CHT Evaluation 3 — Questions and Answers
Question 1: Which outcome measure is most appropriate for assessing upper extremity disability and symptom severity in patients with carpal tunnel syndrome?
- DASH questionnaire
- Boston Carpal Tunnel Questionnaire (BCTQ) (Correct answer)
- QuickDASH
- PRWHE
Correct answer: Boston Carpal Tunnel Questionnaire (BCTQ)
The Boston Carpal Tunnel Questionnaire (BCTQ) is the most widely used and validated disease-specific outcome measure for carpal tunnel syndrome.
Question 2: A CHT evaluates wrist flexion active ROM and finds 60°. The normal value is 80°. What percentage of normal does the patient retain?
- 60%
- 75% (Correct answer)
- 80%
- 50%
Correct answer: 75%
60/80 = 0.75, so the patient retains 75% of normal wrist flexion range of motion.
Question 3: The Tinel's sign is positive during nerve evaluation. What does a positive Tinel's sign indicate?
- Complete nerve transection
- Nerve regeneration or irritation at the percussion site (Correct answer)
- Normal nerve function
- Tendon adhesion
Correct answer: Nerve regeneration or irritation at the percussion site
A positive Tinel's sign (tingling with percussion over a nerve) indicates nerve regeneration or irritation at that point along the nerve.
Question 4: During evaluation of a patient 6 weeks post flexor tendon repair, the therapist notes a positive Finochietto-Brunner sign. What does this indicate?
- Tendon rupture
- Tendon adhesions limiting excursion (Correct answer)
- Normal tendon gliding
- Joint contracture
Correct answer: Tendon adhesions limiting excursion
The Finochietto-Brunner sign (increased passive DIP flexion when MCP is flexed) suggests tendon adhesions limiting differential glide.
Question 5: A therapist administers the Purdue Pegboard Test. What domain does this test primarily assess?
- Grip strength
- Fine motor dexterity and coordination (Correct answer)
- Sensory discrimination
- Joint range of motion
Correct answer: Fine motor dexterity and coordination
The Purdue Pegboard Test assesses fine motor dexterity, bimanual coordination, and fingertip dexterity relevant to work tasks.
Question 6: Which goniometric measurement position is used as the zero starting point (neutral) for wrist radial-ulnar deviation assessment?
- Full radial deviation
- Wrist in neutral (0°) with hand in anatomical position (Correct answer)
- 20° of wrist extension
- Wrist in maximum ulnar deviation
Correct answer: Wrist in neutral (0°) with hand in anatomical position
The wrist is positioned at neutral (0°) with the hand in anatomical position before measuring radial and ulnar deviation.
Question 7: In evaluating a patient with suspected triangular fibrocartilage complex (TFCC) tear, which clinical test applies a compressive load and rotation to the distal radioulnar joint?
- Allen test
- Watson test
- TFCC compression/ulnar grind test (Correct answer)
- Finkelstein test
Correct answer: TFCC compression/ulnar grind test
The TFCC compression (ulnar grind) test loads the TFCC by compressing and rotating the wrist in ulnar deviation to reproduce TFCC pain.
CHT Evaluation 3
Which outcome measure is most appropriate for assessing upper extremity disability and symptom severity in patients with carpal tunnel syndrome?