other considerations include frame of reference, age, elder's environment, pain perception, thinning of skin and decreased adipose tissue, medication side effects, pad splint well, use soft straps, label splint
55
Special considerations for geriatric splinting include all of the following EXCEPT which?
A. Thickening of skin and increased adipose tissue
B. medication side effects
C. Padding splint well
D. Label splint
A. Generally, with age, skin thins and decreases in adipose tissue
56
T/F: Dynamic splints have moving parts and soft splints prevent movement
False! Soft splints allow movement
57
```
Dynamic splints are designed to do all of the following EXCEPT:
A. correct contractures
B. Decrease passive motion
C. Protect recent surgery
D. substitute for lost active motion
```
B. Dynamic splints increase passive motion
58
How should you use a dynamic splint to correct contractures?
A. Finger loop angle of pull 90 degrees
B. Dorsal blocking splint with hinged wrist and joint wrist blocks
C. Mechanical stretch of prolonged gentle pull over 8-12 hours to remodel soft tissue
D. Use antivibratory gloves
C. Mechanical stretch of prolonged gentle pull over 8-12 hours to remodel soft tissue
59
How can you use a dynamic splint to increase passive motion?
A. Finger loop angle of pull of 90 degrees; adjust splint as client improves to maintain 90 degrees of pull
B. Mechanical, prolonged gentle pull over 8-12 hours
C. Neoprene wrap thumb support
D. Dorsal blocking splint with hinged wrist and joint wrist blocks
A. Finger loop angle of pull of 90 degrees and adjust as client improves to maintain 90 degrees of pull
B. This is to correct contractures
C. This is for CMC osteoarthritis and de Quervain syndrome
D. This is to protect recent hand flexor tendon repair surgery
60
How can you use a dynamic splint to protect a recent hand flexor tendon repair surgery?
A. Use a finger loop angle of pull
B. Mechanical stretch of prolonged gentle pull
C. Dorsal blocking splint with hinged wrist and joint wrist blocks
D. Use cock-up splint
C. Dorsal blocking splint with hinged wrist and joint wrist blocks to maintain wrist extension at 30 degrees and MCP extension at 60 degrees while allowing full wrist flexion
61
How can you use a dynamic splint to substitute for loss active motion?
A. Use a finger loop angle of pull
B. Use a neoprene wrap thumb support
C. Use a PIP extension splint
D. Use a radial nerve injury splint with dynamic MCP extension assist if needed
D. Use a radial nerve injury splint with dynamic MCP extension assist if needed
62
```
A soft, circumferential orthosis
A. Should not be used with pediatrics
B. Improves client compliance with wearing
C. Should only be worn during the day
D. Should not be used with geriatrics
```
B. Improves client compliance
63
All of the following are considered soft, circumferential orthosis EXCEPT:
A. Carpal tunnel wrist support
B. Antivibratorygloves
C. Neoprene wrap thumb support for CMC osteoarthritis and de Quervain syndrome
D. Finger loop angle of pull of 90 degrees
D. A finger loop angle of pull of 90 degrees is used with a dynamic splint
64
All of the following are considered soft, circumferential orthosis EXCEPT:
A. Mechanical stretch with use of prolonged gentle pull
B. Forearm bands for medial and lateral epicondylitis
C. MCP anti-ulnar deviation splints for RA
D. Buddy taping
E. Neoprene tube digit extension splint
F. Pediatric neoprene thumb abductor and supinator TheraTogs
A. Mechanical stretch with use of prolonged gentle pull is used with a dynamic splint
That one thing you need
flashcards
Decks in class (27)
# Cards
-
Musculoskeletal Impairments46
-
Burns & Cardiopulmonary Diseases56
-
MET Levels12
-
Vision17
-
Hands52
-
PAMS19
-
Splints64
-
Rancho Levels16
-
SCI Levels28
-
ACL Levels28
-
Nasty Children Gross Motor4
-
Glasgow Coma Scale6
-
FIM6
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MMT11
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Nasty Children Release4
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Nasty Children Grasp3
-
Groups16
-
Neurodegenerative Diseases64
-
Dimentia22
-
Wheelchairs63
-
Return to Work72
-
Other19
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Nasty Children Feeding16
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Nasty Children scissor6
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Nasty Children Assessments20
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Neurological impairments51
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Frames of Reference37
