hand

Question 1

The transverse retinacular ligament prevents dorsal subluxation of the lateral bands during PIP joint Flexion

Answer 1

The
transverse retinacular ligament prevents dorsal subluxation of the lateral bands during PIP joint extension

Question 2

The most important pulley in the thump is the oblique pulley and this is a continuation of the abductor pollicis insertion and lies between the two
annular pulleys.

Answer 2

is a continuation of the adductor pollicis insertion and lies between the two
annular pulleys.

Question 3

Most hand infections are severe

Answer 3

Most hand infections are mild and can be managed in the outpatient
setting,

Question 4

what The most common infections in the hand ?

Answer 4

The most common infections are a result of inoculation
of tissues by bacteria normally found on human skin. Staphylococcus
and Streptococcus species are by far the most common and should be
covered in initial treatment

Question 5

what are the indicators of a poor prognosis in hand infection?

Answer 5

Subcutaneous purulence and
digit ischemia on presentation are indicators of a poor prognosis

Question 6

X-rays is mandatory with fight bites fracture?

Answer 6

X-rays should be performed if there is suspicion
of a retained foreign body or fracture.

Question 7

In Fight bites the perecentage of the MCP joint is violation is ?

Answer 7

Fight bites require exploration of the wound to rule out jointspace
infection, as the MCP joint is violated in 70% of cases

Question 8

fascia! flaps and skin grafts are not suitable
in the palmar area why ?

Answer 8

fascia! flaps and skin grafts are not suitable
in the palmar area because scar contracture is likely to occur

Question 9

Diagnosis of peripheral nerve compression canot be
achieved with history and physical exan1 alone and without
the use of electrodiagnostic or radiologic imaging techniques,
including radiographs, MRI, CT scan, and ultrasound

Answer 9

Diagnosis of peripheral nerve compression may often be
achieved with history and physical exam alone and without
the use of electrodiagnostic or radiologic imaging techniques,
including radiographs, MRI, CT scan, and ultrasound

Question 10

Dose splinting necessary after nerve decompression ?

Answer 10

Postoperative splinting is generally unnecessary after nerve decompression.

Question 11

Radiographs ofthe wrist are indicated for carpal tunnel syndrom

Answer 11

Radiographs ofthe wrist are indicated for evaluation ofwrist pain.

Question 12

Thenar muscles maintain normal strength with PMNE,true or false?

Answer 12

true

Question 13

whate the early presenting symptoms of PMNE?

Answer 13

muscle weakness while numbness is a relatively late symptom.

Question 14

does Motor function improve after PMNE surgery?

Answer 14

Weakness of FDP IF and FPL resolves
immediately in the recovery room following surgical release.

Question 15

Is ther any role for ultrasound,
MRI, in PMNE?

Answer 15

The role of ultrasound,
MRI, and MR neurograms is not defined

Question 16

What the surgical procedure should don if the pain in the wrist is only in PMNE?

Answer 16

If wrist pain is the main indication for surgery, release of the bicipital aponeurosis under local anesthesia can be highly effective with a quick recovery

Question 17

can we manage the mild form cupital tunnel syndrome conservatively

Answer 17

Nonoperative management with night splinting, physical therapy, and activity and postural modification is indicated for mild disease and has a 50% rate of efficacy

Question 18

Radial tunnel syndrome (RTS), is defined as a weakness without pain in the dorsal forearm. true. false?

Answer 18

false. Radial tunnel syndrome (RTS), defined as pain without weakness in the dorsal forearm

Question 19

can we use Electrodiagnostic studies to differentiate between RTS and epicondylitis?

Answer 19

Electrodiagnostic studies are
not helpful for evaluating the either condition.

Question 20

Is there are differance between nerve graft versus transfer in axillary nerve injury ?

Answer 20

A metaanalysis of grafting versus nerve transfer outcomes for isolated axillary injuries
showed no significant differences between the two techniques, and most patients achieve M4 or better shoulder abduction.

Question 21

How many ways can employed to achieve individual finger extension ?

Answer 21

Nerve transfer to the PIN is the only method of achieving
individual finger extension.

Question 22

the PIN fascicle to supinator should always be excluded to maximize reinnervation of the more critical extensors.

Answer 22

If biceps function is intact, the PIN
fascicle to supinator should be excluded to maximize reinnervation
of the more critical extensors.

