Occupational Therapist Test Occupational Therapist Test Hand Therapy and Upper Extremity 2 — Questions and Answers
Question 1: First-line OT treatment for lateral epicondylitis (tennis elbow) includes:
- Resisted wrist flexion strengthening immediately
- Counterforce bracing and activity modification to reduce wrist extension loading (Correct answer)
- Passive stretching into wrist extension only
- Shoulder mobilization and strengthening
Correct answer: Counterforce bracing and activity modification to reduce wrist extension loading
A counterforce brace worn just distal to the elbow redistributes stress away from the lateral epicondyle, while activity modification reduces repetitive wrist extension loading.
Question 2: Ulnar nerve injury at the wrist primarily results in impaired:
- Thumb opposition strength
- Index finger DIP flexion
- Ring and little finger abduction/adduction via interossei (Correct answer)
- Wrist radial deviation
Correct answer: Ring and little finger abduction/adduction via interossei
The ulnar nerve innervates all interossei and hypothenar muscles; injury at the wrist causes loss of finger abduction/adduction and ulnar two lumbrical function.
Question 3: Dupuytren's contracture most commonly causes progressive flexion contractures of which fingers?
- Index and middle fingers
- Ring and little fingers (Correct answer)
- Thumb and index fingers
- Middle and ring fingers
Correct answer: Ring and little fingers
Dupuytren's contracture involves fibroproliferative thickening of the palmar fascia, most frequently affecting the ring and little finger rays.
Question 4: When fabricating a wrist cock-up splint for carpal tunnel syndrome, the optimal wrist position is:
- 20-30° wrist flexion
- Neutral (0°) to slight extension (0-10°) (Correct answer)
- 45° wrist extension
- Ulnar deviation at neutral flexion
Correct answer: Neutral (0°) to slight extension (0-10°)
Neutral to slight wrist extension minimizes pressure within the carpal tunnel while maintaining functional wrist positioning, especially during sleep.
Question 5: Complex Regional Pain Syndrome (CRPS) of the upper extremity is best characterized by:
- Localized muscle weakness without other features
- Disproportionate pain, autonomic dysfunction, and trophic skin changes (Correct answer)
- Isolated sensory nerve loss in a dermatomal pattern
- Acute purulent inflammatory arthritis
Correct answer: Disproportionate pain, autonomic dysfunction, and trophic skin changes
CRPS presents with burning pain, allodynia, edema, temperature and color changes, and trophic alterations that are disproportionate to the original injury.
Question 6: An extensor tendon injury at Zone III (over the PIP joint) typically results in which deformity if left untreated?
- Mallet finger
- Boutonniere deformity (Correct answer)
- Swan neck deformity
- Trigger finger
Correct answer: Boutonniere deformity
Zone III central slip disruption allows the lateral bands to migrate palmarly, creating boutonniere deformity: PIP flexion and DIP hyperextension.
Occupational Therapist Test Occupational Therapist Test Hand Therapy and Upper Extremity 2
First-line OT treatment for lateral epicondylitis (tennis elbow) includes: