Download CHT Exam Questions And Answers Latest Update and more Exams Nursing in PDF only on Docsity!
CHT Exam Questions And Answers Latest
Update 2024
Ulnar nerve - order of innervation - correct answers FCU - FDP (ring & small) - medial cutaneous branch - ADM - ODM - FDM - ulnar lumbricals - palmar & dorsal interossei
- FPB (deep) - adductor pollicis Radial nerve - order of innervation - correct answers Triceps - anconeus - BR - ECRL - ECRB (1/2 RN & 1/2 PIN) - PIN: supinator - EDC - EDM - ECU - APL - EPL - EPB - EIP Median nerve - order of innervation - correct answers PT - FCR - PL - FDS (index thru small) - AIN: FDP (index & middle) - FPL - PQ; palmar cutaneous branch - under flexor retinaculum: APB - OP - FPB (superficial) - radial lumbricals Order of sensory return - correct answers Pain and Temperature 30 Hz Vibration Moving Touch Constant Touch 256 Hz Vibration Touch Localization
Two Point Discrimination Stereognosis Steindler procedure - correct answers Flexor pronator muscle-tendon transfer to promote elbow flexion s/p C5/C6 BPI. "Steindler.. which way to the beach?" Quadrangular space - correct answers Axillary nerve and posterior circumflex humeral artery Quadrigia phenomenon - correct answers Flexion contracture of involved digit as well as limited flexion of adjacent digits; results if FDP advanced >1cm during repair (limits proximal excursion of other FDP tendons) Egawa's Sign - correct answers Ability to flex the LF, but cannot RD/UD; interosseous paralysis (UN out) (Egawa has road rage 😡) Guyon's canal - correct answers Contains UN and UA; borders of canal are hook of hamate & pisiform
Acute compartment syndrome: causes & symptoms - correct answers Causes: crush, thermal/electrical burns Symptoms: pain, paresthesias, paralysis, pulselessness ( P's) Often intrinsic minus hand Increasing pressure = necrosis Martin-Gruber anastomosis - correct answers MN/UN connection in the FA; intrinsic muscles can be innervated by MN in case of UN injury
- RF/SF FDP out Riche-Cannieu anastomosis - correct answers Occurs in palm - communicating branch between deep branch of UN and recurrent branch of MN in thenar eminence Berretini anastomosis - correct answers Connection between UN/MN common digital nerves "Bear claw - rawr"
Medial collateral ligament (MCL): anterior oblique bundle - correct answers Medial epicondyle to coronoid Greatest constraint to valgus when elbow at 30- degrees Injured in baseball pitchers Medial collateral ligament (MCL): posterior oblique bundle
- correct answers Medial epicondyle to coronoid (below AOL) Greatest constraint to valgus with elbow flexion > 90 degrees Medial collateral ligament (MCL): transverse bundle - correct answers Below AOL and POL; functionally insignificant to valgus restraint Bouvier test - correct answers Tests if PIPJ and extensor mechanism is working Place MP in slight flexion and see if IP's extend
Edema (absent or mild) Skin changes (thin, shiny skin; decreased hair growth; thickened nails) Pain (increased) Cleland's ligament - correct answers Originated from flexor tendon sheath, passes DORSAL to neurovascular bundle, inserts into skin *prevents rotary movement of the skin around the fingers with grasp Grayson's ligament - correct answers Originated from flexor tendon sheath, passes VOLAR to neurovascular bundle, inserts into skin *prevents rotary movement of the skin around the fingers with grasp *may contribute to Dupuytren's PIP contractures Scaphoid fracture - correct answers MOI: axial load to hyperextended and radially deviated wrist
Waist: 65% Proximal pole: 25% (more avascular) Distal pole: 10% (more common in kids) Preiser's disease - correct answers AVN of the scaphoid, resulting from a fracture or repeated trauma Cubital fossa - boundaries - correct answers SUPERIOR: imaginary line through epicondyles LATERAL: Brachioradialis muscle MEDIAL: Pronator teres muscle Signs of venous insufficiency - correct answers Cyanosis (blue tint caused by reduced amounts of hemoglobin) Abnormal capillary refill Snapping lateral bands - correct answers Pain and snapping at lateral PIPJ with flexion TRL loosens - solution: oval 8 splint
Thumb pulley system - correct answers A1 (MPJ) Oblique (mid-P1) - most important for IP flex A2 (IPJ) Nail anatomy - nail plate (rate of growth) - correct answers Concentrated cells with nuclei *grows 0.5-2mm/week - 5.5 months to grow from terminal matrix to tip Nail anatomy - germinal matrix - correct answers Contributes 90% to new nail growth
- distal edge is lunula
- minimal adherence to the nail Nail anatomy - lunula - correct answers White half moon shape at base of nail Nail anatomy - sterile matrix - correct answers Responsible for adherence of nail to the nail bed
- extends distal to the lanula