Question 23

Comparison
of grafting versus motor and sensory transfers in proximal ulnar nerve
injuries showed significantly improved sensory rather than motor?

Answer 23

Comparison
of grafting versus motor and sensory transfers in proximal ulnar nerve
injuries showed significantly improved functional outcomes
with nerve transfer(80%) better than nerve graft 22%.

sensory outcomes were not significantly different with only 30% to 40% of patients reaching S3 or better at 2 years of follow-up

Question 24

Percentage of people whom have an absent EDC of the little finger?

Answer 24

50%

Question 25

location of posterior intraosseous nerve in the wrist?

Answer 25

on the flower of the fourth compartment

Question 26

lister tubercle located between the first and second compartments?

Answer 26

false lister tubercle located between the second and third one

Question 27

EPB insert only to the base of the proximal phalanx?

Answer 27

EPB insert either to proximal phalanx or MPJ extensors hood or terminal phalanx or sometimes absent

Question 28

how many interosseous in the hand?

Answer 28

7 intraosseous 3 palmers(unipenate) and 4 dorsal (bipennate)

Question 29

An Esmarch bandage is recommended to fully exsanguinate the limb during hand infection managment ?

Answer 29

No, Gentle gravity exsanguination is
preferred in infected cases to reduce the risk of causing bacteremia.

Question 30

where is the location of parona space ?

Answer 30

Parona’s space is located in the distal forearm
between the pronator quadratus and the flexor digitorum profundus tendons.

Question 31

risk factors for a poor outcome of flexor tenosynovitis ?

Answer 31

age over 43 years
the presence of subcutaneous pus
diabetes,
peripheral vascular
renal disease.
presence of digital ischemia.

Question 32

During extensors tendons injury juncturea tendinae can extend finger to neutral position ,t or f ?

Answer 32

T

Question 33

What the last muscle innervated by the ulnar nerve?

Answer 33

first dorsal interosseous

Question 34

The location of the wiound is not important in hand infectoin ?

Answer 34

the location is important as if the wound is at the joint warrants an open joint in a sterile environment while if the wound is at the dorsum of the hand can be manage in side room

Question 35

Indication of MERSA managment in hand infection?

Answer 35

Presents of necrosis,previous MERSA infection,prevous hospital addmision

Question 36

hand souked can be used in acute setting only ?

Answer 36

can be used in rehabilitation phase also

Question 37

Facial flap with skin graft on the dorsum of the hand cause contracture more than the volar side? true

Answer 37

false , dorsum reconstraction with faciocutanous falp plus skin graft showed less contracture rather than faciocutanouse flap in the volar aspect of the hand

Question 38

what is the presenting complain of nerve compression?

Answer 38

numbness

Question 39

should patient stop taking anticoagulant befor sugery of nerve cpmression?

Answer 39

patient can keep taking anticoagulant becz expected blood loss is minimum

Question 40

tourniqate is amost in decomopression surgey ?

Answer 40

no

Question 41

Most commom cause of carpal tunnel are?

Answer 41

Idiopathic

Question 42

Diuretic and oral steriod can be used for managment of CTS?

Answer 42

no role for oral steriod or diuretics

Question 43

what is the risk factor for cubital tunnel syndrome?

Answer 43

A- male
b- tobacco smoking
c- heavy manual labor

Question 44

Radial tunnel syndrome are present with weakness and pain true os fals?

Answer 44

Radial tunnel syndrome (RTS), defined as pain without weakness in the dorsal forearm and wrist

Question 45

What the diffrential dignosis of radial runnel syndrem?

Answer 45

RTS has up to a 41 % overlap with lateral epicondylitis, contributing to the debate.

Question 46

What the provactive test for superficial radial nerve compression⚡️

Answer 46

Ulanr deviation , wrist flexion, resisted pronation

Question 47

When i can use compression screws /

Answer 47

This technique is ideal when the fracture length is at least twice the diameter of the bone.

Question 48

Why Plate fixation is rarely used for phalangeal fractures?

Answer 48

because of the close relationship of the extensor mechanism to the periosteum of the underlying bone; plate fixation in the phalanges frequently leads to tendon scarring and stiffness Conversely, the extensor tendons overlying the metacarpals do not sit directly on bone and, as such, are at low risk for adhesions after plate fixation.

