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545 > elbow wrist and hand > Flashcards

elbow wrist and hand Flashcards

1
Q

differential diagnosis star points

A

visceral, osseous, muscular, articular, neuro

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2
Q

supraconylar fracture MOI

A

most common age 12 from FOOSH from height

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3
Q

olecranon fracture MOI

A

FOOSH w direct elbow trauma

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4
Q

Radial head fracture MOI

A

FOOSH

most common of elbow in athletes

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5
Q

Coronoid fracture occurs with ?

A

terrible triad

  • radial head fracture
  • elbow dislocation
  • coronoid fracture
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6
Q

Most serious elbow injury

A

posterior dislocation

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7
Q

dislocation MOI

A

sports / FOOSH

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8
Q

Radial head sublation MOI

A

common in children under 5 with sudden pull on lower arm

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9
Q

Good test to rule out a fracture?

A

Elbow extension test

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10
Q

Lateral elbow aka

A

tennis elbow

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11
Q

Does tennis elbow hurt with flexion or extension

A

ext

ext carpi radialis brevis

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12
Q

signs its lateral elbow tendinopathy

A

hurts with grip n wrist ext
ULNT (radial)
decreased cervical ROM

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13
Q

Treatment of tennis elbow

A

isometric exercise at mid range
isotonic loading
strength / end /flexibilty of forearm mm
manual therapy

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14
Q

what manual therapy would you do to tennis elbow

A

lateral glide of radial and ulna on humerus

trigger points

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15
Q

lateral ligament sprain MOI

A

elbow dislocation

varus stress

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16
Q

symptoms of lateral ligament sprain

A

pain

clicking, catching

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17
Q

Acute treatment of lateral ligament sprain

A

rest, dec swelling

AROM to surrounding joints

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18
Q

After acute stage, treatment for lateral ligament sprain

A

ROM
strengthen around the joint
proprioception

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19
Q

radial tunnel syndrome aka

A

posterior interosseous nerve entrapment

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20
Q

Who gets radial tunnel syndrome

A

those who do lots of pronation/supination

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21
Q

symptoms of radial tunnel syndrome

A

parasthesia in hand/lateral forearm
pain in forearm extensors
tender supinator
positive ULNT (radial)

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22
Q

treatment for radial tunnel syndrome

A

soft tissue techs over supinator
radial nerve glides
strength forearm mm

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23
Q

flexor / pronator tendinopathy aka

A

golfers elbow

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24
Q

golfers elbow is from wrist ext or flex

A

f

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25
Q

medial collateral ligament MOI

A

Throwing

valgus

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26
Q

treatment medial collateral ligament

A

modify activity
throwing technique
soft tissue techs on medial ligament
strengthen flexors and pronators

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27
Q

ulnar nerve entrapment MOI

A

throwing
compressions
recurrent subluxations

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28
Q

Froments sign

A

paper pull

adductor pollicis

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29
Q

wartenburg sign

A

hand flat, can you bring the thumb in

5th finger add

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30
Q

treatment of ulnar nerve entrapment

A

consider cause
valgus - treat the instability
adhesions - soft tissue

padding the elbow

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31
Q

olecranon bursitis MOI

A

single trauma or repeated trauma

resting elbow on hard surface (students elbow)

32
Q

treatment olecranon bursitis

A

ice rest compress

anti inflams

33
Q

posterior impingement in elbow MOI

A

youth athletes doing receptive hyperextension

osteophyte growth

34
Q

treatment for posterior impingement

A

taping
manual therapy
strength / flexibly

35
Q

pronator teres syndrome

A

median nerve trapped in pronator terres

36
Q

what mm get weak if pronator teres syndrome

A

median nerve distribution - thenar mm

37
Q

MOI pronator teres syndrome

A

forceful pronation (throwing)

38
Q

pronator teres aka

A

median nerve entrapment

39
Q

treatment pronator teres syndrome

A

soft tissue on pronator teres

median nerve mobilization

40
Q

most common type of distal radial fracture

A

colles (fork looking)

