Certified Hand Therapist (CHT) Examination flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Semmes-Weinstein 2.83

A monofilament marking of 2.83 indicates normal light touch threshold in the hand; higher markings such as 4.31 indicate diminished protective sensation.

Static two-point discrimination

Measures innervation density; a normal fingertip value is 5 mm or less, while 6 mm or more suggests impaired median nerve sensibility.

Moberg pick-up test

Timed test of picking up small objects with eyes occluded; assesses median nerve sensory recovery and functional sensibility in the thumb and index finger.

Durkan compression test

The examiner applies direct pressure over the carpal tunnel for 30 seconds; reproduction of median nerve symptoms indicates carpal tunnel syndrome.

Phalen test

The patient holds the wrists in maximal flexion for about 60 seconds; tingling in the median nerve distribution is a positive sign for carpal tunnel syndrome.

Tinel sign

Tapping over a nerve produces distal tingling; at the wrist it suggests median nerve irritation, and in healing nerves it indicates advancing regeneration.

Watson scaphoid shift

The examiner presses on the scaphoid tubercle while moving the wrist from ulnar to radial deviation; pain or a clunk suggests scapholunate instability.

Grip dynamometry protocol

Use a standardized position with shoulder adducted, elbow at 90 degrees, forearm neutral, and wrist at 0-30 degrees extension; average three trials and compare with the uninvolved side.

Kleinert flexor tendon protocol

After flexor tendon repair, a dorsal blocking splint with rubber-band traction allows passive digital flexion and active extension, protecting the repair while limiting extension.

Duran protocol

Controlled passive flexion and extension of repaired flexor tendons within a dorsal blocking splint, performed frequently each day, to reduce adhesions without active tension.

Safe position splint

Positions the wrist in 20-30 degrees extension, metacarpophalangeal joints in 70-90 degrees flexion, and interphalangeal joints in extension to protect hand structures.

Retrograde massage

A manual edema technique stroking from distal to proximal toward the heart; used with elevation and compression to reduce hand edema after injury or surgery.

Silicone scar management

Silicone gel sheets or ointment applied to hypertrophic scars; used daily for several months to soften scar, reduce redness, and improve pliability.

Nerve gliding exercises

Gentle sequential movements that mobilize a nerve along its bed; used after nerve repair or compression to reduce adhesions while avoiding tension at the repair site.

Graded desensitization

Progressive exposure of a hypersensitive area to textures, vibration, tapping, and pressure, beginning with tolerated stimuli and advancing as symptoms decrease.

Relative motion splint

A splint that positions adjacent joints to reduce tension on a specific tendon; commonly used for extensor tendon repairs to allow early active motion.

Carpal tunnel contents

The carpal tunnel contains nine flexor tendons, including flexor digitorum superficialis and profundus and flexor pollicis longus, plus the median nerve.

Guyon canal contents

The ulnar tunnel at the wrist contains the ulnar nerve and ulnar artery; unlike the adjacent carpal tunnel, it does not contain flexor tendons.

Flexor zone II

Zone II spans from the distal palmar crease to the flexor digitorum superficialis insertion; it was historically called no man's land because of poor tendon healing.

A2 and A4 pulleys

The A2 and A4 annular pulleys are the most important for preventing flexor tendon bowstringing; they are located at the proximal and middle phalanx respectively.

Scaphoid blood supply

The scaphoid receives retrograde blood flow mainly from the dorsal branch of the radial artery, so proximal pole fractures risk avascular necrosis.

Froment sign

When pinching paper, the thumb interphalangeal joint flexes because the adductor pollicis is weak; this indicates ulnar nerve dysfunction.

Dart-throwing motion

Wrist motion combining radial deviation with extension and ulnar deviation with flexion; it occurs mainly at the midcarpal joint and is used in wrist rehabilitation.

Median nerve thenar innervation

The median nerve innervates the abductor pollicis brevis, opponens pollicis, and superficial head of flexor pollicis brevis; these muscles control thumb opposition.

Level I evidence

Systematic reviews or meta-analyses of randomized controlled trials; the highest level in common evidence hierarchies for questions of treatment effectiveness.

Sensitivity

The proportion of people with a condition who test positive; calculated as true positives divided by true positives plus false negatives.

Specificity

The proportion of people without a condition who test negative; calculated as true negatives divided by true negatives plus false positives.

Positive predictive value

The probability that a positive test result represents true disease; it rises as disease prevalence in the tested population increases.

Intraclass correlation coefficient

A reliability statistic for continuous measures; values above 0.75 are generally good and above 0.90 are excellent for clinical use.

Minimal detectable change

The smallest change in a measure that exceeds measurement error at a given confidence level; often calculated as 1.96 times the standard error of measurement times the square root of two.

Minimal clinically important difference

The smallest change in an outcome that patients perceive as beneficial; it may differ from statistical significance and from minimal detectable change.

Confidence interval

A range of plausible values for a population parameter, usually reported at 95 percent; wider intervals indicate less precision and smaller sample sizes.