Question 49

external fixation the definitive solution for hand fracture management?

Answer 49

Rarely is external fixation the definitive solution for hand fracture management

Question 50

Most common fracture in the hand?

Answer 50

distal phalanx fracture

Question 51

Tuft fractures often healing has good ptognosis?

Answer 51

Tuft fractures often heal with a malunion

Question 52

When we use dorsal block with k-wire in distal phalanx frc?

Answer 52

Dorsal block K-wire fixation is recommended for fractures involving more than one-third of the articular surface or in the setting of volar subluxation of the distal fragment

Question 53

How much the size of screw that use for fracture fixation for phalanx ?

Answer 53

The screw diameter should be less than one-third of the length of the fracture.

Question 54

In metacarpal fracture xray is sufficient for visualization of the fracture pattern ?

Answer 54

Computed tomography scan may better visualize the fracture pattern and assist in surgical planning

Question 55

When we should do surgery for metacarpal fracture ?

Answer 55

For fractures with greater articular involvement, > 1 mm articular incongruity, or collateral ligament instability, surgery is warranted.

Question 56

What the optimum solution for metacarpal head fracture?

Answer 56

Although headless screw fixation is an optimal choice of fixation for metacarpal head fractures, most injuries are comminuted or associated with joint disruption; these injuries may be best treated by dynamic external fixation or acute arthroplasty.

Question 57

Buried antegrade intramedullary pin are better than k-wire in metacarpal neck fracture?why?

Answer 57

Buried antegrade intramedullary pin application may be
superior because it avoids the extensor mechanism and obviates the
risk for pin tract infection

Question 58

all nondisplaced fractures in the metacarpal shaft can be treated with closed reduction.

Answer 58

Nondisplaced oblique and spiral
fractures are usually unstable and are often best treated with surgery.

Question 59

type of stiffness in hand fracture ?

Answer 59

Stiffness with active and passive motion
results from joint contracture, whereas diminished active motion
only is often the result of tendon adhesions

Question 60

CT scan is the most sensitive
and specific imaging modality for diagnosing scaphoid fractures and
also allows assessment of osseous blood supply and soft tissue injuries.

Answer 60

MRI is the most sensitive
and specific imaging modality for diagnosing scaphoid fractures and
also allows assessment of osseous blood supply and soft tissue injuries.
but CT scan most sensitive in bone detection

Question 61

Is better with scaphoid fracture to limit the mobility with thump spica including the thump

Answer 61

false,Recently, a randomized trial demonstrated better healing when the thumb is not included

Question 62

with corneal sensory nerve graft, all patients retained protective sensation? T or F

Answer 62

most patients regained normal sensation, with all patients achieving
protective sensation

Question 63

In axillary nerve repair radial nerve branches to the medial, lateral, and long heads of the muscle. Originally, the branch to the lateral is preferred ?

Answer 63

branches to the medial, lateral, and long heads of the muscle. Originally, the branch to the long head of the triceps was favored, but others have argued in favor of the medial branch because it has a longer extramuscular course

Question 64

Is there is difference between nerve graft and nerve transferee in axillary nerve repaire?

Answer 64

A metaanalysis of grafting versus nerve transfer outcomes for isolated axillary injuries showed no significant differences between the two techniques, and most patients achieve M4 or better shoulder abduction.

Question 65

Wich type of nerve repair can be utilized in musculocutanous in brachial plexus injury?

Answer 65

In the scenario of complete plexus avulsion injuries, the distal spinal accessory or intercostal nerves can be used with an interpositional nerve graft.

Question 66

In radial nerve palsy if the biceps is functional how we can maximaz the reinnervation

Answer 66

Nerve transfer to the PIN is the only method of achieving individual finger extension. If biceps function is intact, the PIN fascicle to supinator should be excluded to maximize reinnervation of the more critical

Question 67

In proximal ulnar nerve repair nerve transfer is better than nerve graft in sonsoty recovery only?

Answer 67

In proximal ulnar nerve repair nerve trans better in motor restoration while no defferanc between transferee or graft in sensory outcome .

Question 68

The triple transfer of spinal accessory to suprascapular, Oberlin transfer, and radial to axillary can get whar type of benefit /
?

