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prevention and care exam 2 > Arm, Wrist, Hand > Flashcards

Arm, Wrist, Hand Flashcards

1
Q

importance of condyles

A

attachment of ligaments and tendons

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2
Q

MOI elbow sprains

A
  • falling either on a flexed or fully extended arm
  • hyperextension
  • valgus force – outwards angulation of distal segment
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3
Q

UCL

A

ulnar collateral ligament:

- anterior band

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4
Q

S&S of elbow sprain

A
  • point tenderness

- pain in hyperextension

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5
Q

elbow sprain

A
  • dislocations constitute extreme sprains

- difficult to do

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6
Q

Valgus

A

Elbow overload stress:

  • weight bearing or non weight bearing (throwing)
  • acute vs. chronic (overuse)
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7
Q

medial overload stress

A

distraction or tensile forces on UCL

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8
Q

lateral overload stress

A
  • compression and shear forces bw radial head and capitellum

- causes erosion or articular surfaces

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9
Q

Dislocation: elbow

A
  • posterior displacement of ulna (olecranon process)
  • high force trauma
  • gross deformity
  • major damage to ligaments and connective tissue
  • damage to muscle and tendon
  • possible nuerovascular symptoms
  • fracture to ulna (coronoid process) - arrow
  • no movement – fixed position
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10
Q

frank jobe

A

passed away – created tommy jones surgery

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11
Q

immediate care of dislocations

A

PRICE

  • immobilize limb
  • monitor distal pulse and capillary refill
  • check for hand/finger movements
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12
Q

what r/o vascular compromise in elbow dislocation

A

monitor distal pulse and capillary refill

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13
Q

r/o nerve damage

A

check for hand/finger movements

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14
Q

Elbow- medial epicondylitis

A

medial epicondyle is larger than lateral

- attachment of wrist flexors

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15
Q

MOI of Elbow- medial epicondylitis

A

overuse from repetitive stress

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16
Q

S&S of Elbow- medial epicondylitis

A
  • point tender over epicondyle
  • weakness of grip
  • stiffness
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17
Q

little league or golfers elbow

A

Elbow- medial epicondylitis

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18
Q

Elbow Injuries: Lateral Epicondylitis

A

attachment of wrist extensors (tennis elbow)

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19
Q

S&S of Elbow Injuries: Lateral Epicondylitis

A
  • point tender over epicondyle
  • stiffness
  • weakness of grip
  • chronic stress
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20
Q

MOI Elbow Injuries: Lateral Epicondylitis

A

repetitive stress

  • gripping w/ wrist movements
  • eccentric loading ``
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21
Q

management of Elbow Injuries: Lateral Epicondylitis

A

stretching and strapping

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22
Q

distal radio ulnar joint

A

pronation/supination

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23
Q

radio-carpal and ulnocarpal joints

A

flex/ext

radial/ulnar deviation (ab/adduct)

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24
Q

wrist: colles fracture

A

distal plate region of distal radius

common

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25
Q

MOI of wrist: colles fracture

A

FOOSH- wrist EXTENDED

  • fall on out stretched hand
  • common in early adolescent
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26
Q

S&S of wrist: colles fracture

A
  • deformity
  • swelling
  • severe pain
  • LOSS OF WRIST FUNCTION
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27
Q

treatment of wrist: colles fracture

A
  • PRICE
  • splint w/ swing and swathe
  • keep fignertips exposed
  • refer to xray
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28
Q

what do to with displaced or deformed arm

A

always stabilize and immobilize

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29
Q

xray of wrist: colles fracture

A

dorsal tilt

silver fork deformity

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30
Q

Wrist Smith Fracture

A

distal radius similar to wrist: colles fracture

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31
Q

MOI of Wrist Smith Fracture

A

wrist FLEXED (opposite of colles w/ ext)

32
Q

S&S of Wrist Smith Fracture

A

same as colles: -deformity (garden spade)

  • swelling
  • severe pain
  • LOSS OF WRIST FUNCTION
  • VOLAR- PALM TILT
33
Q

treatment of Wrist Smith Fracture

A

similar to colles

34
Q

CTS: wrist

A

carpal tunnel syndrome

NUEROPATHY–> deals with nerves not tendon

35
Q

MOI of CTS

A

overuse in awkward hand positions

- gripping or vibration stimulus

36
Q

who is likely to get CTS

A

keyboard operator
typist,
DENTAL HYGENIST (MOST COMMON)

