NBCOT Occupational Therapy Certification Study Guide
Exam Questions with Key Marking Scheme Updated
2024/2025
What is swan neck deformity and how is it treated? - correct answer *pip
hyperextension and dip flexion*
Can be caused by damage to the mcp, pip, and dip
Treated by splinting pip in slight flexion.
What is mallet finger and how is it treated? - correct answer *dip flexion*
Caused by avulsion injury to the extensor tendon at the dip joint
Treated by splinting dip in full extension for 6 weeks.
What is the most common carpal bone fracture? - correct answer scaphoid fracture
What disease is associated with lunate fracture? - correct answer kienbock's disease
Impaired vascularity of the lunate bone causes the bone to break down.
What is a boxer's fracture? - correct answer *fracture of the 4th or 5th metacarpal*
Usually occurs from the impact of the knuckle during a punch.
What is a bennet's fracture and how is it treated? - correct answer *fracture of the 1st
metacarpal base*
,Caused by forced thumb abduction (ouch)
Treated with thumb spica splint
What is a colles fracture? - correct answer *fx of the distal radius with dorsal
displacement*
Most common wrist fracture
Occurs when wrist is extended on impact (foosh)
I remember this by thinking of a collie dog getting tangled up in your legs and tripping
you so you fall with your hand out
What is a smith's fracture? - correct answer *fx of the distal radius with ventral
displacement*
Occurs when wrist is flexed on impact
I remember this because there's a yoga studio called yogasmith and one of my yoga
stretches is to go on your hands and knees and one at a time flex your wrists and put
some light pressure on them as a wrist stretch.
Smith fracture --> yogasmith --> yoga wrist flexion stretch
What does reduction refer to when discussing fractures, and what are the two types of
reduction? - correct answer reduction refers to *resetting a bone* in anatomical
alignment following a fracture.
Thinking of it as *reducing a fracture* by putting the bone back in place
,1). Closed reduction means the bone is reset nonoperatively via manipulation
2). Open reduction means the bone is reset via surgery
What does fixation refer to when discussing fractures, and what are the two types of
fixation? - correct answer fixation refers to how the bone is *stabilized* after it has
been reset. I.e. How do you fix it in place?
1). Internal fixation is operative stabilization via wires, screws, or metal plate
2). External fixation is nonoperative stabilization via splinting or casting. Most ue
fractures are splinted with the wrist in extension and the mps in slight flexion. (your
basic resting hand position)
What is the bunnell test? - correct answer test for *intrinsic tightness* of the hand
Perform pip flexion with mcps blocked in extension, then in flexion. If there is intrinsic
tightness, there will be greater pip flexion when the mcps are flexed.
What is the difference between intrinsic and extrinsic muscles of the hand? - correct
answer the intrinsic muscles are those that are entirely encased in the hand; they both
originate and insert there.
The extrinsic muscles are long muscles that originate in the forearm and insert in the
hand.
What is extrinsic tightness of the hand? - correct answer greater pip flexion when
mcps are extended.
Supposedly due to extensor tendon adhesions. Note that there are extrinsic hand
muscles on both the dorsal and volar aspect, so this doesn't really make sense :)
, What are 4 interventions for hand fractures? - correct answer 1. Orthotics
2. Modalities
3. Early mobilization (3-6 weeks if fixation is stable)
4. Hep
Describe a median nerve injury - correct answer - numbness/weakness in lateral
palm and 3 1/2 digits
- loss of thumb opposition and palmar abduction.
- *ape hand* = resting hand position (low lesion)
- *sign of benediction* = unable to flex 1-3rd digits when making a fist (high lesion)
Low level - dorsal protection splint, wrist flexed 30
High level - same, but also splint elbow flexed 90
What is the sign of benediction? - correct answer - *median nerve* dysfunction, high
level
- pt is unable to flex first 3 digits when asked to make a fist, so they remain extended
while the 4th-5th digits flex, resulting in what looks like the hand of a saint
Dorsal protection splint, wrist flexed 30 degrees plus elbow flexed to 90 degrees
Describe a radial nerve injury - correct answer *wrist drop* (impaired ability to extend
the wrist and digits).
Impairs ability to grasp, manipulate, and release objects.
