105 lines
4.1 KiB
Mathematica
105 lines
4.1 KiB
Mathematica
DVBCWHT9 ;ALB/RLC HAND, THUMB, FINGERS WKS TEXT ; 16 JAN 2007
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;;2.7;AMIE;**120**;FEB 17, 2004;Build 4
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;
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TXT ;
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;;A. Review of Medical Records:
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;;
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;;B. Medical History (Subjective Complaints):
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;;
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;; Comment on;
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;;
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;; 1. History of hospitalizations or surgery (Date and location if known,
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;; reason or type of surgery).
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;; 2. History of trauma to hands or fingers.
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;; 3. History of neoplasm:
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;;
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;; a. Date of diagnosis, diagnosis.
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;; b. Benign or malignant.
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;; c. Types and dates of treatment.
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;; d. Date of last treatment.
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;;
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;; 4. Treatment-type, dose, frequency, response, and side effects.
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;; 5. Dominant hand and how determined.
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;; 6. Current symptoms-any decreased strength or dexterity.
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;; 7. Effects on occupational functioning and activities of daily living.
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;; 8. Are there flare-ups of joint disease affecting hand, thumb or fingers?
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;; If so:
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;;
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;; a. State severity, frequency and duration of flare-ups.
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;; b. Name precipitating and alleviating factors.
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;; c. Estimate to what extent, if any, flare-ups result in additional
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;; limitation of motion or functional impairment. (Per Veteran).
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;;
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;;C. Physical Examination (Objective Findings):
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;;
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;; Designate fingers as: thumb, index, long, ring, and little. Provide a detailed
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;;assessment of each affected joint. State whether the individual is right
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;;or left hand dominant. Use a goniometer for measuring joint angles. Refer to
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;;Residuals of Amputations worksheet, if applicable.
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;;
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;; 1. Evaluation of Ankylosis
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;;
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;;For each anklyosed joint, include angle of anklyosis. Describe any
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;;rotation or any angulation of bone.
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;;
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;;Zero degrees of flexion represents the fingers fully extended, making
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;;a straight line with the rest of the hand. The "position of function"
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;;of the hand is:
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;;
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;; Wrist dorsiflexion: 20 to 30 degrees
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;; Metacarpophalangeal flexion: 30 degrees
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;; Proximal interphalangeal joint flexion: 30 degrees
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;; Thumb abduction and rotation: thumb pad faces the finger pads.
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;;
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;; 2. Evaluation of Limitation of Motion of Single or Multiple Digits of the
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;; Hand
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;;
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;;Provide range of motion for each digit of the hand.
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;;
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;;Normal Ranges of Motion for index, long, ring and little fingers:
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;;
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;; Metacarpophalangeal joint: zero to 90 degrees of flexion
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;; Proximal interphalangeal joint: zero to 100 degrees of flexion
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;; Distal (terminal) interphalangeal joint: zero to 70 or 80 degrees
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;; of flexion
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;;
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;; 3. Evaluation of Hand as a unit
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;;
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;;Measure the gap, in inches:
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;;
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;; Between the tip of the thumb and the fingers
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;; Between the tips of the fingers and the proximal transverse crease
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;; of the palm
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;; Between the thumb pad and the fingers with the thumb attempting
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;; to oppose the fingers
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;;
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;;Describe strength for pushing, pulling and twisting. Describe dexterity for
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;;twisting, probing, writing, touching and expression. Comment on whether and
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;;how (e.g. decreased range of motion, in degrees) the flexion deformity
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;;interferes with the function of the other fingers.
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;;
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;; 4. Additional detailed measurements and consideration of other factors
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;; affecting function
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;;
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;; a. Measure the active range of motion of each affected joint.
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;; b. Measure the range of motion of each affected joint after at least
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;; three repetitive motions. State whether and to what extent the
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;; range of motion (in degrees) is additionally limited by pain,
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;; fatigue, weakness, or lack of endurance following repetitive use.
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;; If more than one of these is present, state, if possible, which
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;; has the major functional impact. Include rationale for all
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;; conclusions. If unable to do repetitive motions, so state and
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;; provide reason.
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;;
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;;D. Diagnostic and Clinical Tests:
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;;
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;; 1. Include results of all diagnostic and clinical tests conducted in
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;; the examination report.
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;;
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;;E. Diagnosis:
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;;
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;;
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;;
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;;Signature: Date:
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;;END
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