List 5 vasomotor changes Correct Ans-vasoconstruction: dusky, pallor, cool
vasodilation: redness
vasomotor spasm
prolonged capillary refill
temp asymmetry
List 3 sudomotor changes Correct Ans-Hyperhidrosis (excessive sweating)
anhydrosis (dry)
Oedema (edema)
(Sudomotor = anything that stimulates the sweat glands)
List 4 trophic changes Correct Ans-abn hair growth
loss of skin wrinkles; glossy shiny skin due to edema and subcutaneous atrophy
Penciling of tips due to atrophy of palmar pads
nail changes: ridges, brittle, conform to shape of atrophied pulp.
What test can help dx CRPS? Correct Ans-Triple phase bone scan
(Diagnosis is based primarily on hx/exam. May also use bilateral x-ray to look for
osteoporosis; isolated cold stress test; laser doppler velocimetry)
, CHT Exam Prep - Conditions Questions and Answers
Order of application of graded motor imagery Correct Ans-Laterality recognition
(Identifying observed pic of hand is R or L)
Imagined movements (affected hand still, imagining hand making pictured mvmt)
Mirror movements
What is a stress loading program for pts with CRPS? Correct Ans-active exercises that
provide stress to tissue with minimal joint motion. Uses scrubbing and carrying. Used in early
rehab of CRPS
Begin scrubbing 3-5 min and work up to 10 mins 3x/day. Follow this by carrying 1-5# for 3-5
min and work up to 10 mins 3x/day.
Desensitization program for CRPS pt Correct Ans-20 mins, 5x/day with one to two separate
modalities.
3 goals of fracture helaing Correct Ans-regenerate mineralized tissue in the fracture area
restore mechanical strength to the bone
reconstitute normal soft tissue gliding and mvmt around the fracture site
3 stages of fracture healing Correct Ans-1. Inflammation - immediately after fx to day 5
(hematoma develops and provides stability at the site and tissue regeneration is initiated)
, CHT Exam Prep - Conditions Questions and Answers
2. Repair day 5-21 (callus is formed to stabilize the fracture more and granulation tissue
replaces the hematoma)
3. Remodeling - day 21 to 18 months (resorption and deposition of bone to restore the
strength of the bone)
Injured bone gains about 80% of its original strength within 3 mos of the injury, but tensile
strength takes up to 18 months to occur.
What is the most critical biologic factor in regards to fx healing? Correct Ans-blood supply.
Indirect or secondary fracture healing stages (5) Correct Ans-1. Hematoma
2. orchestra of cellular activity encouraging healing and nutrition.
3. an adequate blood supply
4. building and evolving cellular differentiation
5. mechanical stability.
(Casting is this kind of healing)
Direct healing of fracture Correct Ans-Occurs in a mechanically stable environment with
motionless fixation such as with plates and screws. Union occurs by direct formation of bone
across the cortex and intramedullary canal at the fx site.
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