Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

*Surgery > Elbow, Forearm, Hand > Flashcards

Elbow, Forearm, Hand Flashcards

1
Q

What is functional ROM in the elbow?

A

30-130*

50 pronation

50 supination

Normal is 0-145

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What part of the UCL of the elbow is most important for valgus stress?

A

anterior bundle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Distal Biceps Rupture

A

tenderness to palpation, ecchymosis

may not feel a defect

hook test is reliable, MRI confirmation

loss of 40% supination strength and 30% flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Distal Biceps Rupture Risk Factors and Incidence

A

rare, dominant elbow, men in their 40s

steroids, smoking, hypovascularity, intrinsic degeneration, mechanical impingement in the space available for the biceps tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Treating distal biceps rupture

A

non- op in low-demand patient; will lose sup, flex, grip

surgical treatment for young health patients who dont want to lose function

1 vs 2 incision technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tennis Elbow

A

overuse syndrome of muscular inflammation

possible tears, degen of common extensor tendon

gradual onset, dull aching pain, worse with activity, radiates to forearm, flex/ext reproduces pain, normal xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tennis elbow vs Golfer elbow

A

T- lateral epicondyle

G- medial epicondyle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment of Tennis Elbow

A

rest, activity mod, PT, NSAIDs, corticosteroid injection, PRP

T elbow strap, long arm cast, self-limiting

surgery for recalcitrant cases (release of conjoint tendon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MCL/UCL of elbow

A

overhead athletes, valgus stress

microtraumas from repetitive valgus stress

late cocking and early acceptance of throwing

valgus load increases with poor throwing mechanics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treatment of MCL/UCL of elbow

A

Non-Op: 6 weeks rest, strengthening/change in mechanics, progressive throwing program

Operative: Tommy John

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Valgus Extension Overload

A

Pain at deceleration phase of throwing
pitching mechanics

Examination shows loss of extension, osteophytes of the posteromedial
olecranon

Treatment is rest or surgery if nonresponsive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Osteochondritis Dissecans

A

separation of articular cartilage and subchondral bone of the capitellum

After age 10, kids have better outcome than adult

risks: repetitive overhead motion, gymnasts, throwers

Types 1- intact, stable 2- collapse 3- loose body

1 no surg, panners no surg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Olecranon bursitis

A

acute traumatic blow

tender, painful swelling over olecranon

acutetx: aspiration with compression

chronic/recurrent tx: excision of bursa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Dislocation of elbow

A

fall on outstretched hand, obvious deformity, posterior more often, must diff from supracondylar fracture

emergent reduction, temp stiffness common, some residual restriction happens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Fracture of head/neck of radius

A

fall on open hand extended elbow

pain on rotation or flexion, tenderness, local swelling

Lesser fractures sling and splint with early motion

Displaced = ORIF

Peds = lesser is <30* angulation, otherwise ORIF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Fracture of Olecranon

A

fall on tip of elbow

Non-displaced- immobilize

Displaced- ORIF required; tension band wiring, allows early ROM exercise

17
Q

Carpal Tunnel

A

median nerve, wrist, most common UE neuropathy,

diabetes, pregnancy, repetitive motion, obesity

tingling in radial 3.5 digits
worse at night, drop things, cant open jars, thenar atrophy

tinels, phalens, med n compression test, 2 pt discrimination, semmes-weinstein, thumb opposition
EMG-NCV test

activity mod, splint, steroid, oral med

surgical ligament release for >3 mo

18
Q

Dupuytren’s Contracture

A

1 or more Nodular thickening an contraction of palmar fascia (RING*),
N Euro genetic disposition, Men >50, epileptics, DM, Pulm, alcohol, smoking, vibrational repetitive trauma

difficulty grasping things, gloves, putting hand in pocket

splints meh, percutaneous aponeurotomy, collagenase injection, surgery to excise cords, release joint, skin closure

