4- Upper Limb Conditions Flashcards
What forms the carpal tunnel in the wrist?
Carpal bones
Flexor retinaculum
Which clinically important nerve passes through the carpal tunnel?
Median nerve
How does carpal tunnel syndrome arise?
Swelling/synovitis in the tunnel causes median nerve compression
List aetiology + conditions assoc. with carpal tunnel syndrome
Rheumatoid arthritis
Pregnancy, diabetes, renal failure
Wrist fracture (Colles)
Women are more affected than men by carpal tunnel syndrome. True/False?
True
List clinical features of carpal tunnel syndrome
Parasthesiae in median-nerve-innervated fingers
Weakness, clumsiness
Muscle wasting
What is Tinel’s test?
Percussion over the median nerve
What is Phalen’s test?
Hold wrist hyper-flexed (decreases space in carpal tunnel)
Describe surgical treatment of carpal tunnel syndrome
Division of transverse carpal ligament under local anaesthetic
Which nerve is compressed in cubital tunnel syndrome? Where?
Ulnar nerve, behind the medial epicondyle
What is the name of the tight band of fascia that forms the roof of the cubital tunnel?
Osborne’s fascia
The common extensor origin of the upper limb arises from which epicondyle?
Lateral epicondyle
Medial epicondyle for common flexor origin
What is the nickname for lateral epicondylitis?
Tennis elbow
What muscle origin is stressed in lateral epicondylitis?
Common extensor origin (resisted extension)
What is the nickname for medial epicondylitis?
Golfer’s elbow
What muscle origin is stressed in medial epicondylitis?
Common flexor origin
Lateral epicondylitis is more common than medial epicondylitis. True/False?
True
becos more people play tennis lol
What is Dupuytren’s disease?
Hyperplasia of palmar fascia, forming nodules and cords causing contractures of MCP and PIP joints
Which type of collagen is produced in Dupuytren’s disease?
Type III
Which fingers are usually affected by contracture in Dupuytren’s disease?
Ring finger
Little finger
Males are more affected by Dupuytren’s than females. True/False?
True
10:1
Up to how many degrees of Dupuytren’s contracture at the MCP joint can be tolerated before surgery is recommended?
30’
What surgical procedures are done for Dupuytren’s disease?
Fasciectomy
Fasciotomy
Amputation (severe)
What is trigger finger?
Clicking/locking of finger in flexed position
How does trigger finger arise?
Tendonitis of flexor tendon causes nodular enlargement which catches in fascia over metacarpal
Outline treatment of trigger finger
Steroid injection
Surgical incision
Which joints in the hand are usually affected by OA?
PIPJs
DIPJs
What are Heberden’s nodes? Which joints do they affect?
Bony thickening in the hands
DIPJs
What are Bouchard’s nodes? Which joints do they affect?
Bony swellings in the hands
PIPJs
Which hand joints are usually affected by RA?
MCPJs
List hand manifestations of RA
Swan-neck
Ulnar deviation
Boutonniere deformity
Z-thumb
What is Boutonniere deformity?
Flexion at PIPJ + hyperextension at DIPJ
What is swan-neck deformity?
Flexion at PIPJ + flexion at DIPJ