37
Q

What is CTS

A
  • inflammation of median nerve OR - increased fluid pressure in tunnel that compresses median nerve
  • wrist flexion increases symptoms
38
Q

structural boundaries of CTS

A

Roof: transverse carpal and ligament (flexor retinaculum)
basement: carpal bones

39
Q

Inside boundaries of CTS

A

flexor tendons of digits and median nerves

40
Q

management of CTS

A
  • no real treatment (self-limiting)

- conservative: exercises for forearm muscles, wrist brace (night)

41
Q

surgical management of CTS

A
  • release of transverse carpal ligament

- poor outcomes

42
Q

Wrist/hand injuries: FX of scaphoid

A

FOOSH

  • Waist: peanut shaped
    • point tenderness: anatomical snuff box
  • xrays
43
Q

volar FX of scaphoid

A

abductor pollcis longus (APL) and EPB

44
Q

Dorsal FX of scaphoid

A

Extensor Pollicis Longus

45
Q

complication FX of scaphoid

A
    • non-union fracture
  • avascular necrosis (AVN)
  • proximal segment fails to heal and becomes necrotic
46
Q

surgical repair of FX of scaphoid non union fracture

A

bone graft: to get two bones to fuse together

47
Q

Handlebar Palsy

A

Tunnel of Guyon: pisiform and hook of hamate (ulnar nerve)

**condition not injury

48
Q

Handlebar Palsy MOI

A

compression

49
Q

S&S of Handlebar Palsy

A

numbness, tingling, weak grip

50
Q

Handlebar Palsy is common in?

A

cyclists and weight lifters

51
Q

splinting of wrist/hand injuries

A
  • immobilize joints above/below injured site
  • resting position
  • bandage distal to proximal
  • board under
  • place something in hand for ext.
52
Q

Bennett’s FX: hand

A
  • base of 1st metacarpal

- carpo-metacarpal joint of thumb: base of thumb by hand

53
Q

MOI of Bennett’s FX: hand

A

axial loading with slight flexion

54
Q

FX and dislocation of Bennett’s FX: hand

A
  • oblique
    • base of 1st MC subluxate from pull of abductor pollicis longus tendon that inserts on it
    • non union FX
55
Q

Bennett’s FX: hand most common in

A

dodgeball

56
Q

S&S Bennett’s FX: hand

A
  • point tender
  • xray
  • deformity
  • decrease
57
Q

Problem with Bennett’s FX: hand

A
  • can become arthritic and hypomobile– stiffness

- thumb is important digit: highly mobile and opposition and pinching

58
Q

Gamekeeper’s thumb

A

unstable thumb

59
Q

MOI of Gamekeeper’s thumb

A
  • valgus force of hyper-abducted thumb

- ski pole injury and sprain and rupture of UCL

60
Q

S&S Gamekeeper’s thumb

A
  • pain over the area of the ulnar collateral ligament
  • snapping or popping at time of injury
  • swelling of MCP joint
  • inability to move thumb and grip tightly using thumb
61
Q

Stener Lesion

A

distal attachment becomes avulsed and displaced

62
Q

What prevents re attchachment of torn ends in Stener Lesion

A

interposing aponeurosis

63
Q

Stener Lesion unstable 1st MCP joint

A

impairs prehension (grasping)

64
Q

complication with Stener Lesion

A

impairs healing and grasping

65
Q

management of gamekeeper’s thumb

A

taping and bracing to prevent hyper abduction

66
Q

complication with gamekeepers thumb

A

Stener Lesion

67
Q

mallet finger

A

Distal phalengeal joint

68
Q

MOI of mallet finger

A

jamming tip of finger with forced flexion

69
Q

S&S of mallet finger

A

avulsion fx off distal phalanx: extensor tendon

-deformity: ext. lag (flex 30 degrees)

70
Q

management of mallet finger

A

splint into extension

71
Q

Boutonniere deformity

A

button hole

72
Q

MOI Boutonniere deformity

A

-axial loading with forced flex of prox. phalangeal

73
Q

lateral slip to distal phalanx intact causes

A

hyperextension of DIP

74
Q
  • rupture of central slip of extensor tendon to middle phalanx causes
A

flex of PIP

75
Q

surgical treatment of boutonniere

A

re attach avulsed segment

prevention and care exam 2 (4 decks)

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