19
Q

Trigger Finger

A

painful locking of digit due to thickened flexor tendon, 3-4 digit in adult, thumb in peds, idiopathic or RA/DM

pain, catching, painful nodule

rest, NSAIDs, injection
Surgical release of A1 pulley

20
Q

DeQuervain’s Tenosynovitis

A

Swelling or stenosis of the tendon sheath surrounding the APL and EPB

Locking and pain within the radialaspect of the wrist

middle aged women and repetitive use of thumb

tender to palpation, finkelsteins

Thumb Spica, NSAIDs
corticosteroid injection
Surgical release

21
Q

Flexor tendon injury

A

traumatic or RA

Jersey Finger, Ring

Test both PIP and DIP

Treatment is surgical repair within one week of injury

22
Q

Extensor Tendon Injury

A

mallet finger, inability to fully straighten

tx: continuous splinting of DIP 6 weeks and PM 2 weeks more

consider surgery for non-compliant patients

23
Q

•Galeazzi fracture

A

radial fracture with dislocation of the distal radioulnar joint

24
Q

Monteggia fracture

A

ulnar fracture with dislocation of the proximal radiocapitellar joint

25
Q

Distal Radius Fractures

A 
Most common orthopaedic
injury
• Bimodal distribution
• Predictor of subsequent fractures
• Fall on outstretched arm
• Treatment
• Closed reduction and splinting,
then casting
• ORIF if more than 5 degrees dorsal
angulation
26
Q

Fractures of the Scaphoid

A 
• Fall on outstretched hand.
• High incidence AVN and nonunion.
• Tenderness and swelling in
“anatomic snuffbox”.
• Initial x-rays often normal.
• Whenever suspected - short-arm
cast with thumb spica.
• May take 3 to 6 months to heal.
• Surgical treatment often
preferred.
27
Q

Boxer’s Fracture

A 
• Direct impact to the metacarpal
head
• Volar angluation
• 10-15 degrees angulation
acceptable without reduction
• All others reduce
• Heals with loss of knuckle
• Don’t accept malrotation
• Up to 70 degrees acceptable in
5
th MC
• Otherwise surgery
28
Q

Fractures of the Phalanges

A 
• Dorsal angulation due to
intrinsics.
• Stable - closed reduction and
splinting.
• Unstable - closed reduction
with percutaneous pinning or
ORIF.
• Absolutely no angulation or
malrotation acceptable.
29
Q

Paronychia

A 
• Infection of the nail fold
• Adults: S. aureus
• Children: mixed orophalangeal flora
• Diabetics: mixed infection
• Acute infection: warm soaks, oral
antibiotics (Augmentin or clindamycin)
• If abscess, perform incision and drainage
with partial nail plate removal, antibiotics
30
Q

Felon

A 
• Infection and abscess of the
fingertip pulp space
• May occur from direct trauma or
spread from paronychia
• Untreated may lead to
osteomyelitis of distal phalanx
• Treatment: I&D of abscess and IV
antibiotics
31
Q

Pyogenic Flexor Tenosynovitis

A 
• Infection of the synovial sheath
around the flexor tendon of the
hand
• S. aureus and MRSA are most
common
• May develop into a “horseshoe
abscess”
• Present with pain and swelling
• Kanavel Signs:
• Tenderness at sheath
• Flexed posture
• Pain with passive extension
• Fusiform swelling of digit
32
Q

Herpetic Whitlow

A 
• Viral infection of the finger caused
by HSV-1
• Usually self-limiting, resolves within
7-10 days
• Small vesicular rash that coalesces
into a crust
• Treatment is observation and/or
acyclovir
33
Q

Human Bite

A 
• Direct inoculation from
tooth in “fight bite”
• S. viridans and S. aureus
most common
• Eikonella corrodens in up to
29%
• May be associated with
extensor tendon laceration
• Treatment is I&D with IV
antibiotics
34
Q

Dog and Cat Bites

A

• Most infections are delayed presentation
(>7 days)

Dog bites
• Pasteurella (50% of infections)

Cat bites
• Pasteurella (75% of infections)
• Pasteurella multocida and Pasteurella septica

Treatment is non-operative
• Copious irrigation of wound
• Antibiotics: Augmentin is effective against
Pasteurella
• Rabies prophylaxis
• Immobilization

Surgical treatment if abscess is present

35
Q

PIP/DIP Dislocation

A

difficult to reduce, axial traction

*Surgery (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions