What does the CHT exam cover?

Upper-extremity anatomy and kinesiology, wound and scar healing, orthopedic conditions, tendon and nerve injuries, evaluation, orthoses/splinting, interventions and modalities, and surgery/post-op rehab.

The Hand Therapy Certification Commission (HTCC) offers the Hand Therapy Certification Examination (CHT) to qualified occupational and physical therapists.

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100+ Free CHT Practice Questions

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Sample CHT Practice Questions

Try these sample questions to test your CHT exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1How many bones make up the human wrist (carpus)?

A.8

B.6

C.10

D.12

Explanation: The carpus consists of 8 carpal bones arranged in two rows. The proximal row (radial to ulnar) is scaphoid, lunate, triquetrum, and pisiform; the distal row is trapezium, trapezoid, capitate, and hamate.

2Which muscle is the primary flexor of the distal interphalangeal (DIP) joint of the fingers?

A.Flexor digitorum profundus

B.Flexor digitorum superficialis

C.Lumbricals

D.Flexor carpi radialis

Explanation: The flexor digitorum profundus (FDP) inserts on the distal phalanges and is the only muscle that flexes the DIP joints. The flexor digitorum superficialis flexes the PIP joints by inserting on the middle phalanges.

3The median nerve provides motor innervation to which of the following intrinsic muscles?

A.All interossei

B.Adductor pollicis

C.Abductor pollicis brevis

D.Abductor digiti minimi

Explanation: The recurrent (motor) branch of the median nerve supplies the thenar muscles, including abductor pollicis brevis, opponens pollicis, and the superficial head of flexor pollicis brevis. The ulnar nerve supplies the interossei, adductor pollicis, and hypothenar muscles.

4Which carpal bone is most commonly fractured?

A.Scaphoid

B.Lunate

C.Triquetrum

D.Hamate

Explanation: The scaphoid is the most commonly fractured carpal bone, typically from a fall on an outstretched hand. Because its blood supply enters distally, proximal pole fractures are at high risk for avascular necrosis and nonunion.

5What is the normal active range of motion for flexion of the metacarpophalangeal (MCP) joint of the fingers?

A.Approximately 0-90 degrees

B.Approximately 0-30 degrees

C.Approximately 0-120 degrees

D.Approximately 0-160 degrees

Explanation: The finger MCP joints normally flex to approximately 90 degrees. The PIP joints flex to about 100-110 degrees and the DIP joints to about 70-90 degrees, which together contribute to total active motion.

6The 'intrinsic plus' (safe) position for hand immobilization places the MCP joints in which position?

A.Flexion of 60-70 degrees

B.Full extension

C.Hyperextension

D.Neutral with IP joints flexed

Explanation: The intrinsic-plus or 'safe' position places the MCP joints in 60-70 degrees of flexion with the IP joints in full extension and the wrist slightly extended. This keeps the collateral ligaments at maximal length to prevent contracture.

7Which nerve innervates the dorsal sensory area of the thumb, index, and middle fingers' dorsum proximal to the DIP?

A.Radial nerve (superficial branch)

B.Median nerve

C.Ulnar nerve

D.Posterior interosseous nerve

Explanation: The superficial branch of the radial nerve supplies sensation to the dorsal-radial hand and the dorsum of the thumb, index, middle, and radial half of the ring finger proximal to the DIP joints. The fingertips' dorsum is supplied by the median nerve.

8The lumbrical muscles produce which combined action at the fingers?

A.Flexion of the MCP and extension of the IP joints

B.Extension of the MCP and flexion of the IP joints

C.Flexion of all finger joints

D.Abduction of the fingers

Explanation: The lumbricals originate from the FDP tendons and insert into the extensor mechanism, producing MCP flexion with simultaneous PIP and DIP extension. This is the basis of the lumbrical or 'intrinsic plus' grip.

9Which structure is the primary restraint to valgus stress at the thumb MCP joint, commonly injured in 'skier's thumb'?

A.Radial collateral ligament

B.Volar plate

C.Ulnar collateral ligament

D.A1 pulley

Explanation: The ulnar collateral ligament (UCL) of the thumb MCP resists valgus (radially directed) stress. Acute rupture is called 'skier's thumb,' while chronic attritional injury is 'gamekeeper's thumb.'

10The carpal tunnel is bounded volarly by which structure?

A.Extensor retinaculum

B.Palmar aponeurosis

C.Transverse carpal ligament (flexor retinaculum)

D.Pronator quadratus

Explanation: The transverse carpal ligament (flexor retinaculum) forms the volar roof of the carpal tunnel, attaching to the scaphoid tubercle and trapezium radially and the pisiform and hook of hamate ulnarly. The carpal bones form the floor.

About the CHT Practice Questions

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