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Ortho Lecture > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

what comprises the carpus, or wrist

A
  • a core structure of 8 bones
  • more than 20 radiocarpal, intercarpal, and carpometacarpal joints
  • 26 named intercarpal ligaments
  • the six or more parts of the triangular fibrocartilage complex (TFCC)
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2
Q

the hand accounts for about ___ % of upper limb funciton

A

90%

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3
Q

the thumb is involved in _____ of hand function

A

40-50%

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4
Q

the index finger (2nd digit) is involved in about ____ of hand function

A

20 %

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5
Q

this finger accounts for about 20% of all hand function, is the strongest finger, and is important for both precicsion and power fucntions

A

the middle finger (3rd digit) aka chiropractic index finger

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6
Q

distal radio-ulnar joint is what kind of joint

A

double pivot joint

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7
Q

distal radio-ulnar joint unites the

A

distal radius and the ulna and an articular disc (TFCC)

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8
Q

what does the rounded head of the ulnar head contact

A

it contacts both the ulnar notch of the radius laterally, and the TFCC distally

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9
Q

since the ulnar styloid process is approximately one-half inch shorter than the radial styloid process what does this result in

A

more ulnar deviation than radial deviation (ROM 30 degrees vs 20 degress)

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10
Q

fracture of the radius within 20-35 mm of the wrist joint with posterior angulation of the distal fragment

A

colle’s fracture

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11
Q

colle’s fracture is also known as a

A

dinner fork fracture

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12
Q

Mr. Smiths at the front door and cole is at at the back door

A

.

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13
Q

fracture of the radius within 20-35mm of the wrist joint with anterior angulation of the distal fragment

A

smiths fracture

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14
Q

smiths fracture is aka

A

garden spade deformity

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15
Q

the fibrocartilage disc in between the medial proximal row and the distal ulna within the medial aspect of the wrist

A

Triangular fibrocartilage complex (TFCC)

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16
Q

what is the primary function of the TFCC

A

to imporve joint congruency and to cushion against compressive forces

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17
Q

Scaphoid, lunate, and radius

A

3 bones involved in a direct articulation of the wrist

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18
Q

bones involved in indirect articulation of the wrist

A

ulna, triquentrium, pisiform

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19
Q

the TFCC transmits about _____ of the axial load from the hand to the forearm

A

20%

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20
Q

TFCC is made of

A

fibrocartilage (so are IVD’s * you should know this you future doc)

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21
Q

what is the wrist comprised of

A

distal radius and ulna, 8 carpal bones, 5 metacarpal bones

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22
Q

the carpal bones lie in

A

two transverse rows

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23
Q

what does the proximal row contain

A 
(lateral to medial) 
scaphoid (navicular)
lunate
triquetrum
pisiform
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24
Q

what does the distal row contain

A

trapezium
trapezoid
capitate
hamate

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25
Q

what is the most commonly fracture wrist bone

A

navicular

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26
Q

what is the largest bone of the proximal row

A

navicular (scaphoid)

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27
Q

ulnar deviation helps to slide which bone

A

navicular bone slides out from under the radial styloid process for palpation

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28
Q

what is the largest most prominent of the MCP bases

A

capitate

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29
Q

which is the largest of all carpal bones

A

capitate

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30
Q

what is the 2nd most often fractured and the most commonly subluxated

A

lunate

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31
Q

what bones are covered up by the extensor carpi radials brevis tendon which inserts into the base of the 3rd metacarpal

A

lunate
capitate
base of the 3rd metacarpal

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32
Q

which bones is the easiest to fall and become subluxed

A

lunate
(this forms the arch on the dorsum of the hand and a lot of our actions flatten out this curve and cause it to fall anterior)

