Anatomy of Upper Limb Orthosis

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the role of the proximal transverse arch in the hand?

It provides stability for grasping and manipulating objects. (correct)

It facilitates flexion at the wrist joint.

It allows for independent finger movement.

It increases the range of motion at the metacarpophalangeal joints.

What maintains the longitudinal arch of the hand?

The carpal bones arrangement.

The flexor tendons of the fingers.

The extensor tendons of the fingers.

The intrinsic muscles of the hand. (correct)

What is a consequence of disrupting the longitudinal arch in the hand?

Decreased swelling in the hand.

Improved dexterity.

Increased grip strength.

Claw-like deformity. (correct)

Why is it important to clear the distal and proximal palmar creases when fabricating a wrist immobilization orthosis?

To ensure unrestricted range of motion at the MCP joints. Signup and view all the answers

What are the key features of the inflammatory phase of wound healing?

Signs of inflammation like redness and heat. Signup and view all the answers

During which phase of wound healing is rest prioritized?

Inflammatory phase. Signup and view all the answers

What happens during the fibroplasia/proliferation phase of wound healing?

New collagens and blood vessels form. Signup and view all the answers

What is the main function of orthoses in the context of injury recovery?

To aid in the healing of injuries. Signup and view all the answers

What is a recommended approach if the volar skin is highly sensitive?

Consider a dorsal approach Signup and view all the answers

In which direction should an elastic wrap be applied to assist with edema drainage?

Distal to proximal Signup and view all the answers

What should be done to prevent red marks on the skin from the orthosis?

Flare away edges and pad where needed Signup and view all the answers

What is NOT a precaution when considering orthotic application?

Effective communication skills Signup and view all the answers

Which principle should be followed for effective orthotic design?

Keep it simple and basic Signup and view all the answers

How should straps on an orthosis be designed?

To hold the limb securely without rotation Signup and view all the answers

What type of orthosis always includes the term 'non-articular' in its name?

Non-articular orthosis Signup and view all the answers

Which of the following is essential for an orthosis designed for ease of use?

Easy on, easy off functionality Signup and view all the answers

What should NOT be included in a simple orthotic design?

Unnecessary components Signup and view all the answers

Which of the following correctly describes the naming convention for articular orthoses?

Named after the joint or joints they affect Signup and view all the answers

What is the primary function of immobilization orthoses?

To immobilize joints and allow healing Signup and view all the answers

Which of the following terms is relevant only for articular orthoses?

Direction Signup and view all the answers

What should be done if color changes in the skin occur while wearing an orthosis?

Loosen the straps or adjust the fit Signup and view all the answers

Which type of orthosis is specifically designed to mobilize joints?

Mobilization orthosis Signup and view all the answers

What describes the types of forces non-articular orthoses use for stabilization?

Two-point pressure force Signup and view all the answers

What is an example of a wrong identification for an articular orthosis?

Humerus orthosis Signup and view all the answers

Which characteristic is essential when constructing an orthosis for a professional appearance?

Cut with smooth scissor strokes Signup and view all the answers

What is the primary function of the 'Ulnar fracture/functional brace'?

To stabilize an ulnar fracture to promote healing Signup and view all the answers

Which of the following is NOT a common name for wrist immobilization orthoses?

Ulnar fracture stabilization brace Signup and view all the answers

Where should the hypothenar bar be positioned on a wrist orthosis?

Proximal to the distal palmar crease and distal to the thenar crease Signup and view all the answers

What is the ideal length and circumference for the forearm trough of an orthosis?

Two-thirds the length of the forearm, half the circumference Signup and view all the answers

What is the primary purpose of mobilization orthoses during the fibroplasia/proliferation phase of wound healing?

To promote tissue growth and lengthening for improved passive range of motion. Signup and view all the answers

What happens during the scar maturation/remodeling phase in wound healing?

Reorganization and strengthening of scar tissue. Signup and view all the answers

Which of the following is NOT a characteristic of the inflammatory phase of wound healing?

Development of new granulation tissue. Signup and view all the answers

What classification system is used for a comprehensive description of splints in hand therapy?

American Society of Hand Therapists’ Splint Classification System (ASHTSCS) Signup and view all the answers

How do articular orthoses function regarding joint mobility?

They utilize three-point pressure systems to affect joint function. Signup and view all the answers

What is a common technique employed during the fibroplasia/proliferation phase to promote tissue growth?

Static progressive orthoses for gentle mobilization. Signup and view all the answers

Which phase of wound healing lasts from approximately six weeks to 12 to 24 months?

