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CHT Exam Prep - Trauma/Wounds/Tendon Transfers- Qs & As
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CHT Exam Prep - Trauma/Wounds/Tendon Transfers- Qs & As
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CHT Exam Prep - Trauma/Wounds/Tendon Transfers- Qs& As
After repair to completely transected nerve, stretching and gliding exercises should begin
when Correct Ans-Week 4
3 signs present with low ulnar nerve palsy Correct Ans-Claw hand, jeanne's sign, froment's
sign
Pollock's sign Correct Ans-due to loss of ulnar innervated FDP in high ulnar lesion,
therefore CANNOT flex DIP of small finger
With high and low ulnar nerve palsies, name 4 transfers utilizing muscles innervated by the
radial nerve. Correct Ans-ECRB to adductor pollicis (thumb adduction)
APL to first dorsal interosseous (index abduction)
EIP to APB (thumb opposition)
Brachioradialis for MP flexion (stops clawing)
V-Y Advancement Flap Correct Ans-Thumb tip amputations with exposed bone are
managed by V-Y advancement flaps.
Tendon excursion is calculated by what? What is the ratio? Correct Ans-Extensor tendon
excursion can be calculated through radians. The angle is always = to 57.29 degrees, or 1
radian.
, CHT Exam Prep - Trauma/Wounds/Tendon Transfers- Qs
& As
1 radian = 10 mm tendon excursion. (e.g. moving the MP joint 57.29 degrees will yield 10 mm
extensor tendon excursion)
Therefore, to get the suggested 5mm excursion, a joint must be moved through .5 radian, or
28.64 degrees of flexion.
Note a joint with smaller moment arm produces less tendon excursion.
Most important goals of thumb reconstruction is restoration of what two things? Correct
Ans-Opposition and sensation.
What is affected by low ulnar nerve palsy? Correct Ans-MP joint flexion, Thumb adduction,
index abduction
In low median nerve palsy, pt loses thumb opposition. What 3 motions make up thumb
opposition? Correct Ans-abduction, flexion, and pronation.
(note, thumb retroposition involves abduction, extension, and supination)
What is the primary difference between high versus low ulnar nerve palsy? With high ulnar
nerve palsy, what is the most common transfer to provide flexion of the DIP joints to the ring
and small fingers? Correct Ans-Primary difference in high versus low ulnar nerve palsy is
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