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Clinical Reasoning Flashcards

7 cards from real CHT practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Clinical Reasoning flashcards as text

  1. A patient with a distal radius fracture reports pain with DRUJ loading 8 weeks post-fixation. Which structure should the CHT prioritize evaluating first?

    Answer: TFCC

    The triangular fibrocartilage complex (TFCC) is the primary stabilizer of the DRUJ and is commonly injured with distal radius fractures.

  2. A patient demonstrates a positive Finkelstein's test and a negative grind test. Which diagnosis is MOST consistent with these findings?

    Answer: De Quervain's tenosynovitis

    A positive Finkelstein's test with a negative grind test indicates De Quervain's tenosynovitis involving the first dorsal compartment, not CMC arthritis.

  3. 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.

  4. A CHT evaluates a patient with ulnar nerve injury at the wrist. Which intrinsic muscle function would be LEAST affected?

    Answer: Index finger abduction via first dorsal interosseous

    The first dorsal interosseous is also innervated by the ulnar nerve, but index abduction is primarily served by the median-innervated first lumbrical; however, FDI is ulnar—the least affected would be FCR, but among the listed, index abduction has redundancy.

  5. A patient with complex regional pain syndrome type I refuses to move the affected hand due to fear. Which clinical reasoning approach is MOST appropriate initially?

    Answer: Graded motor imagery followed by mirror therapy

    Graded motor imagery progressing to mirror therapy is the evidence-based approach for CRPS that addresses central sensitization before introducing physical movement.

  6. During clinical reasoning, a CHT suspects median nerve compression at the wrist rather than pronator teres. Which finding BEST supports carpal tunnel syndrome over pronator syndrome?

    Answer: Positive Phalen's test with thenar atrophy

    Positive Phalen's test with thenar atrophy localizes median nerve compression to the carpal tunnel, distal to the pronator teres.

  7. A therapist notes that a patient's TAM (total active motion) is 180 degrees but TPM (total passive motion) is 240 degrees. What does this discrepancy indicate?

    Answer: Tendon adhesions limiting active glide

    A significant gap between TAM and TPM indicates the tendon is not gliding fully actively, suggesting adhesions rather than joint contracture as the primary limitation.