4- Upper Limb Conditions

Question 1

What forms the carpal tunnel in the wrist?

Answer 1

Carpal bones

Flexor retinaculum

Question 2

Which clinically important nerve passes through the carpal tunnel?

Answer 2

Median nerve

Question 3

How does carpal tunnel syndrome arise?

Answer 3

Swelling/synovitis in the tunnel causes median nerve compression

Question 4

List aetiology + conditions assoc. with carpal tunnel syndrome

Answer 4

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

Question 5

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

Answer 5

True

Question 6

List clinical features of carpal tunnel syndrome

Answer 6

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

Question 7

What is Tinel’s test?

Answer 7

Percussion over the median nerve

Question 8

What is Phalen’s test?

Answer 8

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

Question 9

Describe surgical treatment of carpal tunnel syndrome

Answer 9

Division of transverse carpal ligament under local anaesthetic

Question 10

Which nerve is compressed in cubital tunnel syndrome? Where?

Answer 10

Ulnar nerve, behind the medial epicondyle

Question 11

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

Answer 11

Osborne’s fascia

Question 12

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

Answer 12

Lateral epicondyle

Medial epicondyle for common flexor origin

Question 13

What is the nickname for lateral epicondylitis?

Answer 13

Tennis elbow

Question 14

What muscle origin is stressed in lateral epicondylitis?

Answer 14

Common extensor origin (resisted extension)

Question 15

What is the nickname for medial epicondylitis?

Answer 15

Golfer’s elbow

Question 16

What muscle origin is stressed in medial epicondylitis?

Answer 16

Common flexor origin

Question 17

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

Answer 17

True

becos more people play tennis lol

Question 18

What is Dupuytren’s disease?

Answer 18

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

Question 19

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

Answer 19

Type III

Question 20

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

Answer 20

Ring finger

Little finger

Question 21

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

Answer 21

True

10:1

Question 22

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

Answer 22

30’

Question 23

What surgical procedures are done for Dupuytren’s disease?

Answer 23

Fasciectomy
Fasciotomy
Amputation (severe)

Question 24

What is trigger finger?

Answer 24

Clicking/locking of finger in flexed position

Question 25

How does trigger finger arise?

Answer 25

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

Question 26

Outline treatment of trigger finger

Answer 26

Steroid injection

Surgical incision

Question 27

Which joints in the hand are usually affected by OA?

Answer 27

PIPJs

DIPJs

Question 28

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

Answer 28

Bony thickening in the hands

DIPJs

Question 29

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

Answer 29

Bony swellings in the hands

PIPJs

Question 30

Which hand joints are usually affected by RA?

Answer 30

MCPJs

Question 31

List hand manifestations of RA

Answer 31

Swan-neck
Ulnar deviation
Boutonniere deformity
Z-thumb

Question 32

What is Boutonniere deformity?

Answer 32

Flexion at PIPJ + hyperextension at DIPJ

Question 33

What is swan-neck deformity?

Answer 33

Flexion at PIPJ + flexion at DIPJ