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Brad 4th Ed Part 2 > Ch.38 Upper Extremity Wrist and Hand > Flashcards

Ch.38 Upper Extremity Wrist and Hand Flashcards

1
Q

Hx of FCU tendonitis

A

volar wrist pain w/ wrist flexion & ulnar deviation (racquet sports, golf)

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2
Q

What can be associated with FCU tedonitis?

A

Pisotriquetral compression sydnrome as pisiform bone embedded in FCU tendon

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3
Q

Tx of FCU tendonitis

A

wrist hand orthoses in 25 deg flexion or surgery to resect pisiform bone w/or w/o Z-plasty lengthening of FCU tendon

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4
Q

Hx of FCR tendonitis

A

Lateral wrist pain w/ wrist flexion, radial deviation and grip

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5
Q

Tx of FCR tendonitis

A

wrist hand orthoses in 25 deg flexion

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6
Q

Tendons involved in de Quervain’s syndrome

A

Abductor pollicis longus & extensor pollics brevis over radial styloid

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7
Q

Tx of de Quervain’s syndrome

A

rest, thumb spica splint, first dorsal compartment steroid injection

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8
Q

What is Intersection syndrome?

A

Friction b/w abductor pollicis longus & extensor pollicis brevis tedongs 4-6 cm proximal to Lister’s tubercle

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9
Q

Who is Intersection syndrome seen in?

A

Oarsmen, racquet sports, wt lifters

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10
Q

PE of Intersection syndrome

A

Dorsoradial distal forearm pain aggravated by wrist extension

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11
Q

Tx of Intersection syndrome

A

neutral wrist-hand orthosis, steroid injection to point at maximal tenderness, rarely surgery

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12
Q

Hx of extensor carpi ulnaris tendonitis

A

dorsoulnar wristpain w/ reptitive wrist extension & ulnar deviation in nondominant hand of tennis two-handed backhand

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13
Q

Hx of ECU subluxation

A

pop after forceful volar wrist flexion & ulnar deviation w/ pain

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14
Q

Tx of ECU tendonitis

A

neutral wrist-hand orthosis

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15
Q

What should be assessed for if pt w/ ECU tendonitis does not get better with conservative therapy?

A

Triangular fibrocartilage complex injury

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16
Q

Tx of ECU tendon subluxation

A

Acute: cast of wrist in pronated and dorsiflexion for 6 wk or surgery Chronic: sugrical reconstruction

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17
Q

What is the MC wrist ligament injury?

A

Scapholunate instability

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18
Q

Hx of scapholunate instability

A

Fall on hand in pronation, wrist extension & ulnar deviation

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19
Q

What is the dorsal intercalated segemental instability (DISI) pattern?

A

scaphoid into flexed position, lunate and triqetrum become extended

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20
Q

What test may indicate scapholunate instability?

A

Watson test

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21
Q

What can be seen on X-ray in DISI pattern?

A

scapholunate angle >60 deg on lateral view or gap >3 mm b/w scaphoid and lunate on AP view

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22
Q

Tx of scapholunate ligament injury

A

Surgery

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23
Q

What hand fx is prone to AVN or nonunion?

A

proximal or middle scaphoid fx d/t disrupted BS

24
Q

Tx of middle or proximal scaphoid fx

A

6 wk in long arm thumb-spica cast w/ elbow 90 deg flexion & wrist in neutral w/ thumb in slight ext & ABD

25
Q

Tx of distal 1/3 scaphoid fx

A

short arm thumb spica cast w/ wrist in neutral & thumb in slight ext & ABD

26
Q

MC fx of the body

A

distal radius

27
Q

What is the classification system for distal radius fx?

A

Frykman

28
Q

MC distal radius fx

A

Frkyman type I or Colles fx

29
Q

What is a Colles fx?

A

fx 2 cm proximal to distal radius w/ dorsal angulation of distal segment & radial shortening

30
Q

Tx of Colles fx

A

Closed reduction & immobilization w/ sugar tong splint w/ wrist in slight flexion & ulnar deviation for 3 days then cast for 6 wks if non-displaced on xray

31
Q

What is Kienbock’s disease?

A

Progressive collapse of lunate d/t repetitive compressive forces to wrist

32
Q

Hx of Keinbock’s disease

A

Pain & stiffness of wrist

33
Q

PE of Keinbock’s disease

A

Pain to palpation over dorsum of lunate

34
Q

Tx of Keinbock’s disease

A

immobilization to allow revascularization, may need surgery to correct ulnar minus wrist

35
Q

What is the trianular fibrocartilage complex (TFCC)?

A

Avascular central articular disc & vascular dorsal & palmar radioulnar ligaments

36
Q

Hx of TFCC injury

A

Axial load to wrist w/ rotational stress l/t locking & catching

37
Q

PE of TFCC injury

A

Pain at hollow b/w FCU & ECU tendon distal to ulnar styloid process

38
Q

Tx of TFCC injury

A

Surgery

39
Q

What can rupture of the central slip of extensor tendon at base of middle phalanx result in?

A

Boutonniere injury

40
Q

What is a Boutonneire injury?

A

Inability to actively extend PIP joint

41
Q

MOI of central slip extensor tedon rupture

A

Crush injury, forced flexion or lateral volar PIP dislocation

42
Q

What causes a mallet finger?

A

Disruption of distal extensor tendon at insertion on dorsal proximal aspect of distal phalanx

43
Q

What is the MOI of a mallet finger?

A

Hyperflexion force to an extended DIP joint

44
Q

PE of a mallet finger

A

DIP joint in flexed position, pt unable to actively extend

45
Q

Tx of a mallet finger

A

Splint DIP joint 24hr/day for 6-8 weeks

46
Q

MOI of flexor digitorum profundus rupture (jersey finger)

A

Forced extension of flexed finger

47
Q

Which finger is most likely to be effected by FDP tendon rupture?

A

Ring Finger

48
Q

What is the MC dislocated joint in the hand?

A

PIP joint

49
Q

What is the MC direction of PIP dislocation?

A

Dorsal

50
Q

Tx of dorsal PIP dislocation

A

Reduction, Xrays, 45 deg extension block splint with 10 deg reduction in angle each week

51
Q

What is a gameskeeper’s thumb?

A

1st metacarpophalangeal jointUCL sprain

52
Q

What is the MOI of a 1st MCP joint UCL sprain?

A

Radially directed force acrost 1st MCP joint

53
Q

What is a Stener lesion?

A

Interposition of adductor pollicis aponeurosis b/w proximal phalanx and UCL ligament

54
Q

Tx of 1st MCP joint UCL sprain

A

Partial: thumb spica splint; Rupture: surgery

55
Q

What is a jammed finger?

A

Collateral ligament sprains of DIP or PIP joints

Brad 4th Ed Part 2 (28 decks)

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