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33
Q

the mid carpal joint lies between the

A

two rows of carpals

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34
Q

a _____ articulation because each row has both a concave and convex segment

A

compound

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35
Q

the proximal row of the carpals is ____ laterally and ____ medially

A

convex

concave

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36
Q

which bones present with a concave surface to the distal row of carpals

A 
scaphoid
lunate
trapezium
trapezoid
triquetrum
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37
Q

which bones present with a convex surface to a reciprocally arranged distal row

A

scaphoid
capitate
hamate

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38
Q

articulation between he distal borders of the distal carpal row bones and the bases of the metacarpals

A

carpometacarpal joints

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39
Q

____ of the CMC joints is provided by the palmar and dorsal carpometacarpal and inter metacarpal ligaments

A

stability

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40
Q

what do the 2nd-5th metacarpals articulate with

A

the respective proximal phalanges in biaxial joints

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41
Q

the MCP joints allow ____ -____ and _____-_____ deviation associated with a slight degree of axial rotation

A

flexion-extension

medial-lateral

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42
Q

what shape is the first carpometacarpal joint

A

functionally the seller (saddle-shaped) carpometacarpal (CMC)

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43
Q

which joint is the most important of the thumb

A

first carpometacarpal joint

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44
Q

what articulation does the first carpometacarpal joint consists of

A

the articulation between the base of the first metacarpal and the distal aspect of the trapezium

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45
Q

what motions occur in the first carpometacarpal joint

A

flexion/extension
adduction/adduction
and opposition (which includes varying amounts of flexion, internal rotation, and palmar adduction)

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46
Q

how are the MCP’s and the IP’s normally held in during rest

A

a position of slight flexion

consider inspecting for damage

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47
Q

fracture though the base of the first metacarpal neck with dorsal and radial displacement of the shaft

A

bennett’s fracutre

posterior lateral
(doral medial)?

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48
Q

what type of joint is the metacarpophalaneal joint of the thumb

A

a hinge joint

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49
Q

what does the metacarpophalangeal joint of the thumb consists of

A

a convex surface on the head of the metacarpal, and a concave surface not he base of the phalanx

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50
Q

how many phalanges

A

14

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51
Q

what does a phalange consist of

A

base
shaft
head

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52
Q

what mark the concave proximal bases of the phalanges

A

two shallow depressions, which correspond to the pulley-shaped heads of the adjacent phalanges

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53
Q

what produce the pulley-shaped configuration of the phalangeal heads

A

two distinct convex condyles

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54
Q

fracture of the fourth or fifth metacarpal neck with ANTERIOR displacement of the head

A

Bar Room Fracture

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55
Q

fracture of the second or third metacarpal neck with ANTERIOR displacement of the head

A

Boxer’s fracture

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56
Q

what type of joints are interphalangeal joints

A

hinge joints that allow motion in only one plane

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57
Q

what contributes greatly to finger joint stability

A

the congruency of the IP joint surfaces

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58
Q

this joint is a hinged joint capable of flexion and extension

A

Proximal IP (PIP) joint

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59
Q

this joint has similar structures but less stability and allows some hyperextension

A

distal IP (DIP)

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60
Q

explain Heberden’s Nodes

A

1) found on one or more fingers, except the thumb
2) distal joints are enlarged by hard nodules, 2 to 3 mm in diameter, one on either side of the dorsal midline
3) nodules are painless; motion is unlimited
4) process is a localized OA
5) involvement of several joints is more common in women in home they appear at the menopausal age
6) condition in women is usually hereditary
7) single joint is more commonly involved in men
8) condition in men is usually the result of trauma

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61
Q

abnormal fusiform enlargement at the PIP joint which can indicate SYNOVITIS secondary to RA

A

Bouchard’s Nodes

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62
Q

MOI=RA

PIP joint deforms into hyperextension and the DIP joint is flexed

A

Swan Neck Deformity

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63
Q

the central slip of the extensor digitorum communist tendon is avulsed from the insertion in to the middle base of the middle phalanx, the PIP is flexed and the DIP is extended
MOI=trauma

