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AT 541 > Forearm Injuries > Flashcards

Forearm Injuries Flashcards

0
Q

Forearm fractures

A
  • pretty common
  • ulna and radius generally fracture individually
  • audible pop or crack
  • moderate/severe pain
  • swelling
  • loss of function
  • discoloration
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1
Q

Contusion management

A
  • price
  • rule out fracture
  • monitor
  • pad/protect
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2
Q

Compound forearm fracture

A
  • monitor for shock
  • cover/keep clean
  • call 991
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3
Q

Management for fracture

A
  • eval
  • check pulse
  • Ice
  • splint
  • sling
  • refer for X-ray
  • long term casting
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4
Q

Colles fracture

A
  • almost all wrist fractures will be this
  • distal end of radius or ulna
  • fall on out stretched hand forcing wrist into hyperextension
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5
Q

Smith fracture

A

Anterior displacement of distal fragment

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6
Q

Signs/symptoms of a colles fracture

A
  • forward displacement of radius causing visible deformity (dinner fork deformity)
  • ice/splint/refer
  • if you think it’s a sprain, and it doesn’t get better refer them
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7
Q

Thenar eminence

A

Thumb side

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8
Q

Hypothenar eminence

A

Non- thumb side

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9
Q

Wrist sprains

A
  • most common
  • usually fall on hyperextended wrists
  • violent flexion or torsion
  • multiple incidents may disrupt blood supply and nutrition to carpals
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11
Q

Management of wrist sprains

A
  • price
  • splint
  • analgesics for pain
  • rehab
  • tape
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12
Q

Triangular Fibrocartilage Complex Injury (TFCC)

A
  • forced hyperextension
  • violent twist or torque of wrist
  • pain along side ulnar side of wrist, difficulty with wrist extension, possible clicking
  • swelling
  • refer, immoblize (4 weeks)
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13
Q

Tenosynovitis

A
  • repetitive wrist acceleration and deceleration
  • overuse
  • pain with use or passive stretching
  • tenderness/swelling
  • crepitus
  • rest, NSAIDs, immobilization, US
  • Increase ROM/strength
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14
Q

Tendinitis

A
  • overuse
  • pain with active use or passive stretching
  • RICE, NSAIDs, rest
  • heat to promote healing
  • ROM/strength
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15
Q

Nerve Compression, Entrapment, Palsy

A
  • median/ulnar nerve
  • overuse/direct trauma
  • sharp/burning pain
  • claw hand deformity
  • refer/decompression may need surgery
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16
Q

Bishop/benediction Hand

A
  • Ulnar nerve
  • thumb, pointer and middle up
  • ring/pinky folded down
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17
Q

Drop wrist

A
  • Radial nerve

- can’t extend hand

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18
Q

Claw Hand

A
  • Ulnar and Median nerve

- all fingers folded, but spread apart

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19
Q

Ape Hand

A
  • Median Nerve

- same as claw hand but fingers are together

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20
Q

Carpal Tunnel Syndrome

A
  • compression of the median nerve due to inflammation of tendons and sheaths of carpal tunnel
  • repeated wrist flexion
  • tenosynovitis of flexor tendons
21
Q

Signs/Symptoms for Carpal Tunnel

A
  • sensory and motor deficits
  • tingling, numbness, and paresthesia
  • digits 2-4
  • thumb weakness
22
Q

Phalen’s Test

A
  • carpal tunnel syndrome
  • position is held for 1 min
  • backs of hands together
  • positive test = pain/numbness/tingling
  • *Tinel’s sign
23
Q

Management for Carpal Tunnel

A
  • conservative treatment
  • referral
  • rest, immob., NSAIDs
24
Q

de Quervain’s Disease (Hoffman’s disease)

A
  • stenosing tenosynovitis in thumb (extensor pollicis brevis & abductor pollicis longus)
  • overuse
  • aching pain, may radiate into hand or forearm
  • positive finkelstein’s test
  • weakness during thumb extension and abduction; painful catching and snapping
25
Q

Finkelstein’s Test

A
  • athlete makes fist with thumb tucked inside
  • wrist is ulnarly deviated
  • positive sign is pain
26
Q

Management of de Quervain’s

A
  • immobilization
  • rest
  • ice
  • NSAIDs
  • US
  • Joint mobes to maintain ROM
27
Q

