CHT Evaluation 4 — Questions and Answers
Question 1: A patient presents with inability to fully extend the DIP joint with the PIP held in extension. Which evaluation finding most suggests mallet finger?
- Passive DIP extension is also limited
- Passive DIP extension is full but active extension is lost (Correct answer)
- Active PIP extension is limited
- Full active DIP extension with pain
Correct answer: Passive DIP extension is full but active extension is lost
In mallet finger, the terminal extensor tendon is disrupted, so passive DIP extension is preserved but active DIP extension is lost.
Question 2: When using the total active motion (TAM) formula, which joints are included in the calculation?
- Only MCP and PIP joints
- MCP, PIP, and DIP joints (Correct answer)
- Only PIP and DIP joints
- MCP, PIP, DIP, and wrist joints
Correct answer: MCP, PIP, and DIP joints
TAM sums active flexion at the MCP, PIP, and DIP joints minus any extension deficits at those same joints.
Question 3: A patient with rheumatoid arthritis presents for hand evaluation. What deformity is characterized by PIP hyperextension and DIP flexion?
- Boutonniere deformity
- Mallet deformity
- Swan-neck deformity (Correct answer)
- Ulnar drift
Correct answer: Swan-neck deformity
Swan-neck deformity is characterized by PIP hyperextension combined with DIP flexion, commonly seen in rheumatoid arthritis.
Question 4: Which standardized dexterity test requires the patient to turn over small cards and sort them into categories, assessing hand speed and coordination?
- Nine-Hole Peg Test
- Minnesota Manual Dexterity Test
- Jebsen-Taylor Hand Function Test (Correct answer)
- O'Connor Finger Dexterity Test
Correct answer: Jebsen-Taylor Hand Function Test
The Jebsen-Taylor Hand Function Test includes a card-turning subtest among its seven timed tasks assessing functional hand activities.
Question 5: During sensory re-education evaluation, which finding would indicate the patient is in the early phase of sensory recovery?
- Normal moving two-point discrimination
- Perception of 30 Hz vibration (tuning fork) but not 256 Hz (Correct answer)
- Normal static two-point discrimination
- Ability to localize constant touch
Correct answer: Perception of 30 Hz vibration (tuning fork) but not 256 Hz
Recovery of 30 Hz vibration perception before 256 Hz indicates early-phase sensory return, as larger fibers recover first.
Question 6: A CHT administers grip strength testing to detect sincerity of effort. Which pattern is most consistent with a genuine maximum voluntary contraction?
- Equal strength at all dynamometer handle positions
- A bell-shaped curve peaking at position 2 or 3 (Correct answer)
- Highest strength at position 5
- Randomly variable results across positions
Correct answer: A bell-shaped curve peaking at position 2 or 3
Genuine maximum effort produces a bell-shaped curve with peak grip at handle position 2 or 3 due to biomechanical advantages.
Question 7: In wound evaluation, which tissue color indicates healthy granulation tissue during wound bed assessment?
- Yellow/cream
- Black or brown
- Red/pink (beefy red) (Correct answer)
- Gray or white
Correct answer: Red/pink (beefy red)
Healthy granulation tissue appears beefy red or pink, indicating good vascularity and active wound healing.
CHT Evaluation 4
A patient presents with inability to fully extend the DIP joint with the PIP held in extension.
Which evaluation finding most suggests mallet finger?