A

Boutonniere Deformity

looks like a button over the PIP joint

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64
Q

what do the major ligaments of the wrist include

A

palmar instrinsic ligaments
volar extrinsic
dorsal extrinsic
intrinsic ligaments

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65
Q

the extrinsic palmar ligaments provide the majority of the

A

wrist stability

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66
Q

the intrinsic ligaments serve at _____ _____, binding the proximal row into a unit of rotational stability

A

rotational restraints

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67
Q

medial and lateral collateral ligaments of the fingers are named

A

Graysons (medial) and Cleland’s (lateral)

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68
Q

formed by the large articular concave surface of the distal end of the radius, the scaphoid and lunate of the proximal carpal row, and the TFCC

A

radiocarpal joint

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69
Q

a dense CONNECTIVE tissue “bracelete” that encases the forearm and maintains the relationships of the tendons that cross the wrist

A

antebrachial fasica

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70
Q

serves to prevent the tendons from “bow stringing” when the tendons turn a corner at the wrist

A

extensor retinaculum (this sister cries a lot)

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71
Q

what are the tunnel-like structures formed by the retinaculum and the underlying bones called

A

fibro-osseous compartments

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72
Q

what are the extensor retinaculum compartments, from lateral to medial,

A
  • abbudctor pollicis longus and extensor pollicis brevis
  • extensor pollicis longus
  • extensor digitorum and indicis
  • extensor digiti minimi
  • extensor carpi ulnaris
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73
Q

this transforms the carpal arch into a tunnel, through which pass the median nerve and some of the tendons of the hand

A

flexor retinaculum

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74
Q

proximally, the retinaculum attaches to the

A

tubercle of the scaphoid and the pisiform

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75
Q

distally the retinaculum attaches to the

A

hook of hamate, and the tubercle of the trapezium

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76
Q

what is the condition known as when the median nerve is compressed in this relatively unyielding space

A

carpal tunnel syndrome

phalanx sign

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77
Q

avulsion of the flexor digitorum profundus tendon

A

jersey finger

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78
Q

what is the MOI for the jersey finger

A

the finger gets caught int an object and actively flexed DIP joint is suddenly and forcible extended resulting in a rupture

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79
Q

serves as a conduit for the median nerve and nine flexor tendons

A

carpal tunnel

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80
Q

what make the floor of the canal

A

the palmar radoiocarpal ligament + palmer ligament complex

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81
Q

what is the root of the tunnel

A

the flexor retinaculum (transverse carpal ligament)

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82
Q

within the tunnel the ulnar and radial borders are

A

trapezium and hook of hamate respectively

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83
Q

within the tunnel the median nerve divides into a

A

motor branch and distal sensory branches

84
Q

a depression superficial to the flexor retinaculum, located between the hook of the hamate and the pisiform bones

A

tunnel of guyon

85
Q

what forms the roof of the tunnel of guyon

A

palmar (volar) carpal ligaments
palmaris brevis mucles
palmar aponeurosis

86
Q

what forms the floor of the tunnel of guyon

A

flexor retinaculum (transverse carpal ligament)
pisohamate ligament
pisometacarpal ligament

87
Q

what does the tunnel serve as

A

a passage way for the ulnar nerve and artery into the hand

88
Q

ulnar nerve and artery compression injuries between the pisiform and the hook of the hamate

A

cyclist hand

also caused my crutch use and weight lifting

89
Q

a dense fibrous structure continuous with the palmaris longs tendon and fascia covering the thinner and hypothenar muscles

A

palmar aponeurosis

90
Q

a fibrotic condition of the palmar aponeurosis that results in nodule formation or scarring of the aponeurosis, and which may ultimately cause finger flexion contractures

A

Dupuytren’s Contracture

91
Q

what is some evidence of Dupuytren’s contracture

A

small painless nodule that can be palpated in the palmar aponeurosis near the base of the digit

92
Q

Within Dupuytren’s Contracutre palpation of the palm reveals a______.