41
Q

is colles fracture anterior or posterior displacement of radial

A

posterior

42
Q

how long do you cast colles fracture

A

6 weeks, may need to change it 2-3 weeks in as swelling goes down

43
Q

management of distal radius fracture

A

AROM at surrounding joints

reduce edema

44
Q

after cast is removed what could you do with distal radius fracture

A 
edema mangement 
retrograde massage
wrapping techniques (Cuban)
compression glove 
active ROM
45
Q

once fracture is healed what can you do

A 
joint mobilization 
modalities for pain/circ
stretching
resistive exercises
isokinetic at 8 weeks
functional activities
46
Q

complications of colles fracture

A 
malunion 
median nerve damage
complex regional pain syndrome 
carpal tunnel
late rupture of extensor pollicis
47
Q

most common carpal fracture

A

scaphoid fracture

48
Q

signs its a scaphoid fractures

A

tender snuffbox
loss of grip strength
pain with wrist extension loaded
direct pain at scaphoid

49
Q

is scaphoid fracture sugerical

A

if its unstable or displaced yes because of avascular necrosis risk

50
Q

treatment of scaphoid fracture

A

immobilization (8-12wks)

or surgical

51
Q

good test to rule out wrist fracture

A

Amsterdam wrist rules

52
Q

7 features of Amsterdam wrist rules

distal radius fracture

A 
age
sweling
deformation 
tender distal radius
pain on palmar flexion 
pain on supination 
pain on radioulnar tests
53
Q

7 features of Amsterdam wrist rules

any wrist fracture

A 
age
male
swelling
swell at snuffbox
deformation 
distal radius tender
pain on radial deviation
54
Q

whats de quervain effect

A

abd pollicis longs and ext poll brevis

55
Q

what test for de quervain

A

finkelstein

56
Q

treatment of de quervain

A

ergonomics
splinting
stretch /strengthen

57
Q

radial sensory nerve compression due to

A

radial styloid fracture
tight cast
trauma/sports
compression of brachioradialis and ext carpi radials longs

58
Q

T/F de quervains has sensory changes

A

false

59
Q

which fracture has more pain initially but after 12 months no significant difference

A

ulnar styloid fracture

60
Q

fracture of hook of hamate cause

A

direct blow

checking bat

61
Q

sensory or motor changes during fracture of hook of hamate

A

both because ulnar nerve

62
Q

symptoms of hook of hamate fracture

A

decreased grip strength
ulnar wrist pain
tender hook of hamate

63
Q

MOI fracture of triquetrum

A

FOOSH

64
Q

where is TFCC

A

between distal end of ulnar and proximal carpal row

65
Q

can TFCC heal

A

central portion is avascular and can’t

66
Q

TFCC tear symptoms

A

ulnar side wrist pain

worse with grip, rotation and wb

67
Q

assessing TFCC

A

swelling on dorsal wrist
pain in resisted ext / ulnar deviation
wrist click
reduced grip

press test

68
Q

TFCC management

A 
brace for 4-6 wks
NSAAIDs
AAROM
resisted strength
sport specific

could be surgical if these fail

69
Q

borders of carpal tunnel

A

scaphoid
trapezium
hamate
pisiform

roof is flexor retinaculum

70
Q

whats in the carpal tunnel

A

median nerve
flexor dig profundus (4 tendons)
flexor dig superficial ( tendons)
flexor pollicis longus tendon

71
Q

who gets carpal tunnel

A

middle age
women
diabetes
pregnant

72
Q

how does carpal tunnel develop

A

tenosynovium (irritation / inflammation)

73
Q

clinical features of carpal tunnel

A 
tingling, numbness in median area (first 3 fingers)
nocturnal pain
pain in forearm / wrist
wrist flexion activites
weakness of hand
74
Q

is palm effected during carpal tunnel

A

no because the superficial sensory branch of median doesn’t go through carpal tunnel

n

75
Q

special tests carpal tunnel

A

tinel tap
phalens/ reverse phalens
carpal compression test
ULTT (median)

76
Q

objective findings for carpal tunnel

A

thenar atrophy / mm weakness

difficulty manipulating small objects

loss of 2 point discrimination

545 (34 decks)

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