Answer 68

The triple transfer of spinal accessory to suprascapular, Oberlin transfer, and radial to axillary shows improved supination and shoulder external rotation compared to grafting

Question 69

The volar scapholunate ligament is far stronger than its dorsal counterpart and this serves to prevent excessive extension of
the scaphoid relative to the lunate? tor f

Answer 69

F.
The dorsal
scapholunate ligament is far stronger than its volar counterpart and this serves to prevent excessive flexion of
the scaphoid relative to the lunate

Question 70

wich side is prefferable to harvest left or right phrenic nerve for nerve transfere?

Answer 70

The negative effects on respiratory function seem to be much greater when the right
phrenic nerve is used rather than the left.

Question 71

what are the contraindication to nerv transferred?

Answer 71

Contraindications to nerve transfer include an extended time interval between injury and transfer (usually more
than 14–18 months is considered too long), where there is no expendable donor, and where the donor nerve has
a motor strength below MRC grade M4

Question 72

The dorsal root, which contributes to motor and sensory ?T orF

Answer 72

The dorsal root, which contributes sensory nerves only, is thicker and more resistant to avulsion forces.

Question 73

Most closed injuries of the brachia! plexus are axnotamesis

Answer 73

Most closed injuries of the brachia! plexus are actually mixed in nature {Mackinnon’s sixth degree injury)

Question 74

When we should do nerve conduction study after suspected brachial plexus injury?

Answer 74

baseline nerve conduction study and EMG should be per formed no earlier than 3 to 4 weeks after trauma,

Question 75

when shoula we do EMG or NCS after brachial plexus injury?

Answer 75

The baseline nerve conduction study and EMG should be
performed no earlier than 3 to 4 weeks after trauma,

Question 76

when do we decide to do nerve transfer or tendon transfer?

Answer 76

Delay presentation till 6-9 months considered nerve transfer no proximal construction
mor than 9 month considred tendon transfere

Question 77

what the factor that effect the type of surgical intervention for brachial plexus injury?

Answer 77

: time since trauma,
surgeon comfort with technique,
the extent of the zone of injury,
and availability of donor nerves or musculotendinous units.

Question 78

Tendon transfers are always paired with arthrodeses

Answer 78

Tendon transfers are often paired with arthrodeses (shoulder
or wrist) for an enhanced functional result

Question 79

conventional tendon transfers are viable options for
complete and incomplete brachia! plexus injury,

Answer 79

conventional tendon transfers are only viable options for incomplete brachia! plexus injury,

Question 80

what type of ERBS palsy needs urgent surgical intervention?

Answer 80

The most common pattern
of injury that necessitates operative exploration is a combination of
root avulsions and extraforaminal ruptures of CS, C6, and C7

Question 81

when should do a reconstruction procedure for the elbow or wrist joint?

Answer 81

Both shoulder and elbow reconstructions are typically done in the range of 4 to 6 years of age.
Hand and forearm function often accommodates surprisingly well.
Therefore, waiting until age 6 to 13 years before undertaking hand
reconstructive procedures

Question 82

Is the electro diagnostic study is relatable in erbs palsy?

Answer 82

Electrodiagnosis in infants is notoriously unreliable because of its tendency to overestimate the axonal function that is present

Question 83

what is the Tetraplegia?

Answer 83

Tetraplegia results from traumatic injuries to the cervical spine causing the loss of upper motor and sensory neurons.

Question 84

What is the most common level of cervical spine injury?

Answer 84

common levels of the cervical spine
injury are at CS and C6, marked by a loss of elbow extension, wrist flexion, and finger flexion and extension

Question 85

When I should do surgery for hand fracture ?

Answer 85

■ Articular incongruity
■ Digital malrotation, shortening, or angulation
■ Multiple fractures
■ Open fractures
■ Fractures with soft tissue injury or bone loss

Question 86

Plate fixation does not use for phalangeal fracture ? why?

Answer 86

Conversely, the extensor tendons overlying the metacarpals
do not sit directly on bone and, as such, are at low risk for adhesions
after plate fixation

Question 87

are external fixation the
definitive solution for hand fracture?

Answer 87

. Rarely is external fixation the
definitive solution for hand fracture management.

Question 88

when I should use Dorsal block K-wire fixation?

Answer 88

fractures involving more than one-third of the articular surface or in the setting of volar subluxation of the distal fragment

Question 89

what type of fixation that can be used for comminuted metacarpal head fracrure?