A

hard cord over the flexor tendon

passive extension of the finger raises the cord taut where it can be readily seen

93
Q

a complex tendon, which covers the dorsal aspect of the digits is formed from a combination of the tendons of insertion from extensor digitorum, extensor indices, and extensor digit minimi

A

extensor hood

94
Q

what does the extensor hood do

A

creates a “cable” system that provides a mechanism for EXTENDING the MCP and IP joints, and allows the lumbrical, and possibly interosseous muscles, to assist int eh flexion of the MCP joints

95
Q

class rant related to dorsal wrist?

A

a small tiny tear in the joint capsule allowing for synovial fluid to escape, the body then tries to put a wall around the fluid

96
Q

occasionally a cystic, pea-sized swelling (ganglion) occurs on the dorsal or solar aspect of the wrist

A

Dorsal wrist

97
Q

MOI for dorsal wrist

A

perhaps biomechanics alterations

98
Q

terminal phalanx of the finger is permanently flexed at the distal joint; it cannot be voluntarily extended

A

mallet finger

99
Q

what occurs with mallet finger

A
  • rupture of the extensor tendon that inserts on the terminal phalanx
  • possibly a fracture of the distal phalanx
100
Q

avulsion fractures- tendon pulls some of the bone off

A

this won’t present with a mallet finger

101
Q

what is the contour of the palmar surface

A

the MCP joints area= hills and valleys

102
Q

what are the hills/mounds/peaks of the palmar surface

A

the neuromuscular bundles that supply the fingers and lumbrical muscles

103
Q

what are the valleys of the palmar surface

A

the paths of the flexor tendons at the point where they cross the joints

104
Q

long narrow balloons filled with synovial fluid, which wrap around a tendon so that one part of the balloon wall (visceral layer) is directly on the tendon, while the other part of the balloon wall (parietal layer) is separate

A

Synovial sheaths

105
Q

what do the annular and cruciate pulleys do?

A

restrain the flexor tendons to the MCP’s and phalanges and contribute to fiber-osseous tunnels through which the tendons travels

106
Q

from the MP joint and volar plate

A

A1

107
Q

from the proximal phalanx

A

A2

108
Q

from the PIP joint volar plate

A

A3

109
Q

from the DIP joint solar plate

A

A5

110
Q

the distal palmar crease (approximately at the knuckles of the MCP’s) =

A

the proximal border of surgical “no man’s land”

111
Q

the surgical no mans land wi where

A

2 flexor tendons run into 1 sheath

112
Q

the distal border of the surgical no mans land is

A

PIP joints

113
Q

flexion of the finger feels norma;: but re-extension is accompanied by a painful snap that the patient sometimes refers to the dorsal of the hand

A

trigger finger

114
Q

what finger is usually involved with trigger finger

A

either the 4th or 5th finger

115
Q

True or False: Trigger finger is more common in women than men

A

TRUEf

116
Q

what age group does trigger finger occur in

A

ages of 40-60 years old

117
Q

trigger finger is more common in people with certain medical problems that include

A

diabetes

rheumatoid arthrits

118
Q

where are the flexors located

A

the anterior compartment (these flex the wrist and digits)

119
Q

where are the extensors located

A

the posterior compartment (extend the wrist and the digits)

120
Q

what muscles are part of the anterior compartment and are the superficial muscles

A

pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris

121
Q

what muscles are part of the anterior compartment and are the intermediate muscles

A

flexor digitorum superficialis

122
Q

what muscles are part of the anterior compartment and are the deep muscles

A

flexor pollicis longus
flexor digitorum profundus
pronator quadratus

123
Q

what muscles are part of the posterior compartment and are the superficial muscles

