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Musculoskeletal 1 > Conditions of Elbow, Hand and Wrist > Flashcards

Conditions of Elbow, Hand and Wrist Flashcards

1
Q

Common findings of carpal tunnel are? This is commonly due to?

A

Common Findings - paresthesias in median n. distribution (particularly at rest), (+) tine’s, Phalins and/or compression tests.
Due to - repetitive wrist motions/gripping, pregnancy, diabetes, or RA
- compression of median n. (inflamed nerve or tendons)
- long term may cause atrophy of thenar muscles

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2
Q

What medical diagnostic is used for carpal tunnel?

A
  • EMG

- NCV (70%)

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3
Q

If carpal tunnel is suspected what need to be ruled out?

A
  • cervical referral

- pronator teres syndrom

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4
Q

What is DeQuervain’s Tenosynovitis? Why does it happen?

A
  • inflammation of extensor policies braves & abductor polices longus tendons at first dorsal compartment
  • results from repetitive micro trauma or swelling during pregnancy.
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5
Q

Common findings of DeQuervain’s Tenosynovitis? Can medical diagnostics be used?

A
  • pain in snuffbox, swelling, decreased pinch/grip strength and/or positive Finkelstein’s test
  • MRI or USI but usually not needed
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6
Q

What is the difference between Colles’ fractures and Smith’s fractures (4)?

A
  • colles’ are most common
  • colles’ is the “dinner fork” deformity with DORSAL displacement with radial shift
  • smith’s is the “garden spade” deformity with VOLAR displacement with radial shift
  • both caused by FOOSH (immobile 5-8 weeks) carpal tunnel syndrome, and plain films
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7
Q

Most common fractured carpal is? How is it diagnosed?

A
  • scaphoid (FOOSH)
  • immobile 4-8 weeks
  • plain films (wrist series scaphoid view)
  • avascular necrosis of proximal fragment common
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8
Q

What is boxer’s fracture (4)?

A
  • fracture of neck of 5th metacarpal
  • caused by punching something
  • usually casted 2-4 weeks
  • plain films
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9
Q

What is Dupuytren’s contracture (5)?

A
  • banding on palm and digit flexion contracture
  • results from contracture of palmer fascia that adhere to skin
  • more prevalent in men than women
  • usually affects 4th and 5th digit in non-diabetics
  • usually affects 3rd and 4th in diabetics
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10
Q

What is Boutonniere deformity (4)?

A
  • rupture of central tends slop of extensor hood
  • extension of MCP and DIP
  • flexion of PIP
  • from trauma or RA degeneration of sheath
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11
Q

What is Swan Neck deformity (4)?

A
  • conjecture of intrinsic muscles with dorsal subluxation of lateral extensor tendons
  • extension of PIP
  • flexion of MCP and DIP
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12
Q

What is Ape hand deformity (3)?

A
  • thenar muscle atrophy, 1st digit moves dorsally until inline with 2nd
  • median n. dysfunction
  • EMG or NCV
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13
Q

What is Mallet finger (4)?

A
  • rupture/avulsion of extensor tendon at its insertion into distal phalanx of digit
  • flexion of DIP
  • trauma facing distal phalanx into flexed position
  • MRI or USI
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14
Q

What is Gamekeeper’s thumb(5)?

A
  • sprain or rupture of UCL of 1st MCP
  • result in medial instability of thumb
  • immobilized for 6 weeks
  • occurs during fall while skiing
  • MRI or USI
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15
Q

Distal humeral fractures complications include (6)?

A
  • loss of motion
  • myositis andossificans
  • malalignment
  • neurovasuclar compromise
  • ligament injury
  • CRPS
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16
Q

Supracondylar fractures (distal humerus) must be immediately examine for what?

A
  • neuromuscular impairment
  • radial nerve
  • high rate of malunion (bone doesn’t heal properly)
17
Q

Lateral epicondyle fractures common in what population?

A
  • young (often ORIF required)
18
Q

Clinical signs of an elbow dislocation include (3)?

A
  • rapid swelling
  • severe elbow pain
  • obvious deformity
19
Q

The majority of elbow dislocation are which direction (3)?

A
  • posteriolateral
  • often secondary to hyperextension
  • anterior and radial head dislocation only 1/2%
20
Q

Complete elbow dislocation may result in (5)?

A

injury/repture of the following…

  • UCL
  • anterior capsule
  • LCL
  • brachialis muscle
  • and/or wrist flex/ext.
21
Q

How can you determine causation of the loss of motion with elbow extension (4)?

A
  • if loss of motion is in capsular pattern = contracture
  • if non-capsular pattern = loose body, ligament sprain, and/or CRPS
  • diagnosis made by our clinical exam
  • capsular pattern is (Flex>Ext)
22
Q

What causes lateral epicondylagia (3)?

A
  • gradual onset secondary to repetitive wrist ext. and/or strong grip with extended wrist
  • chronic degeneration of extensor carpi radialis braves at lateral epicondyle
  • must rule out nerve involvement from cervical or peripheral (radial n.)
23
Q

What causes medial epicondylagia (3)?

A
  • gradual onset secondary to repetitive excessive pronation and/or strong gripping
  • chronic degeneration of pronator theres and/or flexor carpi radialis at medial epicondyle
  • must rule out nerve involvement from cervical or peripheral (ulnar n.)
24
Q

UCL injury at the elbow typically occurs from(1)? Clinical signs include (4)?

A
  • repetitive valgus stress with overhead activities
  • medial elbow pain
  • paraesthisa in ulnar distribution
  • (+) Tinel’s sign
  • MRI
25
Q

What can cause Ulnar nerve entrapment (6)?

A
  • trauma to cubital tunnel
  • traction d/t laxity at elbow
  • compression from thickened retinaculum
  • hypertrophy of flexor carpi ulnas
  • repeated subluxation or dislocation
  • DJD at cubital tunnel
26
Q

What can cause Median nerve entrapment (3)?

A
  • occurs with repetitive gripping activities

- entrapped in pronator theres and under superficial head of flexor digitorum superficial

27
Q

Clinical signs of Median nerve entrapment (3)?

A
  • aching pain and weakness in forearm
  • (+) Tinel’s sign
  • paraesthesia in median n. distribution
28
Q

Clinical signs of Ulnar nerve entrapment (3)?

A
  • medial elbow pain
  • (+) Tinel’s sign
  • paraesthesia in ulnar n. distribution
29
Q

Clinical signs of Radial nerve entrapment (3)?

A
  • lateral elbow pain
  • pain over supinator
  • paresthesia in radial distribution
30
Q

What can cause Radial nerve entrapment (2)?

A
  • entrapment of distal branches (posterior interosseous nerve) within the radial tunnel
  • commonly from overhead throwing activities
31
Q

What causes Osteochondriosis of Capitellum (4)?

A
  • repetitive compression fo capitellum and radial head
  • there is erosion of central and/or lateral aspect of capitellum or radial head
  • fragment may form loose body
  • occurs in youth 12-15 yr old
32
Q

What is Panner’s disease(3)?

A
  • localized avascular necrosis of capitellum
  • leads to loss of articular cartilage and subchondral bone
  • occurs in youth 10 and younger

Musculoskeletal 1 (10 decks)

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