Quiz C - Wrist & Hand

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You are working with a patient with rheumatoid arthritis (RA) of the hand and wrist. You notice several deformities, including hyperextension of the proximal interphalangeal (PIP) joints and flexion of the distal interphalangeal (DIP) joints of digits 2, 3, and 4. This deformity is called: A. Swan-neck deformity. B. Heberden's deformity. C. Boutonnière deformity. D. Saddleback deformity.

A. Swan-neck deformity

When do strengthening exercises for the wrist muscles begin following a Colles or Smith fracture? A. When the fracture is clinically healed B. After the patient can move the wrist painlessly C. While the cast is in place D. After the cast is removed

B. ?

Which of the following is NOT a primary characteristic of complex regional pain syndrome (CRPS)? A. Autonomic disturbances such as sweating or dryness of the skin B. Flexibility of the wrist joint and pain C. Trophic changes D. Functional impairment such as not using the hand due to pain

B. Flexibility of the wrist joint and pain

What is the biomechanical cause of a Boutonnière deformity? A. Overstretching or rupture of the collateral ligaments of the metacarpophalangeal (MP) joints B. Rupture of the central band (central slip) of the extensor hood mechanism, causing the lateral bands to slip in a volar direction at the PIP joint C. Volar displacement of the extensor carpi ulnaris tendon, causing a flexion force at the wrist joint D. Overstretching of the volar plate (palmar plate) and bowstringing of the lateral bands of the extensor hood mechanism

B. Rupture of the central band (central slip) of the extensor hood mechanism, causing the lateral bands to slip in a volar direction at the PIP joint

What is the name of the common distal radius fracture that results from a fall on the dorsum of the hand? A. Bennett Fracture B. Smith's fracture C. Boxer's Fracture D. Colles Fracture

B. Smith's Fracture

Each of the following is true about flexor tendon-gliding exercises except: A. Maintain or develop free gliding between the FDS and FDP tendons and adjacent bones. B. To perform these exercises, the therapist passively moves the patient's fingers into five different positions in a particular sequence. C. Maintain or develop free gliding between the FDS and FDP tendons. D. To perform these exercises, the patient actively moves the fingers into five different positions.

B. To perform these exercises, the therapist passively moves the patient's fingers into five different positions in a particular sequence.

Which fracture occurs at the palmar base of the proximal first metacarpal and results in a fracture dislocation treated with rigid cast immobilization or surgery? A. Boxer's Fracture B. Smith's fracture C. Bennett Fracture D. Colles Fracture

C. Bennett Fracture

A skier experiences a complete rupture of the ulnar collateral ligament of his thumb which shows a small fracture of the proximal phalanx. What treatment would you expect to see for this patient? A. Surgery to correct the nerve entrapment, neuroma, or joint derangement B. Continuous uninterrupted splinting of the distal interphalangeal (DIP) joint for 6 weeks in hyperextension C. Surgical repair and a short arm thumb spica cast for 4 weeks D. Nonsurgical treatment with a thumb spica cast or rigid immobilization for 3-4 weeks

C. Surgical repair and a short arm thumb spica cast for 4 weeks

Which of the following injuries may be seen more in gymnasts than in golfers or baseball players? A. Acute sprain of the ulnar collateral ligament of the thumb B. Carpal tunnel syndrome (CTS) C. Triangular fibrocartilage complex D. Colles fracture

C. triangular fibrocartilage complex

A patient with RA of the hands and wrists is experiencing an acute flare of the disease. To protect the inflamed joints and minimize deforming forces on the hands and wrists, you should teach the patient to: A. Avoid all activities with the hands until there is no pain. B. Exercise the hands in functional ways such as wringing out a dishrag under warm water. C. Stretch the extrinsic finger tendons across all the joints simultaneously to gain mobility and counter contractures. D. Avoid strong gripping motions that require wrist extension, radial deviation of the wrist, and ulnar deviation of the fingers.

D. Avoid strong gripping motions that require wrist extension, radial deviation of the wrist, and ulnar deviation of the fingers.


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