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MSS Year 2 > DSA 23 Webb Elbow, Wrist, Hand > Flashcards

DSA 23 Webb Elbow, Wrist, Hand Flashcards

1
Q

What muscles attach to the medial epicondyle? (6)

A 
pronator teres
palmaris longus
flexor carpi ulnaris and radialis
flexor digitorum superficialis 
flexor pollicis longus
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2
Q

What muscles attach to the lateral epicondyle? (7)

A 
extensor carpi radialis longus and brevis 
supinator
anconeus
extensor carpi ulnaris 
extensor digitorum
extensor digiti minimi
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3
Q

Where does the ulnar nerve run?

A

close to the medial epicondyle down to the medial forearm and 4 and 5th digits

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4
Q

What tendon attaches at the olecranon?

A

triceps brachii tendon

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5
Q

What is a typical hx for a distal biceps rupture? (3)

A
  1. sudden force overload with elbow midflexion
  2. forced flexion
  3. males (50s)
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6
Q

What are PE findings in a distal bicep rupture? (4)

A
  1. swelling/bruising
  2. weakness in flexion with supination mostly effected
  3. palpable defect distal bicep
  4. popeye arm
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7
Q

What imaging test is confirmatory for a distal biceps rupture?

A

MRI

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8
Q

How is a distal bicep tendon rupture different from a proximal?

A

both heads are torn in a distal bicep tendon rupture

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9
Q

Where does the distal bicep tendon attach?

A

radial/bicipital tuberosity

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10
Q

What is tx for a distal bicep tendon rupture?

A

surgery unless comorbidities are present, more difficult to reattach the long you wait to operate

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11
Q

What is a typical hx for a tricep rupture? (2)

A
  1. pain, swelling, bruising

2. weakness with extension

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12
Q

What are some PE findings for a tricep rupture? (3)

A
  1. swelling, bruising
  2. weakness with extension
  3. gap where triceps attach
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13
Q

What are some findings on imaging for a tricep rupture?

A

xray - bone piece might be present

mri- confirm retraction

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14
Q

What is the tx for a tricep rupture?

A

surgically reattached with transosseous tunnels and suture

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15
Q

What is a typical hx for an elbow dislocation (2)

A
  1. severe elbow pain and deformity after fall on outstretched hand
  2. inability to move elbow
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16
Q

What are some PE findings for an elbow dislocation? (3)

A
  1. Inability to move elbow
  2. prominent boney structures like olecranon
  3. Shortened and flexed extremity
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17
Q

What imaging do you order for a dislocated elbow?

A

AP and Lateral xray

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18
Q

How do you classify dislocations?

A

the distal fragment in relation to the proximal fragment

19
Q

What structures are torn with dislocations?

A

collateral ligaments

20
Q

What is a Nursemaids Elbow?

A

In toddlers, adults pull child up by wrist with elbow extended, the child experienced immediate pain and wont use arm, holds arm across body in flexed pronated position

21
Q

How do you reduce a Nursemaids Elbow?

A

Firm, quick supination with elbow flexed

22
Q

What nerve is very important to check with a distal humerus fx?

A

radial nerve

23
Q

What is the usual tx for a distal humerus fx?

A

surgical fixation

24
Q

What is the tx for a nondisplaced olecranon fx?

A

nonoperative, a few weeks in a long arm cast/splint

25
Q

What is the tx for a displaced olecranon fx?

A

operative, screws and plates

26
Q

What are some PE findings for a radial head fx? (3)

A
  1. painful to palpate lateral elbow
  2. swelling
  3. painful supination and pronation
27
Q

What are the contents of the carpal canal? (4)

A

. Median Nerve and Flexor tendons (FDS, FDP, FPL)
Flexor digitorium Superficialis
Flexor digitorium profundus
Flexor pollicus longus

28
Q

Name the wrist bones (8)

A 
Scaphoid
Lunate
Triquestrum
Pisiform
Hamate
Capitate
Trapezoid
Trapezium
29
Q

Describe Tinels Test

A

lightly tapping (percussing) over the nerve to elicit a sensation of tingling or “pins and needles” in the distribution of the nerve

30
Q

Describe Phalens test

A

The patient is asked to hold their wrist in complete and forced flexion (pushing the dorsal surfaces of both hands together) for 30–60 seconds, symptoms (such as burning, tingling or numb sensation over the thumb, index, middle and ring fingers) conveys a positive test result and suggests carpal tunnel syndrome

31
Q

Describe Finkelsteins test

A

placing your thumb against your hand, making a fist with your fingers closed over your thumb, and then bending your wrist toward your little finger. If you have De Quervain’s tendinosis, this test is quite painful, causing tendon pain on the thumb side of the wrist.

32
Q

Describe Allen’s test

A
  1. The hand is elevated and the patient/person is asked to make a fist for about 30 seconds.
    1. Pressure is applied over the ulnar and the radial arteries so as to occlude both of them.
    2. Still elevated, the hand is then opened. It should appear blanched (pallor can be observed at the finger nails).
    3. Ulnar pressure is released and the colour should return in 7 seconds.

If color returns as described above, the Allen’s test is considered to be “positive.” If color fails to return, the test is considered “negative” and the ulnar artery supply to the hand is not sufficient. The radial artery therefore cannot be safely pricked/cannulated.

33
Q

What nerve can be pinched from a distal radius fx and the swelling?

A

median nerve in the carpal canal

34
Q

Describe a Colles’ fx

A

One of the most common distal radius fractures is a Colles fracture, in which the broken fragment of the radius tilts upward

35
Q

Describe a Smith’s fx

A

fractures of the distal radius with associated palmar angulation of the distal fracture fragment

36
Q

Describe a Barton’s fx

A

There exist two types of Barton’s fracture - dorsal[1] and palmar, the latter being more common.

Carpal displacement distinguishes this fracture from a Smith’s or a Colles’ fracture.

37
Q

Describe a Chauffeur’s fx

A

a type of fracture of the forearm, specifically the radial styloid process.

38
Q

When do you tx a scaphoid fx with surgery with screws?

A

if it is displaced or in a pt with high level use (athlete, surgeon)

39
Q

Describe a Boxer’s fx

A

fracture of the fourth and/or fifth metacarpal bones transverse neck

40
Q

When do you need to send dislocations to an orthopaedic?

A

when a fx is also present

41
Q

What is a typical hx for Mallet finger? (3)

A
  1. Can’t extend finger
  2. held in flexion at DIP joint
  3. Passively you can get the finger to extend but not actively
42
Q

Why do you get Mallet Finger?

A

The terminal extensor tendon has pulled off its distal attachment and the unopposed pull of the Flexor digitorium profundus on the distal phalanx pulls the joint into flexion

43
Q

When does a Mallet finger require surgery?

A

if the joint is subluxed or large boney fragments requires surgery

MSS Year 2 (6 decks)

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