Occupational Therapy Department

Course Name: Hand Assessment and Splinting (061013210)

Lecture 2&3. Pain, Wounds, Scar, Vascular, Edema, and assessment Date: 27/3/2022

The objective of lecture 2&3:

By the end of this lecture, students will be able to:

1. Implement cervical, pain, scar, wound, and edema assessments.

2. Document the results of cervical, pain, scar, wound, and edema assessments
3. Interpret the results of cervical, pain, scar, wound, and edema assessments.

Physical Examination

Watch the video and after you watch it do the cervical screening for your colleague.

https://www.youtube.com/watch?v=AkB8fASzgJM

https://www.youtube.com/watch?v=bk69u4G3U1o
Pain

1- Numeric analog scales

2- Visual analog scale

3- Verbal rating scale

4- Graphic representation
Wounds

1- wound size (length, width, and depth)

 2- Wound drainage

bloody (sanguinous)

serous (clear or yellow)

purulent (pus)

deep or dark red (hematoma)

Choose one type of wound drainage and search for a picture of it and ask your colleague to
guesses the drainage of the wound in your picture
Type of Wound drainage?
Does your colleague guess the type of wound drainage?
 3- Wound color

Red

Yellow

Black

Choose one of the colors of the wound and search for a picture of it and ask your colleague to
guesses the color of the wound in your picture

wound color?
Does your colleague guess the wound color?
Scar Assessment

Observe scar location, length, width, and height

Scar color
Red or purplish color

Neutral color

Choose one type of scar color and search for a picture of it and ask your colleague to guesses
the color of the scar in your picture

scar color?
Does your colleague guess the scar color?
Hypertrophic scars

Keloids

Choose one type of scar search for a picture of it and ask your colleague to guesses the
scar type of your picture

Type of scar?
Does your colleague guess the type of the scar type?
Edema
1- Volumetric measurement

Procedure
1. Place the volumeter on the same level surface for each test.
2. Fill volumeter with tepid water (91.7° to 95°F) to the point of overflow.
3. Dry the collection beaker and place it below the spout.
4. Ask the patient to remove any jewelry.
5. Instruct the patient to keep the hand as vertical as possible and avoid contact with the sides
of the volumeter while slowly immersing the hand into the volumeter to avoid spillage over the
rim.
6. The palm of the hand should face the patient (forearm midposition), and the thumb should
face the spout.
7. The patient is asked to stop when the third web space makes contact with the dowel in the
volumeter and to wait until water stops spilling from the spout.
8. The water can then be measured in a graduated cylinder in milliliters or weighed. If the
overflow is greater than 500 mL, it will be necessary to pour the contents from the overflow
beaker into the graduated cylinder twice and add the sums together.
9. Record the results and repeat procedure on the opposite arm

Assess the volume of your colleague's hands and find the difference between his/her hands

2- Figure-of-8 Measurement
Procedure
The patient sits with the involved arm abducted and externally rotated 90 degrees, the
elbow flexed 90 degrees, the wrist neutral, the fingers adducted and extended, and the
thumb abducted in plane of the hand

1. Begin on the radial–palmar side of the wrist, aligning the distal edge of the measuring
tape with the distal wrist crease (see Fig. 57.3A).
2. Wrap the tape measure in an ulnar direction across the wrist, staying proximal to the
distal wrist crease until passing over the tendon of the flexor carpi ulnaris (see Fig.
57.3A).
3. The tape is then wrapped across the dorsum of the hand distally and obliquely,
passing over the midpoint of the second MCP head with the distal edge of the tape
aligned with the radial aspect of the palmar digital crease of the second digit (see Fig.
57.3B).
4. At the palmar digital crease of the second digit, the tape is drawn in an ulnar direction
across the palmar surface with the distal edge aligned with the palmar digital crease of
the fifth digit (see Fig. 57.3C).
5. Continuing over the palmar crease of the fifth digit, the tape is drawn back across the
dorsum of the hand in a proximal oblique direction, passing over the abductor pollicis
longus (APL) tendon (see Fig. 57.3D).
6. At the dorsum near the tendon of the APL, the distal edge of the tape is realigned
with the distal wrist crease and directed back to the starting point (see Fig. 57.3D).