College of Massage Therapists of British Columbia (CMTBC) Practice Exam

What does the Bishop’s Hand Deformity primarily affect?

1. Permanent extensor contracture

2. Intrinsic muscle function

3. Flexion at the proximal interphalangeal joints

4. Palmar grip strength

The correct answer is: Permanent extensor contracture

The Bishop’s Hand Deformity, also known as the "claw hand," is characterized by the atrophy of the intrinsic muscles of the hand, particularly affecting the interossei and the lumbricals. This deformity primarily leads to permanent extensor contracture, making it difficult for the individual to extend the affected fingers at the proximal interphalangeal joints. In this condition, the two main factors contributing to the deformity are the imbalance between the flexor and extensor forces on the fingers due to the weakened intrinsic muscles. This results in the predominance of the long flexors, causing the affected fingers to assume a flexed position at the proximal interphalangeal joints when trying to extend them. The other options do relate to the effects of the deformity, but the direct outcome associated with Bishop’s Hand is the contracture itself. Understanding this relationship helps clinicians address the functional limitations and design effective rehabilitation strategies for patients.