A
  • extensor carpi radialis longus
  • extensor carpi radialis brevis
  • extensor digitorum and extensor digiti minimi
  • extensor carpi ulnaris
124
Q

what muscles are part of the posterior compartment and are the deep muscles

A
  • abductor pollicis longus
  • extensor pollicis brevis
  • extensor pollicis longus
  • extensor indicis
125
Q

a depression on the dorsal of the hand at the base of the thumb, just distal to the radius

A

anatomic snuff box

126
Q

what is the anatomic snuff box formed by

A

the tendons of APL and EPB, the ulnar border formed by the tendon of the EPL

127
Q

what lies on the floor of the anatomic snuff box

A

the deep branch of the radial artery and the tendinous insertion of the ECRL. underneath these structures= scaphoid and trapezium bones

128
Q

floor of anatomic snuff box

A

scaphoid

129
Q

ulnar border of anatomic snuff box

A

ulnar border

130
Q

radial border of anatomic snuff box

A

radial border

131
Q

overuse and repetitious ulnar and radial deviation of the wrist
-swelling and inflammation in Tunnel 1

A

De Quervians Disease

132
Q

what is De Quervians disease aka

A

Stenosing tenosynovitis

133
Q

what tendons are involved with De Quervian’s Disease

A
  • abductor pollicus longus

- extensor pollicus brevis

134
Q

what test gives a positive for De Quervian’s Disease

A

Finkelstein test

135
Q

De Quervians Disease appears to be significantly more common in women

A

TRUE: some sources even quote a female- to -male ratio as high as 8:1

136
Q

patients with De Quervians Disease usually report

A

pain at the dorsolateral aspect of the wrist referral of pain toward the thumb and/or lateral forearm. This condition responds well to nonsurgical treatment.

137
Q

what are the short muscles of the thumb

A
  • abductor pollicis brevis
  • flexor pollicis brevis
  • opponens pollicis
  • adductor pollicis
138
Q

ulnar collateral ligament avulsion of the MCP joint aka Game Keepers thumb

A

Skier’s Thumb

139
Q

what are the short muscles of the 5th digit

A
  • abductor digiti minimi
  • flexor digiti minimi
  • opponens digit minimi
140
Q

what are the interosseous muscles of the hand

A
  • three palmar interpose. Each functions to adduct the digit, to which it is attached, toward the middle digit
  • four dorsal interpose. Each functions to abduct the index, middle and ring fingers from the mid-line of the hand
141
Q 
function to perform the motion of IP joint extension with the MCP joint held in extension
-can assist in MCP flexion
A

lumbricales

142
Q

what forms the transverse arch

A

formed with the palmar concavity of the carpal bones, scaphoid + trapezium laterally, and pisiform + hamate medially

143
Q

what forms the metacarpal arch

A

metacarpal heads

144
Q

what forms the longitudinal arch

A

formed by the 3rd and 5th digit, spans lengthwise, keystone at the MCP joints

145
Q

what forms the oblique arches

A

formed by the thumb in opposition to the other fingers

146
Q

what are the 3 peripheral nerves that supply the skin and muscles of the wrist and hand

A

median
ulnar
radial nerve

147
Q

what its he vasculature of the wrist

A

the brachial artery bifurcates at the elbow into radial and ulnar branches, which are the main arterial branches to the hand

148
Q

what are the vascular arches of the hand

A

dorsal arches

palmar arches

149
Q
  • occurs in males 20-40 yrs of age
  • previous trauma, occupational excessive dominant hand use
  • usually unilateral- pt presents with localized and radiating wrist pain; swelling and disability
  • entrapment neuropathy, DJD
A

Keinboch’s Disease

150
Q

what is Keinboch’s Disease aka

A

avascular necrosis

151
Q

what occurs with Keinboch’s Disease

A
  • increased lunate density
  • short ulnar bone (in 75% of cases)
  • treatment- reduction of hand trauma
  • replace lunate with plastic implant
152
Q

how many degrees of forearm pronation is available

A

90 degrees

153
Q

what occurs during pronation

A

the concave ulnar notch of the radius glides around the peripheral surface of the relatively fixed convex ulnar head

