Hand Therapy Certification Examination flashcards

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

Total active motion

Sum of active MCP, PIP, and DIP flexion minus extension deficits; used to grade flexor tendon repair outcomes and compare with the contralateral side.

Semmes-Weinstein monofilament

Set of calibrated nylon filaments applying logarithmic forces; the 2.83 filament (0.07 g) represents the threshold for normal fingertip light touch.

Two-point discrimination

Test of innervation density using two points applied simultaneously; static normal is 6 mm or less, moving normal 4 mm or less on the fingertip.

Manual muscle testing grades

Six-point scale from 0 (no contraction) to 5 (normal); grade 3 indicates full antigravity range, grade 4 holds against moderate resistance.

Jamar dynamometer position

Grip strength is measured with the handle at position 2 and the average of three trials recorded; a 20% side-to-side difference is clinically meaningful.

Pinch strength norms

Lateral (key) pinch averages 6-8 kg, tip-to-tip 4-6 kg, and three-jaw chuck 6-8 kg in healthy adults; document the pinch type tested.

Strickland formula

Flexor tendon outcome grade using PIP and DIP active flexion minus extension lag, expressed as a percentage of normal and categorized into excellent, good, fair, or poor.

Kleinert protocol

Early controlled mobilization after flexor tendon repair using a dorsal blocking orthosis with active extension and passive flexion via a rubber band traction system.

Tendon gliding exercises

Sequenced hand positions (hook, full fist, straight fist, tabletop, straight fist) that produce differential excursion of flexor and extensor tendons to limit adhesions.

Three-point pressure orthosis

Orthotic design applying force at three points to correct or resist a deformity, commonly used for contracture management and joint alignment.

CIMT

Constraint-induced movement therapy restrains the less affected limb and provides massed, repetitive practice of the affected upper limb; used in selected post-stroke rehabilitation.

Joint protection principles

Techniques such as respecting pain, avoiding sustained grip, using larger joints, and modifying activity to reduce stress on inflamed joints in arthritis.

Low-load prolonged stretch

Sustained low-magnitude force applied over extended time (often via static progressive or dynamic orthosis) to remodel shortened tissue and improve joint range.

Sensory re-education

Progressive discrimination training after nerve injury using textures, shapes, and graded stimuli to promote cortical reorganization and functional hand sensibility.

Edema control sequence

Elevation above heart level, distal-to-proximal compression, retrograde massage, and active exercise reduce edema that otherwise impairs tendon glide and joint motion.

Brachial plexus order

Roots, trunks, divisions, cords, and branches; C5-C6 musculocutaneous, C5-C7 axillary, C5-T1 radial, median, and ulnar nerves arise from this plexus.

Rotator cuff actions

Supraspinatus initiates abduction, infraspinatus and teres minor externally rotate, and subscapularis internally rotates; all insert on the humeral head.

Carpal tunnel syndrome

Median nerve entrapment at the wrist producing nocturnal paresthesia, thenar wasting, and sensory loss in the thumb, index, middle, and radial half of the ring finger.

Ulnar claw deformity

Ulnar nerve lesion, especially at the elbow, causing hyperextension of the MCP joints and flexion of the IP joints of the fourth and fifth digits from intrinsic weakness.

De Quervain tenosynovitis

Inflammation of the first dorsal compartment containing the abductor pollicis longus and extensor pollicis brevis; Finkelstein test is positive.

Lateral epicondylalgia

Overload tendinopathy at the common extensor origin, most often the extensor carpi radialis brevis; pain with resisted wrist extension and gripping.

Dupuytren contracture

Fibroproliferative disorder of the palmar fascia most commonly affecting the fourth and fifth digits; a positive Hueston tabletop test indicates surgical referral.

Scaphoid fracture risk

Most common carpal fracture; the retrograde blood supply puts the proximal pole at risk of avascular necrosis; anatomic snuffbox tenderness is the key sign.

Hypertrophic scar versus keloid

Hypertrophic scars remain within the original wound boundary and often regress; keloids extend beyond the boundary and recur after excision.

Pressure therapy parameters

Custom garments delivering 15-25 mmHg worn about 23 hours daily for 6-12 months reduce hypertrophic scarring after burn or surgical wounds.

Silicone gel sheeting

First-line noninvasive scar treatment applied 12-24 hours daily; improves scar color, thickness, and pliability through hydration and occlusion.

TIME wound framework

Assessment of Tissue nonviability, Infection or Inflammation, Moisture imbalance, and Edge of wound; guides debridement, infection control, and dressing selection.

Moist wound healing

Maintaining a moist wound bed accelerates epithelialization; dressing choice is matched to exudate level, from films and hydrocolloids to foams and alginates.

Scar massage technique

Circular, longitudinal, and perpendicular strokes applied after wound closure and medical clearance to improve scar pliability and reduce adherence to underlying tissue.

Signs of wound infection

Increasing pain, spreading erythema, warmth, purulent drainage, and fever warrant medical referral and possible wound culture.

Levels of evidence

Level I is systematic reviews of randomized trials, descending through individual RCTs, cohort studies, case-control studies, case series, to Level V expert opinion.

Patient-reported outcome measures

Standardized questionnaires such as DASH, QuickDASH, PRWE, and the Michigan Hand Outcomes Questionnaire that must be reliable, valid, and responsive to change.