4- Upper Limb Conditions Flashcards

1
Q

What forms the carpal tunnel in the wrist?

A

Carpal bones

Flexor retinaculum

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2
Q

Which clinically important nerve passes through the carpal tunnel?

A

Median nerve

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3
Q

How does carpal tunnel syndrome arise?

A

Swelling/synovitis in the tunnel causes median nerve compression

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4
Q

List aetiology + conditions assoc. with carpal tunnel syndrome

A

Rheumatoid arthritis
Pregnancy, diabetes, renal failure
Wrist fracture (Colles)

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5
Q

Women are more affected than men by carpal tunnel syndrome. True/False?

A

True

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6
Q

List clinical features of carpal tunnel syndrome

A

Parasthesiae in median-nerve-innervated fingers
Weakness, clumsiness
Muscle wasting

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7
Q

What is Tinel’s test?

A

Percussion over the median nerve

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8
Q

What is Phalen’s test?

A

Hold wrist hyper-flexed (decreases space in carpal tunnel)

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9
Q

Describe surgical treatment of carpal tunnel syndrome

A

Division of transverse carpal ligament under local anaesthetic

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10
Q

Which nerve is compressed in cubital tunnel syndrome? Where?

A

Ulnar nerve, behind the medial epicondyle

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11
Q

What is the name of the tight band of fascia that forms the roof of the cubital tunnel?

A

Osborne’s fascia

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12
Q

The common extensor origin of the upper limb arises from which epicondyle?

A

Lateral epicondyle

Medial epicondyle for common flexor origin

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13
Q

What is the nickname for lateral epicondylitis?

A

Tennis elbow

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14
Q

What muscle origin is stressed in lateral epicondylitis?

A

Common extensor origin (resisted extension)

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15
Q

What is the nickname for medial epicondylitis?

A

Golfer’s elbow

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16
Q

What muscle origin is stressed in medial epicondylitis?

A

Common flexor origin

17
Q

Lateral epicondylitis is more common than medial epicondylitis. True/False?

A

True

becos more people play tennis lol

18
Q

What is Dupuytren’s disease?

A

Hyperplasia of palmar fascia, forming nodules and cords causing contractures of MCP and PIP joints

19
Q

Which type of collagen is produced in Dupuytren’s disease?

A

Type III

20
Q

Which fingers are usually affected by contracture in Dupuytren’s disease?

A

Ring finger

Little finger

21
Q

Males are more affected by Dupuytren’s than females. True/False?

A

True

10:1

22
Q

Up to how many degrees of Dupuytren’s contracture at the MCP joint can be tolerated before surgery is recommended?

A

30’

23
Q

What surgical procedures are done for Dupuytren’s disease?

A

Fasciectomy
Fasciotomy
Amputation (severe)

24
Q

What is trigger finger?

A

Clicking/locking of finger in flexed position

25
Q

How does trigger finger arise?

A

Tendonitis of flexor tendon causes nodular enlargement which catches in fascia over metacarpal

26
Q

Outline treatment of trigger finger

A

Steroid injection

Surgical incision

27
Q

Which joints in the hand are usually affected by OA?

A

PIPJs

DIPJs

28
Q

What are Heberden’s nodes? Which joints do they affect?

A

Bony thickening in the hands

DIPJs

29
Q

What are Bouchard’s nodes? Which joints do they affect?

A

Bony swellings in the hands

PIPJs

30
Q

Which hand joints are usually affected by RA?

A

MCPJs

31
Q

List hand manifestations of RA

A

Swan-neck
Ulnar deviation
Boutonniere deformity
Z-thumb

32
Q

What is Boutonniere deformity?

A

Flexion at PIPJ + hyperextension at DIPJ

33
Q

What is swan-neck deformity?

A

Flexion at PIPJ + flexion at DIPJ