154
Q

what is pronation limited by

A

the bony impaction between the radius and the ulna

155
Q

how many degrees of forearm supination is available

A

85-90 degrees

156
Q

what is supination limited by

A

the interosseous membrane, and the bony impaction between the ulnar notch of the radius and the ulnar styloid process

157
Q

what are the movements of flexion and extension of the wrist shared by

A 
radiocarpal ariculation
intercarpal articulation
(in varying proportions)
158
Q

during wrist flexion where does most of the motion occur

A

midcarpal jiont (60% or 40degrees verseus 40% or 30degrees at the radoiocarpal joint)

159
Q

what is wrist flexion and extension associated with

A

slight ulnar deviation and supination of the forearm

160
Q

during wrist extension most of the motion occurs at the

A

radiocarpal jiont (66.5% or 40 degrees versus 33.5% or 20 degrees at the mid carpal joint)

161
Q

what is wrist extension associated with

A

slight radial deviation and pronation of the forearm

162
Q

where does radial deviation occur

A

between the proximal and distal rows of the carpal bones

163
Q

what is the motion of radial deviation limited by

A

impact of the scaphoid onto the radial styloid, and ulnar collateral ligament

164
Q

where does ulnar deviation occur

A

primarily at the radoiocarpal joint

165
Q

where is ulnar deviation limited by

A

radial collateral ligament

166
Q

where does thumb flexion and extension occur

A

in the frontal plane that is perpendicular to the sagittal plane of finger flexion and extension

167
Q

what happens in the plane of thumb flexion and extension

A

the metacarpal surface is concave, and the trapezium surface is convex

168
Q

where does thumb abduction and adduction occur

A

in the sagittal plane, that is perpendicular to the frontal plane of finger abduction and adduction

169
Q

what occurs during thumb abduction and adduction

A

the convex metacarpal surface moves on the concave trapezium

170
Q

name the power grips that have been recognized

A

fist grip
cylindrical grip
ball grip
hook grip

171
Q

what is the grip called where the digits work together to provide support and static control

A

Power

172
Q

when the digits hold the object against the hand which muscles are working

A

extrinsic

173
Q

grip limited to MCP joints and mainly involves the radial side of the hand

A

Precision and Prehension

174
Q

how do digits provide control

A

by working with the thumb to form a tripod for precision handling

175
Q

intrinsic muscles are important in

A

precision grips

176
Q

lateral or key pinch, and tip pinch or tip-to-tip prehension

A

chuck aka three fingered pinch

177
Q

the examination of the forearm, wrist and hand requires

A

sound knowledge of differential diagnosis, and must include an examination of the entire upper KINETIC CHAIN, and the cervical and thoracic spine

178
Q

what is the importance of a HISTORY of forearm, wrist and hand include

A
  • helps focus examination
  • relevant information must be gathered about the site, nature, behavior, and onset of the current symptoms
  • should include information about the patient’s age, hand dominance, hobbies/activities, and occupation
179
Q

during a systems review a clinician should be able to determine

A

the suitability of the patient for chiropractic care

180
Q

during a systems review, if the clinician is concerned with any signs or symptoms of a visceral, vascular, neurogenic, psychogenic, or systemic disorder what should they do?

A

the patient should be REFERRED back to their physician because that is out of the scope of practice

181
Q

what should the physical examination begin with

A

a general observation of the patients posture-especially the cervical spine, and the thoracic spine, and the position of the hand in relation to the body

  • the contour of the palmar surface, including the arches, should be examined
  • if a finger is involved, its attitude should be observed
182
Q

what all should the clinician be observing

A
  • inspect for lacerations, surgical scars, masses, localized swelling, erythema
  • scars should be examined for degree of adherence, degree of maturance, hypertrophy (excess collagen within boundary of would), and keloid (excess collagen that no longer conforms to wound boundaries)
  • the location and type of edema should be noted
  • the nails should be inspected for abnormalities
183
Q
  • natural convexity is replaced by concave nails in a saucer form
  • nail plate is thinner and weaker
  • result of a severe fungus infection
A

spoon nails (koilonychia)

