Splints for the NBCOT

Stephanie Shane OTR/LNBCOT Tutor

C bar splintMedian Nerve Injury

Used to maintain web spaceNo joint stabilization

Flail arm splintBrachial Plexus Injury (BPI)

Thumb Extension SplintRadial Nerve Palsy

Opponens splintMedian Nerve Injury

thumb posterior splintMedian Nerve Injury

Ulnar Nerve InjuryUlnar Nerve Injury Splint

Ulnar Nerve Splint dynamically flexes the MP joints of the ring and little finger to allow functional use of the hand

Spinal Cord c6-c7Tenodesis splint

Carpal Tunnel SyndromeWrist splint positioned 0-15 degrees

extension

Thumb Spica Splint

Ulnar Deviation SplintUlnar Drift

Duran dorsal protection splintFlexor tendon injuryRadial nerve palsy

tendinitis/tenosynovitiswrist fracture

Silver ringsSwan Neck Deformity

Boutonniere

Resting splintFlaccidity

Cone SplintSpasticity

Airplane SplintBurns

ulnar gutter splintmedian nerve compression

(CTS)

Volar splint with the wrist in a neutral

carpal tunnel release surgeryradial nerve palsy

tendinitis/tenosynovitisrheumatoid arthritis

wrist fracture

general considerations of splinting

• Comfort• - Function• - Cosmesis• - Patient acceptance and compliance• - Patient education• - Tratment plan integration

common splinting precautions

• Preexisting skin problems• -Bony prominences• -Friction• -Pressure spots

NBCOT QUESTIONS

• When assessing an individual who is suspected of having carpal tunnel syndrome, the OT tests for Tinel’s sign by gently tapping the median nerve at the level of the: – elbow– mid-forearm– palmar crease– carpal tunnel

• An OT practitioner documents that an individual exhibits elbow flexion strength of grade 1. according to the manual muscle test system of letters and numbers, the word that would be the equivalent of grade 1 would be: – absent– trace – good– normal

• An individual is able to complete the full range of shoulder flexion while in a side-lying position during an evaluation. However, against gravity, the individual is not quite able to achieve 75% of the range for shoulder flexion. This muscle should be graded as: – Good (4)– Fair (3)– Fair minus (3-)– Poor plus (2+)

• A method that an OT practitioner can use to document total finger flexion without recording the measurement in degrees would be to measure the: – Passive flexion at each joint and total the numbers.– Distance from the fingertip to the distal palmar crease

with the hand in a fist.– Active flexion at each joint and total the measurements.– Distance between the tip of the thumb and the tip of the

fourth finger.

• An OT practitioner is assessing the range of motion of an individual who actively demonstrates internal rotation of the shoulder to 70 degrees. The practitioner would MOST likely document this measurement as: – Within normal limits.– Within functional limits.– Hypermobility that requires further treatment.

• An OT practitioner measures an individual’s elbow PROM three times, and gets three different measurements, varying by up to 10 degrees. The BEST action for the therapist to take is to:– Check the alignment of the goniometer. – Use a larger goniometer.– Use a smaller goniometer. – Attempt to force the individual’s arm further into

flexion.

• An OT practitioner is evaluating two-point discrimination in an individual with median nerve injury. The MOST appropriate procedure is to:– Apply the stimuli beginning at the little finger and

progress toward the thumb. – Test the thumb area first, then progress toward the little

finger.– Present test stimuli in an organized pattern to improve

reliability during retesting. – Allow the individual unlimited time to respond.

• An individual’s PIP joint appears flexed, and the DIP joint appears hyperextended. The OT can BEST document this condition as a: – Mallet deformity.– Boutonniere deformity.– Subluxation deformity.– Swan neck deformity.