Nonoperative = wrist cock up splint
Operative = wrist extension splint
Exam Questions with Key Marking Scheme Updated
2024/2025
What is swan neck deformity and how is it treated? - correct answer *pip
hyperextension and dip flexion*
Can be caused by damage to the mcp, pip, and dip
Treated by splinting pip in slight flexion.
What is mallet finger and how is it treated? - correct answer *dip flexion*
Caused by avulsion injury to the extensor tendon at the dip joint
Treated by splinting dip in full extension for 6 weeks.
What is the most common carpal bone fracture? - correct answer scaphoid fracture
What disease is associated with lunate fracture? - correct answer kienbock's disease
Impaired vascularity of the lunate bone causes the bone to break down.
What is a boxer's fracture? - correct answer *fracture of the 4th or 5th metacarpal*
Usually occurs from the impact of the knuckle during a punch.
What is a bennet's fracture and how is it treated? - correct answer *fracture of the 1st
metacarpal base*
,Caused by forced thumb abduction (ouch)
Treated with thumb spica splint
What is a colles fracture? - correct answer *fx of the distal radius with dorsal
displacement*
Most common wrist fracture
Occurs when wrist is extended on impact (foosh)
I remember this by thinking of a collie dog getting tangled up in your legs and tripping
you so you fall with your hand out
What is a smith's fracture? - correct answer *fx of the distal radius with ventral
displacement*
Occurs when wrist is flexed on impact
I remember this because there's a yoga studio called yogasmith and one of my yoga
stretches is to go on your hands and knees and one at a time flex your wrists and put
some light pressure on them as a wrist stretch.
Smith fracture --> yogasmith --> yoga wrist flexion stretch
What does reduction refer to when discussing fractures, and what are the two types of
reduction? - correct answer reduction refers to *resetting a bone* in anatomical
alignment following a fracture.
Thinking of it as *reducing a fracture* by putting the bone back in place
,1). Closed reduction means the bone is reset nonoperatively via manipulation
2). Open reduction means the bone is reset via surgery
What does fixation refer to when discussing fractures, and what are the two types of
fixation? - correct answer fixation refers to how the bone is *stabilized* after it has
been reset. I.e. How do you fix it in place?
1). Internal fixation is operative stabilization via wires, screws, or metal plate
2). External fixation is nonoperative stabilization via splinting or casting. Most ue
fractures are splinted with the wrist in extension and the mps in slight flexion. (your
basic resting hand position)
What is the bunnell test? - correct answer test for *intrinsic tightness* of the hand
Perform pip flexion with mcps blocked in extension, then in flexion. If there is intrinsic
tightness, there will be greater pip flexion when the mcps are flexed.
What is the difference between intrinsic and extrinsic muscles of the hand? - correct
answer the intrinsic muscles are those that are entirely encased in the hand; they both
originate and insert there.
The extrinsic muscles are long muscles that originate in the forearm and insert in the
hand.
What is extrinsic tightness of the hand? - correct answer greater pip flexion when
mcps are extended.
Supposedly due to extensor tendon adhesions. Note that there are extrinsic hand
muscles on both the dorsal and volar aspect, so this doesn't really make sense :)
, What are 4 interventions for hand fractures? - correct answer 1. Orthotics
2. Modalities
3. Early mobilization (3-6 weeks if fixation is stable)
4. Hep
Describe a median nerve injury - correct answer - numbness/weakness in lateral
palm and 3 1/2 digits
- loss of thumb opposition and palmar abduction.
- *ape hand* = resting hand position (low lesion)
- *sign of benediction* = unable to flex 1-3rd digits when making a fist (high lesion)
Low level - dorsal protection splint, wrist flexed 30
High level - same, but also splint elbow flexed 90
What is the sign of benediction? - correct answer - *median nerve* dysfunction, high
level
- pt is unable to flex first 3 digits when asked to make a fist, so they remain extended
while the 4th-5th digits flex, resulting in what looks like the hand of a saint
Dorsal protection splint, wrist flexed 30 degrees plus elbow flexed to 90 degrees
Describe a radial nerve injury - correct answer *wrist drop* (impaired ability to extend
the wrist and digits).
Impairs ability to grasp, manipulate, and release objects.
Nonoperative = wrist cock up splint
Operative = wrist extension splint