Answer 89

metacarpal head fractures, most injuries are comminuted or associated with joint disruption; these injuries may be best treated by dynamic external fixation or
acute arthroplasty

Question 90

Nondisplaced metacarpal spiral fracture best treated with splint and immobilization?

Answer 90

Nondisplaced oblique and spiral fractures are usually unstable and are often best treated with surgery.

Question 91

how you can assess the outcome after hand fracture managment?

Answer 91

The Jebsen-TaylornHand Function test is one of the most common functional tests
patient-reported outcome measures include the Disabilities of the Arm, Shoulder,
Hand, Short Form-36,
Michigan Hand Questionnaire

Question 92

Most sensitive imaging techniqe for diagnosis of scaphiod frac?

Answer 92

MRI is the most sensitive
and specific imaging modality for diagnosing scaphoid fractures and
also allows assessment of osseous blood supply and soft tissue injuries

Question 93

what are the causes of nonunion in scaphoid fracture?

Answer 93

The overall incidence is approximately 10%, but this rate may be elevated by delayed presentation, fracture comminution, smoking, incomplete immobilization, or errors in surgical technique

Question 94

does epitendinous repair is necessary at zones 3,4,5?

Answer 94

epitendinous sutures may not be necessary because there is more room in
these zones for tendon excursion, which decreases the intensity ofthe
adhesions. Furthermore, multiple structures are cut in these zones,
which require expedient repairs to keep the tourniquet time within
2 hours

Question 95

can we correct tendons rapture with 3 week of primery intervention ?

Answer 95

Rupture within the first 3 weeks ofthe initial tendon repair
warrants an attempt for repeat repair, which has reasonable success.
Ifthe rupture occurs more than 3 weeks after the primary repair, tendon reconstruction should be considered.

Question 96

How you manage the closed injury to the extensors tendons?

Answer 96

Acute closed injuries of the digital extensor system are
best treated with splinting
The mainstay of rehabilitation at the digital level (zones
1-4) remains static splinting; however, early motion protocols have shown promising results in more proximal injuries (zones 5-8)

Question 97

What are the factors that increase the adhesion with extensors tendons injuries?

Answer 97

• The proximity of the tendons to bone,
• the high incidence of associated periosteal stripping
• capsular injuries,
• limited excursion of the extensors
• Furthermore, the mechanical strength of the repair and - status of local soft and hard tissues may not allow early mobilization.
• The stronger opposing action of the flexor system makes early rehabilitation even more problematic
  makes repair prone to adherence.

Question 98

what is the last muscle that receives innervation from the posterior interosseous nerve?

Answer 98

The most distal muscle belly, which occasionally extends beyond the carpus, is the extensor
indicis proprius (EIP). This is the last muscle to receive innervation from the PIN,

Question 99

They course volar to the deep transverse
metacarpal ligament before attaching to the radial lateral band of the
respective finger,True or false?

Answer 99

T

Question 100

The interossei course volar to the deep transverse metacarpal ligament and insert into the digital lateral bands
The lumbrical muscles course volar to the deep transverse metacarpal ligament before attaching to the radial lateral band of the respective finger

Answer 100

The interossei course dorsal
The lumbrical muscles course volar

Question 101

the distal injury of the extensor tendon most commonly a closed injury?

Answer 101

True

Question 102

What the consequence of the mallet finger ?

Answer 102

within 4 weeks of trauma are considered acute; after
4 weeks, they are chronic. If left untreated, hyperextension of the PIP
joint can develop because of proximal and dorsal migration of the
lateral bands,17 creating the swan-neck deformity

Question 103

Most injuries are partial IN ZONE 4 extensors tendons ?

Answer 103

TRUE

Question 104

Most patients should be assessed
for possible ulnar neuropathy with medial epicondylitis

Answer 104

all patients should be assessed
for possible ulnar neuropathy

Question 105

change in the ECRDL occurs with lateral epicondylitis

Answer 105

Changes within the ECRB tendon
substance represent the sine qua non for lateral epicondylitis

Question 106

Greater possibility of radial nerve injury with open lateral epicondylitis?

Answer 106

Greater possibility of radial nerve injury

Question 107

How many of the patients with medial epicondylitis have ulnar neuritis?

