Exam 5: Wrist and Hand Injuries/Pathologies

Question 1

If a patient presents with pain over the radial styloid process with gripping activities, what is the initial hypothesis

Answer 1

DeQuervain syndrome

Question 2

If a patient presents with an insidious onset of numbness and tingling in the first three fingers along with worse pain at night, what is the initial hypothesis

Answer 2

carpal tunnel

Question 3

If a patient presents with paresthesia over the dorsal aspect of the ulnar border of the hand and the 4th and 5th, what is the initial hypothesis

Answer 3

ulnar nerve compression at canal of guyon

Question 4

If a patient presents with the inability to extend the MCP or IP joint, what is the initial hypothesis

Answer 4

Dupuytren or trigger finger

Question 5

If a patient presents with pain with loading the wrist after falling on the hand with the wrist in hyperextension, what is the initial hypothesis

Answer 5

scaphoid fracture or carpal instability

Question 6

Which tendon injury involves repetitive trauma that results in nodules on a thickened flexor tendon and thickening of the annular pulley

Answer 6

trigger finger

Question 7

Trigger finger can be related to middle aged (men/women) and is associated with what four things

Answer 7

RA, diabetes, dupuytren’s and repetitive trauma

Question 8

If a patient has trigger finger, they will have pain in the ___ joint of the finger and ___ joint of the thumb. They will also have a palpable nodule at the ___ pulley

Answer 8

PIP
MP
A1

Question 9

The goal of treating trigger finger is to restore normal tendon function without compromising overall function of the tendon system. List non-operative treatment interventions to make this possible

Answer 9

steroid injections
splinting
engaging in normal activities

Question 10

The goal of treating trigger finger is to restore normal tendon function without compromising overall function of the tendon system. List the progression of surgical intervention

Answer 10

release of A1 pulley
immediate AROM
all ROM types at week one
AROM, strengthening, and return to activities by week 3

Question 11

What are the other names for a distal radius fracture and what is the MOI

Answer 11

colles fracture or dinner fork deformity.

MOI: FOOSH

Question 12

With a colles fracture, the more extension of the wrist, the more (proximal/distal) the fracture site

Answer 12

distal

Question 13

Medical management of a colles fracture for the (young/elderly) population involves a closed reduction and casting

Answer 13

elderly

Question 14

Medical management of a colles fracture for the (young/elderly) population involves a ORIF with an external fixator

Answer 14

young

Question 15

What is another term for a smith’s fracture

Answer 15

reverse colles

Question 16

(colles/smith’s) fracture is a complete fracture of the distal radius with volar displacement of the distal fragment

Answer 16

smith’s

Question 17

Smith’s fractures occur primarily in the ____ population and the MOI is _______________

Answer 17

elderly; falling on the back of the hand with the wrist flexed

Question 18

what is the most commonly fractured bone in the wrist

Answer 18

schapoid

Question 19

True or false:

a scaphoid fracture often does not show up on an xray

Answer 19

true

Question 20

What is the best way to confirm a fracture of the wrist

Answer 20

bone scan

Question 21

true or false:

a ganglion cyst is a nerve problem

Answer 21

false, it is a tendon problem