Scar Maturation/Remodeling Phase Signup and view all the answers

What is the key feature of the fibroplasia/proliferation phase?

Development of collagen and blood vessel networks. Signup and view all the answers

Study Notes

The upper extremity is complex, encompassing shoulder, arm, forearm, wrist, and hand.
Bones, muscles, nerves, and soft tissues interact to enable a wide range of movement.
Disruptions to this intricate system can lead to dysfunction, including pain, weakness, and reduced range of motion (ROM).

Arches of the Hand

The hand has three interconnected arches crucial for a wide range of motion.
The proximal transverse arch is formed by distal carpal bones and a taut volar carpal ligament.
The mobile distal transverse arch is located at the level of the metacarpal heads, adapting based on CMC joint mobility.
The longitudinal arch, spanning from metacarpals to distal phalanges, is maintained by intrinsic hand muscles.
Disruption to the longitudinal arch, potentially from ulnar nerve injuries, can cause a claw-like deformity.

Palmar Creases

The palm's surface features creases formed by fibrous connections attaching thick skin to underlying structures.
These creases serve as anatomical guides when designing orthosis patterns.
Careful clearing of the creases during orthosis fabrication is crucial for unrestricted range of motion at the metacarpophalangeal (MCP) joints.
Excessive clearing can impact the orthosis' mechanical efficiency.

Wound Healing Principles & Tissue Response to Stress

Orthoses are frequently utilized to aid in healing injuries.
The specific type of orthosis used depends on the stage of tissue healing.

Inflammatory Phase

Characterized by increased blood flow, redness, heat, swelling, and pain.
Rest is prioritized, and immobilization devices (orthoses) protect the injured area.

Fibroplasia/Proliferation Phase

New granulation tissue forms, collagen and blood vessels develop, and the wound closes.
Mobilization orthoses provide controlled stretching to promote tissue growth and improve range of motion (PROM).

Scar Maturation/Remodeling Phase

Scar tissue reorganizes and strengthens.
Orthoses assist in mobilizing joints to improve scar tissue alignment and flexibility.

Categorization of UL Orthoses

The American Society of Hand Therapists' Splint Classification System (ASHTSCS) offers a comprehensive splint categorization system.
This system aids in communicating about splints amongst hand therapists, physicians, and healthcare professionals.

Splint Classification System (Expanded)

Splints/orthoses are categorized by location (articular or non-articular).
Further categorized by direction (immobilization, mobilization, restriction, torque transmission).

Location (Articular/Non-articular)

Articular orthoses affect joints using three-point pressure systems. They can immobilize, mobilize, restrict movement, and transmit torque.
Non-articular orthoses use two-point pressure to stabilize/immobilize body segments (long bones). The term "non-articular" should always be included in the orthosis's name.

Location (further categorized)

Articular orthoses are further named after the joint(s) affected (e.g., elbow orthosis, thumb metacarpal orthosis).
Non-articular orthoses are named after the affected long bone (e.g., ulna orthosis, humerus orthosis).

Direction (e.g. immobilization)

Orthoses, with this classification, are categorized based on the movement they restrict/enable.
Immobilization orthoses (static) secure joints to aid in healing, without any active movement.
Mobilization orthoses aid in joint movement.

Effective Orthotic Design

Orthoses should be simple, easy to don/doff, and avoid unnecessary components.
Joints should not be included unnecessarily, unless it improves leverage or mechanical advantage.
A professional appearance is prioritized, with smooth edges and rounded corners.
Materials used should ensure durability.

Wrist Orthoses (forearm-based):

Circumferential supports typically immobilize fractures/maintain alignment without significant joint restriction.

Problem Solution in Orthosis Use

Orthosis use should not excessively press on skin, leading to color changes and temperature alterations.
Skin should be protected using perforations and/or lightweight materials to mitigate pressure-related breakdown.
Proper use/fitting should be monitored for edema reduction (movement of fluid in the body).

Improper Positioning of Joints

Carefully assess joint positioning during orthosis use with attention to wrist, thumb, and finger placements.
Orthoses should not hinder natural/needed movement or cause skin irritation.
Potential complications, including compromised cognition or allergic reactions to materials, need careful attention during orthosis use.

Appropriate considerations when using orthotics

Pay attention to how orthosis affects the joints (and placement), and the general well-being of the patient.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz explores the intricate anatomy of the upper limb and its significance in orthosis design. Topics include the anatomy of the hand, the arches of the hand, and the impact of injuries on functionality. Understand how disruptions in this system can lead to dysfunction and the importance of maintaining its integrity.