CHT Evaluation 5 — Questions and Answers
Question 1: The Patient-Rated Wrist and Hand Evaluation (PRWHE) measures which two domains?
- Pain and stiffness
- Pain and function (Correct answer)
- Strength and dexterity
- Sensation and motion
Correct answer: Pain and function
The PRWHE is a 15-item patient-reported outcome measure assessing pain (5 items) and function (10 items) in patients with wrist disorders.
Question 2: During evaluation of a patient following radial nerve injury, which functional deficit would the CHT expect to find?
- Loss of thumb opposition
- Wrist drop and inability to extend MCPs (Correct answer)
- Loss of intrinsic hand muscle function
- Inability to abduct the thumb
Correct answer: Wrist drop and inability to extend MCPs
Radial nerve injury causes wrist drop and loss of MCP extension due to denervation of the wrist and finger extensors.
Question 3: A therapist uses the moving two-point discrimination test. What is the normal threshold at the fingertip?
- Less than 2 mm
- 2–3 mm (Correct answer)
- 6–10 mm
- 10–15 mm
Correct answer: 2–3 mm
Normal moving two-point discrimination at the fingertip is 2–3 mm, which is slightly better than static two-point discrimination thresholds.
Question 4: Which standardized outcome tool is specifically designed to measure upper extremity functional limitations in patients performing work-related tasks?
- DASH (Disabilities of Arm, Shoulder, and Hand) (Correct answer)
- SF-36
- PRWHE
- MHQ (Michigan Hand Questionnaire)
Correct answer: DASH (Disabilities of Arm, Shoulder, and Hand)
The DASH questionnaire, including its work module, is widely used to assess upper extremity disability and work-related functional limitations.
Question 5: A patient is evaluated for ulnar nerve compression at the elbow. Froment's sign is positive. What does this indicate?
- Weakness of the first dorsal interosseous muscle
- Substitution of FPL for weak adductor pollicis during key pinch (Correct answer)
- Loss of thumb flexion
- Hyperactivity of the extensor pollicis longus
Correct 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.
Question 6: In scar evaluation using the Vancouver Scar Scale (VSS), which four parameters are assessed?
- Color, texture, thickness, and flexibility
- Vascularity, pigmentation, pliability, and height (Correct answer)
- Moisture, thickness, pain, and itch
- Surface area, depth, color, and adhesion
Correct answer: Vascularity, pigmentation, pliability, and height
The Vancouver Scar Scale evaluates vascularity, pigmentation, pliability, and height to provide a standardized assessment of scar maturation.
Question 7: A CHT evaluates thumb CMC joint instability. Which provocative test is most appropriate?
- Finkelstein test
- CMC grind (axial compression) test (Correct answer)
- Watson scaphoid shift test
- Phalen's test
Correct answer: CMC grind (axial compression) test
The CMC grind test applies axial compression and rotation to the thumb CMC joint to reproduce pain and crepitus indicating arthrosis or instability.
CHT Evaluation 5
The Patient-Rated Wrist and Hand Evaluation (PRWHE) measures which two domains?