Answer 107

Ulnar neuritis is especially
important as 23% to 61% of patients with medial epicondylitis have concurrent ulnar neuropathy.

Question 108

Are de Quervain patients successfully treated with splinting alone?

Answer 108

Splinting alone was
observed to be less successful, but when combined with corticosteroids, is likely more successful than injections alone

Question 109

intersection syndrome is an common cause of wrist pain

Answer 109

intersection syndrome is an uncommon cause of wrist pain

Question 110

intersection syndrome is often diagnosed based on physical exam alone,

Answer 110

True

Question 111

The percentage of diapetic patients develop trigger finger ?

Answer 111

10٪؜

Question 112

In trigger finger splinting should include only the mcp joint ?

Answer 112

Pip can splinted instead of mcp joint with similar effects

Question 113

what is the Boyes’s rule in tendons transfere?

Answer 113

Boyes’s 3-5-7 rule Flexors
and extensors of the wrist have an average excursion of approximately
3 cm (33 mm); the extensors of the digits (EDC and extensor pollicis longus [EPL]) have an average of 5 cm; and digital flexors have
7 cm of excursion.

Question 114

In radial nerve palsy radial sensory branch is mandatory to repair?

Answer 114

radial nerve may also be lost. However, this is not a critical sensory loss and typically does not require treatment

Question 115

wich muscle considred the most important mucsle fro thump aposition ?

Answer 115

The APB is the most
important muscle in thumb opposition

Question 116

Clawing of the hand is more more with high ulnar nerve palsy ?

Answer 116

, clawing is less severe in high ulnar nerve palsy as the FDP paralysis lessens the flexion forces on the PIP and DIP joints of the ring and small fingers.

Question 117

Pip joint more staple dorsally?

Answer 117

The extensor system provides the least amount of support, which makes the joint inherently less stable to dorsal forces.

Question 118

Postinjury stiffness is a substantial problem and is often made worse by improper or prolonged immobilization even within the first 2 weeks after injury. T or F

Answer 118

T

Question 119

Almost all type I and II PIP J injuries are stable after reduction and can be
treated nonoperatively with buddy straps ? T OR F

Answer 119

T

Question 120

Forced radial or ulnar deviation of the PIPJ puts stress on the ipsilateral collateral ligament,

Answer 120

Forced radial or ulnar deviation of the PIPJ puts stress on the contralateral collateral ligament,

Question 121

most common complication of PIP dislocation ?

Answer 121

. Stiffness and flexion contracture
are commonly encountered problems after these injuries

Question 122

Why DIPJ have added
hyperextensibility compared to the PIPJ?

Answer 122

Due to shorter and
more laterally positioned checkrein ligaments.

Question 123

Ifan isolated DIPJ dislocation occurs, it is almost
always a volar dislocation.

Answer 123

Ifan isolated DIPJ dislocation occurs, it is almost
always a dorsal dislocation.

Question 124

why there is mor extension in MCPJ than PIPJ?

Answer 124

Different from the PIPJ, there are no checkrein ligaments on the MCPJ volar plate.
This facilitates some hyperextension of the MCPJ

Question 125

how you can diagnose the injury of the sagital band ?

Answer 125

Clinicaly ultrasound or MRI can provide confirmation in
unclear cases

Question 126

The presence of a peripheral pulse exclude impending arterial compromise

Answer 126

The presence of a peripheral pulse may not exclude impending arterial compromise

Question 127

what the ultimate goals of fixation method ?

Answer 127

the ultimate goals are initiation of range of motion
to provide improved function and minimization of soft tissue stripping to achieve bony healing and union of the fracture

Question 128

Is it useful to make epitendinous repair in zone 5

Answer 128

he tedious epitendinous sutures are often
not performed to expedite the surgical sequence because of the relative lack of restrictive adhesion formation in this zone

Question 129

Nerv conduit can give optimum outcome with sensory and motor compared with autologous nerve graft?

Answer 129

Nerve conduits have been shown to
provide sensory recovery but are inferior to autologous nerve grafting
for motor regeneration

Question 130

Always we need to treat the RCL of the thump surgically in case of complete cut?

Answer 130

Surgical repair of RCL injures will need repair only if there is volar subluxation.1

Question 131

Lateral or valor dislocation of the little finger pip joint is common?