184
Q
  • pulmonary disease is the most common cause

- cardiovascular disease is the second cause

A

clubbed nails

-caused by emphysema and COPD

185
Q
  • inflammation of the terminal finger pad is confined by tough fascia attached to the periosteum
  • swelling of the fingertip and dull pain
  • pain gradually heightens and becomes throbbing
  • tenderness is intense
  • presence of pus is indicated by induration of the pulp and loss of resilience
  • pressure in the confined space may cause the abscess to burst through the solar surface of the finger pad
A

Felon

186
Q

what can Felon produce

A

osteomyelitis

187
Q
  • skin over the mantle of the nail and the lateral nail folds is swollen, reddened, painful and tender
  • pus is over the nail, light palpation over the inflamed area provokes exquisite pain
  • pain from pressure on the nail indicates subungqual abscess, between nail plate and periosteum
A

Paronychia aka Hangnail

188
Q

what type of motions occur during an examination

A
  • AROM, then PROM with over pressure
  • the gross motions of wrist, hand, finger and thumb flexions, extension, and radial and ulnar deviation are tested, first actively and then passively
  • any loss of motion compared with the contralateral, asymptomatic wrist and hand should be noted
189
Q
  • over extension of the carpals, possibly straining or spraining structures
  • O’Donoghue’s is used to differentiate between which structures are affected
A

Thrower’s Wrist

190
Q

with palpation of the muscles, tendons, insertions, ligaments, capsules, bones of the wrist and hand should occur

A

as INDICATED, and be compared with the uninvolved side

191
Q

what tests are used to determine the cause of a painful or dysfunctional motion by systematically testing each of the articulations to see whether the maneuvers reproduce the patient’s symptoms

A

pain provocation tests

192
Q

these tests are carried out in the extreme range, and if positive, tin the neutral range

A

isometric strength testing

193
Q

the isometric tests must include

A

the interossei and lumbricales

194
Q

this motions of wrist flexion, extension, ulnar and radial deviation are tested initially

A

straight plane motions

195
Q

if pain occurs with any strength tests this will

A

require more thorough examination of the individual muscles

196
Q

the ___ for the hand is the range in which the hand can performs of its grip and other functional activities

A

functional assessment

197
Q

during the examination the tests are always

A

repeated on, and compared to, the same joint in the opposite extremity

198
Q

what happens during a neuromuscular status examination

A

check the skin for unusually warm or dry areas of the hand-excessive localized warmth of the skin= infection

199
Q

what does unnaturally dry condition (anhydrosis) may indicate

A

nerve damage

200
Q

what Ortho tests are used to test neuromuscular status

A

allen test

tinel’s test for carpal tunnel syndrome

201
Q

diagnosting testing of the forearm, wrist and hand is limited to

A

plain radiographs for most patients

202
Q

bony tenderness with history of trauma or a suspicion of bone or joint disruption indicates

A

a need for radiographs

203
Q

what are standard projections for the wrist

A

posteroanterior
lateral
oblique

204
Q

what are some examples are acute phase goals

A
  • protection of the injury site to allow healing
  • control pain and inflammation
  • control and then eliminate edema
  • restoration of pain-free range of motion in the entire kinetic chain
  • improve patient comfort by decreasing pain and inflammation
  • retard muscle atrophy
  • minimize detrimental effects of immobilization and activity restriction
  • scar management if appropriate
  • maintain general fitness
  • patient to be independent with home exercise program
205
Q

what are functional phase goals

A
  • attain full range of pain free motion
  • restore normal joint kinematics
  • improve muscle strength to within normal limits
  • improve neuromuscular control
  • restore normal muscle force couple relationships

Ortho Lecture (11 decks)

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