Mixed Deck — All CHT Topics Flashcards

A therapist is using iontophoresis with dexamethasone for a patient with trigger finger. Which polarity should the dexamethasone be placed under?

Answer: Negative (cathode)

Dexamethasone is negatively charged, so it is driven into tissue from the negative electrode (cathode) during iontophoresis.

When applying the ICF model to hand therapy practice, 'participation restrictions' BEST describes which patient scenario?

Answer: Inability to return to work as a carpenter

Participation restrictions refer to problems a person experiences in life situations, such as inability to fulfill a work role.

Which documentation element is essential to demonstrate skilled care and justify continued hand therapy services under Medicare?

Answer: Functional progress and skilled intervention rationale

Medicare requires documentation of measurable functional progress and explanation of why skilled therapy is necessary to justify ongoing services.

A CHT treating an athlete is asked by the coach for details about the injury and recovery timeline. The therapist should:

Answer: Obtain written authorization from the patient first

Even for team staff, HIPAA requires written patient authorization before disclosing protected health information to parties outside direct treatment.

Which clinical finding indicates a patient is ready to progress from phase I to phase II of the Duran passive motion protocol after flexor tendon repair?

Answer: Absence of infection and wound healing with passive ROM achieved

Phase II progression requires wound healing, no infection, and full passive ROM being maintained to allow introduction of more active techniques.

Moist wound healing, compared to dry wound healing, has been shown to:

Answer: Accelerate epithelialization and reduce wound pain

Research consistently demonstrates that moist wound healing accelerates epithelialization, reduces wound pain, and improves overall healing outcomes compared to dry wound management.

Which ligament, when ruptured, leads to scapholunate dissociation and DISI deformity?

Answer: Scapholunate interosseous ligament

The scapholunate interosseous ligament (SLIL) is the primary stabilizer between the scaphoid and lunate; its rupture causes carpal instability and dorsal intercalated segment instability (DISI).

When fabricating a dynamic MCP extension splint for a patient with ulnar nerve palsy (intrinsic minus hand), the outrigger should direct force in which direction?

Answer: MCP flexion and IP extension simultaneously

The lumbrical substitute splint flexes the MCPs while extending the IPs to replicate the lost intrinsic muscle function in ulnar nerve palsy.

In a hand therapy practice, informed consent must address which of the following?

Answer: Diagnosis, proposed treatment, risks, benefits, and alternatives

Valid informed consent requires disclosure of diagnosis, planned interventions, expected benefits, potential risks, and available alternatives.

How should Certified Hand Therapist professionals handle technical procedures that have been updated or revised?

Answer: Review the updates, complete any required training, and implement the revised procedures

When procedures are updated, professionals must review the changes, complete any required training to understand the rationale and new requirements, and implement the revised procedures in their practice. Continuing outdated methods risks non-compliance and suboptimal outcomes.

What is the role of supervision in practice?

Answer: To ensure compliance and guidance

Supervision in professional practice serves a vital role in ensuring that therapists, especially those who are newer or in training, adhere to professional standards, ethical guidelines, and legal requirements. Supervisors provide guidance, mentorship, and oversight, helping therapists to develop their clinical skills, refine their reasoning, and navigate complex cases. This support system enhances patient safety and promotes professional development.

How often should equipment be sterilized or disinfected?

Answer: Between each patient use according to manufacturer guidelines

Equipment must be sterilized or disinfected between each patient use following manufacturer guidelines to prevent cross-contamination and ensure patient safety.

When treating a patient with a replanted finger, which modality is CONTRAINDICATED in the early postoperative period?

Answer: Cold (cryotherapy) application over the replanted digit

Cold application is contraindicated after replantation because vasoconstriction threatens the already tenuous vascular supply to the replanted digit.

What is a primary goal of outcome evaluation in hand therapy?

Answer: To measure treatment effectiveness and function.

A primary goal of outcome evaluation in hand therapy is to measure the effectiveness of treatment and the patient's functional improvement. This involves assessing changes in strength, range of motion, pain levels, and the ability to perform daily activities. Outcome measures help therapists determine if interventions are working and guide future treatment decisions.

What does the Kapandji opposition score assess?

Answer: Thumb opposition range of motion

The Kapandji score (0–10) quantifies thumb opposition by rating the ability of the thumb tip to reach successive finger landmarks.

When conducting a risk assessment for CHT operations, which factor should receive the HIGHEST priority?

Answer: Probability and severity of potential harm

The probability and severity of potential harm are the primary factors in risk assessment. While cost and convenience are considerations, they should never override the assessment of how likely an incident is and how severe its consequences could be.

What is the primary purpose of a non-adherent wound contact layer in a dressing system?

Answer: To prevent the dressing from sticking to the wound bed and causing trauma on removal

Non-adherent contact layers protect the wound bed by preventing adherence, which would cause pain and tissue trauma upon dressing removal and disrupt healing.

A patient is evaluated for ulnar nerve compression at the elbow. Froment's sign is positive. What does this indicate?

Answer: Substitution of FPL for weak adductor pollicis during key pinch

Froment's sign occurs when the patient uses FPL (median nerve) to compensate for weak adductor pollicis (ulnar nerve) during key pinch.

The terminal extensor tendon inserts at which phalanx to extend the DIP joint?

Answer: Distal phalanx base

The terminal extensor tendon inserts at the dorsal base of the distal phalanx; disruption causes a mallet finger deformity.

What does 'graded motor imagery' involve?

Answer: Imagined and real movement for pain reduction

Graded motor imagery (GMI) is a rehabilitation technique that involves a sequence of mental and physical exercises designed to retrain the brain's motor cortex. It progresses from left/right discrimination, to imagined movements, and finally to mirror therapy, gradually re-engaging the motor system without causing pain. This approach helps to normalize cortical representation and reduce chronic pain by desensitizing the nervous system to movement.