Answer 131

Lateral dislocations of the little finger PIP joint are more common than volar dislocations, which are rare

Question 132

What is the contents of the 4th extensor’s compartment ?

Answer 132

The fourth compartment contains the EDC and extensor indicis proprius (EIP). In addition, the posterior interosseous nerve lies in the floor of the fourth compartment.

Question 133

Does all introsseos are bipennet?

Answer 133

The palmar interossei are unipennate, while the dorsal interossei are bipennate

Question 134

In boutonniere deformity the surgical option is always an option ?

Answer 134

Specialized surgical repair is usually required only in open injuries.

Question 135

When we need to take phrenic nerve in nerv transfere wich site is better/

Answer 135

The negative effects on respiratory function seem to be much greater when the right phrenic nerve is used rather than the left

Question 136

How mach length of the nerve graft that considred with poor outcom/

Answer 136

In cases where nerve grafts greater than 7 cm are required, the outcomes tend to be poor

Question 137

during replantation, we should tag the flexors and extensors tendons?

Answer 137

Tagging of the extensor tendon is
not usually necessary

Question 138

does using of heparin effect the replantation outcom?

Answer 138

The use of intravenous heparin does not correlate with higher success rates of replantation but
it may be indicated in cases of intimal damage by crush and avulsion
injuries, intraoperative thrombus, or following successful thrombolysis and arteriosclerotic changes

Question 139

The muscle that is responsible for Opposition of the thump?

Answer 139

Opposition is the result of the abductor pollicis brevis, opponens pollicis, and superficial head of the flexor pollicis brevis flexing
and rotating the TM and metacarpophalangeal (MP) joints simultaneously.

Question 140

The advanced imaging technique is useful for thump reconstruction?

Answer 140

Advanced imaging (computerized axial tomography, magnetic resonance imaging) is not indicated in the evaluation ofacute injuries but
may be helpful in patients presenting with complicated injuries for
secondary reconstruction

Question 141

In the first dorsal metacarpal artery flap, patients may have double-sensitivity, experiencing sensation in the dorsal index finger when using the thumb; however, all patients are able to cortically reorient over time

Answer 141

patients may have double-sensitivity, experiencing sensation in the dorsal index finger when using the thumb; however, some patients are able
to cortically reorient over time

Question 142

adult accommodate extremely well to pollicization than children

Answer 142

Children accommodate extremely well to pollicization in congenital
and traumatic cases; however, adults may require a prolonged period
of retraining and secondary procedures to optimize the function.

Question 143

The selection of sensate flaps is essential for thump reconstruction?

Answer 143

T

Question 144

In proximal trans metacarpal thumb injuries,the patients can not make a thump opposition.

Answer 144

In proximal trans metacarpal thumb injuries,
the opponens pollicis, which inserts on the volar-radial aspect of
the thumb metacarpal may still provide some opposition function
at the TM joint.

Question 145

In littler flap, the 2PD and cortical orientation are not improved with neuropathy.

Answer 145

Division of the nerve and coaptation to the thumb
digital nerves result in a minimal loss in s2PD (<10 mm) but better
cortical integration.

Question 146

why routine use of this flap should be limited to use in combination with
other methods for subtotal thumb reconstruction as discussed later?

Answer 146

Due to the issues with donor site morbidity,
significant dissection in the palm, and poor cortical reorientation,

Question 147

why Osteoplastic Reconstruction of the htump is not prefer?

Answer 147

the bulky appearance, bone graft resorption, need for multiple stages,
and issues with double sensitivity limit the use of this procedure.

Question 148

in fully functin index Policiczation giv best result than toe to hand transfere?

Answer 148

with a fully functioning index finger, loss of grip strength and the
resulting three-finger hand provide inferior results when compared
to toe-transfer

Question 149

some of the flaps of the great toe are based on the blood supply to
the first webspace of the foot, usually from the first dorsal metatarsal
artery (FDMtA)

Answer 149

All ofthese flaps are based on the blood supply to
the first webspace of the foot, usually from the first dorsal metatarsal
artery (FDMtA)

Question 150

what is the drawback of the second toe transfer?

Answer 150

least resemble a normal thumb
in terms of its size and shape. Additionally, the second toe is
prone to clawing

Question 151

what is the ectopic manifestation of DD?

