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BR 3rd Ed > Ch 4 - MSK: Hand > Flashcards

Ch 4 - MSK: Hand Flashcards

1
Q

Describe the Flexion ROM of the digits.

A

– MCP: 90°
– PIP: 90°
– DIP: 90°
– Thumb: MCP 50°, IP 90°

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2
Q

Describe the Extension ROM of the digits.

A

– MCP: 30°
– PIP: 0°
– DIP: 0 to 10°
– Thumb: MCP 0°, IP 20°

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3
Q

Describe the Abduction ROM of the digits.

A

– Finger: 20°

– Thumb: 70

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4
Q

Describe the Adduction ROM of the digits.

A

– Finger: 0°

– Thumb: 0°

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5
Q

Describe the muscles and innervation of Finger flexion.

A 
– FDP
■Digits 2 and 3 (AIN: C8, T1)
■ Digits 4 and 5 (ulnar n: C8, T1)
– FDS (median n: C7, C8, T1)
– Lumbricals
■ 1st and 2nd (median n: C8, T1)
■ 3rd and 4th (ulnar n:  C8, T1)
 – Dorsal and palmar interossei (ulnar n:  C8, T1)
 – FDM (ulnar n: C8, T1)
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6
Q

Describe the muscles and innervation of Finger extension.

A

– EDC (PIN: C7, C8)
– EIP (PIN: C7, C8)
– EDM (PIN: C7, C8)

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7
Q

Describe the muscles and innervation of Finger abduction.

A

– 4–Dorsal interossei (ulnar n: C8, T1)

– ADM (ulnar n: C8, T1)

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8
Q

Describe the muscles and innervation of Finger adduction.

A

3-Palmar interossei (ulnar n: C8, T1)

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9
Q

Describe the muscles and innervation of thumb flexion.

A

– FPB (superficial head: median n; deep head: ulnar n: C8, T1)
– FPL (AIN: C8, T1)
– Opponens pollicis (median n: C8, T1)
– Adductor pollicis (ulnar n: C8, T1)

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10
Q

Describe the muscles and innervation of thumb extension.

A

– EPL (PIN: C7, C8)
– EPB (PIN: C7, C8)
– APL (PIN: C7, C8)

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11
Q

Describe the muscles and innervation of thumb abduction.

A

– APL (PIN: C7, C8)

– APB (median n: C8, T1)

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12
Q

Describe the muscles and innervation of thumb adduction.

A

– Adductor pollicis (ulnar n: C8, T1)

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13
Q

Describe the muscles and innervation of thumb opposition to 5th digit.

A

– Opponens pollicis (median n: C8, T1)
– FPB, superficial head (median n: C8, T1)
– APB (median n: C8, T1)
– Opponens digiti minimi (ulnar n: C8, T1)

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14
Q

What is the MOI of collateral ligaments of MCP and PIP?

A

Valgus or varus stress with the finger in an extended position

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15
Q

What is the MOI of volar plate of MCP and PIP?

A

Hyperextension with dorsal dislocation, which is usually reducible

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16
Q

What imaging is needed to assess collateral ligament or volar plate injuries?

A

AP and lateral views to r/o fx, ensure proper reduction and congruency of the joint

17
Q

Who typically gets gamekeeper’s thumb?

A

Skiers
Basketball players
Ball-handling athletes

18
Q

What is the MOI of gamekeepers’ thumb?

A

Forceful radial deviation of the proximal phalanx at the MCP joint

19
Q

What is a Stener’s lesion?

A

Complex tears l/t entrapment of the adductor aponeurosis in the MCP joint and impair healing

20
Q

What indicates instability on radiographs in gamekeeper’s thumb?

A

Radial deviation >40° in extension and >20° in flexion

21
Q

What is the treatment of gamekeeper’s thumb?

A
  • Short arm cast with thumb spica splint

* Stener’s lesion with failure to heal may need surgical treatment

22
Q

What is a jersey finger?

A

Complete or incomplete injury to the flexor tendon (superficialis and/or profundus)

23
Q

What is the classic MOI of a jersey finger?

A

athletes is when a Player’s finger gets caught in the jersey of another when attempting to grab him

24
Q

Which digit is typically involved in a jersey finger?

A

4th digit

25
Q

What is the clinical presentation of a jersey finger?

A

Patient unable to actively flex the DIP joint

26
Q

Describe testing of FDP.

A

Flex the DIP while the PIP joint is held in extension

FDS action eliminated with PIP in extension

27
Q

Describe testing of FDS.

A

Hold the DIP of the noninvolved digits in extension and flex the unrestrained digit

28
Q

What is the MOI of a mallet finger?

A

Sudden passive flexion of the DIP joint when the finger is extended, causing a rupture of the extensor tendon

29
Q

What can occur with a mallet finger injury?

A

Avulsion fracture of the distal phalanx

30
Q

What is the conservative treatment of a mallet finger?

A

Splinting of the DIP in extension for 6 to 8 weeks with a stack splint or custom-made splint

31
Q

What should be done after 6 weeks of conservative treatment of a mallet finger?

A

Gentle active flexion with night splinting should be done for 2 to 4 weeks

32
Q

When is surgery indicated for mallet finger?

A

Poor healing

Avulsed fragment involves >1/3 of the joint

BR 3rd Ed (92 decks)

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