Nail anatomy - hyponychium - correct answers Junction of the nail bed & fingertip skin distally Nail anatomy - eponychium - correct answers Where the new nail starts to grow (dorsal roof of base of nail) Nail anatomy - paronychium - correct answers Lateral nail fold *paronychia: acute or chronic infection around the nail Allen's Test - correct answers 1. Have pt. forcefully make a fist and straighten
- Have pt. hold clenched fist
- Compress the RA and UA at the wrist
- Release the RA - check for flow return
- Repeat test for UA *normal is 3-5 seconds Vasospasm - correct answers Mild paresthesias & marked pallor
*blood-nerve barrier: regulates internal environment of fascicles; excludes toxic materials (e.g. antigens, viruses) Endoneurium (nerve anatomy) - correct answers Surrounds individual axons and protects them from compressive & tensile forces Flexor tendon nutrition (direct & indirect) - correct answers 1. Direct: vincula
- Indirect: synovial diffusion - occurs when tendon is forced against the pulley system with AROM Pseudoboutonnière - correct answers Jamming hyperextension injury, tearing the volar plate
- flexed posture at PIP, but no ORL tightness because the lateral bands stay in place *also seen in RA Secretan's syndrome - correct answers Self-inflicted peritendinous fibrosis caused by repetitively hitting the back of the hand, causing diffuse swelling. *wallbanger's disease - refer to psych
Bruit (vascular terms) - correct answers Adventitious sound heard on auscultation and of venous or arterial origin Doppler echocardiography (vascular terms) - correct answers Sensitive, noninvasive technique for determining blood flow Hemangioma (vascular terms) - correct answers Benign tumor of dilated blood vessels Thrill (vascular terms) - correct answers Abnormal tremor that accompanies a vascular or cardiac murmur felt on palpation Aneurysm (vascular terms) - correct answers Localized abnormal dilation of a blood vessel, usually an artery PIPJ dorsal dislocation - Type I - correct answers Sprain - stable with AROM, < 20 degrees angulation Immobilize 3-10 days, then buddy tape
CHAPTER 2: Evaluation - correct answers ... Intersection syndrome - correct answers A friction tendinitis in the 1st and 2nd dorsal compartments of the wrist Symptoms: (+) Finklestein Pain with resisted thumb MP extension Tenderness 4-5cm proximal to radial styloid Radial tunnel syndrome (cause/location) - correct answers Caused by direct trauma or entrapment as the RN passes anterior to the cubital fossa, pierces the supinator muscle, and runs posterior again into the forearm. Radial tunnel syndrome (symptoms) - correct answers Pain 4-5cm distal to LE in mobile wad Deep, burning pain - aggravated with repetitive FA pronation & wrist flexion Resting and night pain
Resisted LF test - pain in RN distribution Resisted supination - compression at Arcade of Frohse What level would you see more clawing in UN paralysis? (low or high) - correct answers Low - RF/SF FDP still innervated and pull IPs into flexion when unopposed by the lumbricals Not as noticeable in high UN palsy What Semmes-Weinstein monofilament must a pt. be able to feel before starting sensory re-education? - correct answers 4. Distal radius fracture - painful gripping with supination - correct answers DRUJ volar instability (e.g. Smith's fracture) Distal radius fracture - painful gripping with pronation - correct answers TFCC injury or ulnar abutment Distal radius fracture - painful gripping with supination & pronation - correct answers Post-traumatic osteoarthritis
Minnesota Rate of Manipulation Test - correct answers Gross motor coordination test that addresses bilateral turning and placing of objects Manual muscle testing - zero (0) - correct answers No contraction, no movement Manual muscle testing - trace (T) - correct answers Palpate contraction, no movement Manual muscle testing - poor minus (P-) - correct answers Partial ROM, gravity eliminated Manual muscle testing - poor (P) - correct answers Full ROM, gravity eliminated, no resistance Manual muscle testing - poor plus (+) - correct answers Full ROM, gravity eliminated, minimal resistance Manual muscle testing - fair minus (F-) - correct answers Partial ROM, against gravity Manual muscle testing - fair (F) - correct answers Full ROM, against gravity, no resistance
Manual muscle testing - fair plus (F+) - correct answers Full ROM, against gravity, minimal resistance Manual muscle testing - good minus (G-) - correct answers Full ROM, against gravity, < moderate resistance Manual muscle testing - good (G) - correct answers Full ROM, against gravity, moderate resistance Manual muscle testing - normal (N) - correct answers Full ROM, against gravity, maximum resistance Semmes-Weinstein: green (normal sensation) - correct answers 1.65 - 2. Semmes-Weinstein: blue (diminished light touch) - correct answers 3.22 - 3. Semmes-Weinstein: purple (diminished protective) - correct answers 3.84 - 4. Semmes-Weinstein: red (loss of protective) - correct answers 4.56 - 6.