Dislocation of the Lunate

A
  • forceful hyperextension
  • numbness/paralysis of flexor muscles due to pressure on median nerve
  • refer for reduction
28
Q

Kienbock’s Disease

A
  • loss of blood supply to lunate bone from osteonecrosis
  • decreased grip strength
  • immob/NSAIDs
29
Q

Scaphoid Fracture

A
  • falling on an outstretched hand
  • compression of the scaphoid between the radius and second row of carpal bones
  • poor blood supply so it doesn’t heal
  • severe pain in the anatomical snuff box
  • pain with radial flexion
30
Q

Management of Scaphoid Fracture

A
  • referral
  • immobilization 6 weeks or longer
  • rehab
  • unstable fractures may require internal fixation
31
Q

Hamate Fracture

A
  • falling/contact with equipment
  • wrist pain/weakness
  • point tenderness
  • pull of muscle attachment may cause non-union
  • cast wrist/thumb
32
Q

Wrist Ganglion

A
  • synovial cyst (herniation of joint capsule or synovial sheath)
  • area of swelling
  • pain that increases with use
  • aspiration/chemical cauterization, pressure pad, surgical removal
33
Q

Trigger Finger

A
  • overuse resulting in tenosynovitis
  • inflammation of extensor tendons or wrist, fingers and thumb
  • snapping sensation that is palpable, audible and painful
  • painful
  • nodule may be felt within tendon sheath
34
Q

Extensor Tendon Avulsion (Mallet Finger

A
  • blow to the tip of finger
  • pain at DIP
  • unable to extend distal end of finger (stuck at 30 degrees)
  • RICE/splint 6-8 weeks
35
Q

Boutonniere Deformity

A
  • inability to extend DIP
  • swelling and point tenderness
  • splint 6-8 weeks
  • *called a button hole
36
Q

Jersey Finger

A
  • Rupture of flexor digitorum profundnus tendon from insertion on distal phalanx
  • usually ring finger
  • DIP cannot be flexed, finger remains extended
  • must be surgically repaired
  • rehab of 12 weeks
37
Q

Dupuytren’s Contracture

A
  • nodules develop in palmer aponeurosis, limiting finger extension
  • most common in 4th or 5th digits
  • nodules must be removed to restore normal hand function
38
Q

Gamekeeper’s Thumb

A
  • sprain of UCL of MCP joint of the thumb
  • forceful abduction of the proximal phalanx
  • pain over UCL
  • instability
  • immediate referral
  • thumb splint for 3 weeks
39
Q

Sprains of Interphalangeal Joints

A
  • axial loading and or various/valgus stress
  • pain/swelling/point tenderness
  • paraffin/ROM
40
Q

PIP Dorsal Dislocation

A
  • hyperextension
  • obvious deformity
  • reduce?
41
Q

PIP Palmar Dislocation

A
  • twisting motion while digit is semi flexed
42
Q

MCP Dislocation

A
  • twisting or shearing force
43
Q

Metacarpal Fracture

A
  • direct axial force or compressive force
  • 5th metacarpal (boxer’s fracture)
  • splint/refer
44
Q

Bennett’s Fracture

A
  • carpometacarpal joint of the thumb as a result of an axial and abduction force
  • deformity
  • loss of function
45
Q

Distal Phalangeal Fracture

A
  • crushing force
  • pain and swelling
  • drain subungual hematoma if present
46
Q

Middle Phalangeal Fracture

A
  • direct trauma or twisting motion
  • pain/swelling/ over middle phalanx
  • possible deformity
  • buddy tape if no deformity
  • immob if deformity 3-4 weeks, additional splint for 9-10 weeks
47
Q

Proximal Phalangeal Fracture

A
  • spiral or angular force
  • pain/swelling
  • immobilization of the wrist in slight extension
48
Q

PIP Fractures and Dislocation

A
  • axial load on a partially flexed finger
  • pain, swelling, tenderness
  • small bone fragment - buddy taping
  • large bone fragment - splint at 30-60 degrees
49
Q

Fingernail deformities

A
  • changes in normal appearance can be indicative of different diseases
  • scaling or ridging = psoriasis
  • ridging and poor development = nutritional deficiencies
  • yellowing = heart/congenital diseases
  • spooning/depression = iron deficiency

AT 541 (10 decks)

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