5. Wrist & Hand Flashcards

1
Q

CMC

A

Carpometacarpal joint; thumb joint; saddle-joint

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2
Q

MCP

A

Metacarpal-phalangeal joints; Collateral ligaments; knuckles

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3
Q

IP

A

Interphalangeal joints; hinge joints; collateral ligaments; thumb = 1 joint; Digits 2-5 have PIP & DIP

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4
Q

Ulnar n.

A

Travels between pisiform & hamate; Peripheral nerve innervation palmar and dorsal surface of hand 1/2 of 4th digit & all of 5th

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5
Q

Median n.

A

Travels between pisiform & scaphoid; carpal tunnel; Peripheral nerve innervating majority of palmar hand surface & dorsal tips of digits 2, 3, & 1/2 of 4.

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6
Q

Radial n.

A

Travels under radial styloid; Innervates majority of dorsal hand surface & dorsal thumb

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7
Q

Radial a.

A

Under styloid process of radius

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8
Q

Ulnar a.

A

BIFURCATES AROUND HAMATE

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9
Q

Wrist extensors

A

Extensor carpi radialis (longus & brevis); Extensor carpi ulnaris

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10
Q

Wrist flexors

A

Flexor carpi radialis; Flexor carpi ulnaris

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11
Q

Ulnar deviators

A

Extensor carpi ulnaris; Flexor carpi ulnaris

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12
Q

Radial deviators

A

Extensor carpi radialis; Flexor carpi radialis

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13
Q

Thumb Abductor

A

Abductor pollicus longus (radial)

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14
Q

Thumb Extensors

A

Extensor pollicus brevis (radial); Extensor pollicus longus (ulnar); Abductor pollicus longus (radial)

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15
Q

Thumb Flexor

A

Flexor pollicus

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16
Q

Finger flexion

A

Flexor digitorum superficialis & profundus

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17
Q

Finger extension

A

Extensor digitorum; Extensor indicis

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18
Q

Thenar eminence innervation

A

Median n.

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19
Q

Hypothenar eminence innervation

A

Ulnar n.

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20
Q

Carpal Tunnel Syndrome Tests

A

Tinel sign; Phalan’s; Reverse Phalan’s

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21
Q

Finkelstein’s Test

A

Test for DeQuevain’s Disease; patient makes fist around thumb and actively ulnar deviates; (+) = pain at thumb extensors/abductors

22
Q

DeQuevain’s Disease

A

Tenosynovitis of abductor pollicus longus & extensor pollicus brevis

23
Q

Allen Test

A

Test for patency of ulnar and radial aa.

24
Q

Wrist sprains - Mechanism

A

Falling, forced hyperextension or hyperflexion

25
Q

Scaphoid

A

Most commonly fractured carpal; forced hyperextension from fall

26
Q

Boxer’s Fracture

A

Fx of shaft of 5th MC often from wall punch

27
Q

Colles’ Fracture

A

Ben’s fracture; Distal complete fx of radius; Bones drop inferiorly; Unable to actively supinate

28
Q

Most commonly dislocated carpal bone

A

Lunate

29
Q

Sign of Lunate Dislocation

A

3rd knuckle will ride more proximally

30
Q

Trigger Finger

A

Tendon nodule catches in sheeth of finger flexor tendon; Finger tends to “stick”; Palpate with active flexion & extension of phalange; sudden palpable and audible snap

31
Q

Mallet Finger

A

Inability to extend DIP due to rupture of extensor tendon

32
Q

Ganglion Cysts

A

Fluid filled cysts in tendon sheeths; Non-tender; Usually occurs around wrist extensors; COMMON IN TRUCK DRIVERS

33
Q

Tendon Sheeth Ganglion

A

Nodule in flexor tendon sheath; TENDER to palpation

34
Q

Gamekeeper’s Thumb

A

Ulnar Collateral Lig. Sprain of thumb due to hyperextension; from direct blow or falling

35
Q

Skier’s Thumb

A

Ulnar Collateral Lig. Sprain of thumb due to hyperabduction; from falling on outstretched arm while holding something like a ski pole or shovel

36
Q

Volkmann’s Contracture

A

Flexion contracture of elbow & wrist; WRIST EXTENSION CAUSES FINGER FLEXION; Post fracture/dislocation/compartment syndrome

37
Q

Drop Wrist Palsy

A

Extensor muscles of wrist are damaged due to radial n. damage; wrist & fingers can’t extend

38
Q

Claw Hand Deformity

A

Hyperextension of MCP; Flexion of PIP & DIP; due to MEDIAN & ULNAR NERVE PALSY

39
Q

Ape Hand Deformity

A

Inability to oppose or flex thumb due to MEDIAN NERVE PALSY

40
Q

Dupuytren’s Contracture

A

Contracture of palmar fascia; FIXED FLEXION OF MCP & PIP; USUALLY 4TH AND 5TH DIGITS; skin often adheres to fascia

41
Q

Swan Neck Deformity

A

Flexion of MCP; Ext of PIP; Flexion of DIP; frequently caused by RA

42
Q

Boutonniere Deformity

A

Extension of MCP; Flexion of PIP; Extension of DIP; Usually due to tendon rupture

43
Q

Deformities specific to Osteoarthritis

A

Bouchard’s nodes; Heberden’s nodes

44
Q

Bouchard’s Nodes

A

At PIP joint; dorsal surface

45
Q

Heberden’s Nodes

A

At DIP joint; dorsal surface

46
Q

Rheumatoid Arthritis

A

Ulnar deviation of MCP joints only; Flexion of PIP

47
Q

Osler’s Nodes

A

Small, tender nodes in finger pads indicative of bacterial endocarditis

48
Q

Causes of clubbing

A

CHF; COPD; Lung cancer; Lung abscess

49
Q

Cause of spoon nails

A

Plummer-Vinson Syndrome; also causes dysphagia

50
Q

Subungual Hematoma

A

Blood accumulation under the nail; direct trauma