Answer 151

Ledderhose disease (plantar fibromatosis),
Garrod pads (knuckle pads over the dorsum of the PIPjoints),
and Peyronie disease (fibrotic disease causing curvature of the penis).

Question 152

In DD the MPJ flexion contracture can easily be corrected rather than the PIP contracture?

Answer 152

isolated MCP contractures are easily corrected by many methods, partially because that the collateral ligaments do not become pathologically shortened when these joints are fixed in flexion for significant periods of time.
However, PIP joints positioned in flexion for long periods of time
develop intrinsic joint contractures

Question 153

In DD in case of a complete release of the all contacted cord and the contacture is still pressent ,what you can do in this case?

Answer 153

In practice, it may be best to proceed with
PIP joint capsulotomy and/or ligamentous release in select cases

Question 154

The pain from DD can completely eradicated with imputation ?

Answer 154

Phantom sensation and phantom pain after surgery cannot be predicted easily, and sometimes pain related to complex regional pain syndrome is not eliminated with an amputation of the involved digit.

Question 155

Most ganglions can be managed conservatively.

Answer 155

True

Question 156

Most tumour in hand are pianfull

Answer 156

Tumors arising from the hand and wrist usually present as a painless mass

Question 157

In pIp dislocation how i can know that the reduction is stable ?

Answer 157

As long as the joint exhibits stability at 30° of
flexion or less, it can be considered stable

Question 158

In case of PIP volar dislocation does all collateral ligament are injured?

Answer 158

If the volar PIPJ dislocation was from a rotatory mechanism, only
one of the collateral ligaments may be injured, whereas a dislocation after a central slip rupture often injures both collateral ligaments.

Question 159

when i should use surgical intervention in volar PIP dislocation ?

Answer 159

In the setting of a larger intra-articular fracture fragment that is displaced, ORIF may be required. If the deformity
(i.e., boutonniere) is not passively correctable, surgical intervention
is needed.

Question 160

The most encounter problem with PIP dislocation is ?

Answer 160

Stiffness and flexion contracture are commonly encountered problems after these injuries,

Question 161

why the DIP is hyperextension mor than PIP?

Answer 161

due to shorter and
more laterally positioned checkrein ligaments. DIPJ/IPJ arc of active
motion is about 60°, with an additional 10° to 15° of passive hyperextension possible for DIPJ

Question 162

Volar plate arthroplasty is an alternative option for DIP reconstraction , although the potential for flexion contracture is increased with this approach T or F

Answer 162

T

Question 163

checkrein ligaments on the MCPJ volar plate considered one of the stabilizer of th e MCP joint?

Answer 163

there are no checkrein ligaments on the MCPJ volar plate

Question 164

there is no role for imaging technique in sagittal band injury?

Answer 164

The diagnosis is usually
made clinically, but ultrasound or MRI can provide confirmation in
unclear cases.

Question 165

what is the weakest point in thump MCJ ?

Answer 165

Dorsal stability is less stout, provided mostly by the extensor pollicis longus and brevis tendons passing over the joint, along with some strength from the joint capsule itself.

Question 166

Subungual tumors can cause pain, nail deformities, or bleeding. T :F

Answer 166

T

Question 167

What is the main modality for evalutaing hand tumor ?

Answer 167

plain radiographs, are main modality for evaluating hand tumors.

Question 168

What is the main modality for evaluation of complex soft tissue mass?

Answer 168

MRI remains the main modality for imaging complex soft tissues masses

Question 169

myxoid liposarcomas,can follow up with nuclear study?

Answer 169

myxoid liposarcomas, may not be metabolic and have low 18-FDG uptake, which will limit the utility of these scans.

Question 170

Almost most of the time you cannot preserve all of the hand with sarcom

Answer 170

Hand preservation is possible for most patients with soft tissue sarcomas of the hand, even those with relatively large tumors

Question 171

Most common soft tissue tumors of the hand ?

Answer 171

Ganglions are the most common soft tissue tumors seen in the handthey are mucin-filled cysts

Question 172

At wich age ganglion can occures?

Answer 172

At anny age. 20-40

Question 173

What is the difference between an open and endoscopic approach in ganglion removal?

Answer 173

Arthroscopic resection, though technically more difficult,
has the advantage of better visualization of the joint and a better surgical scar, with similar recurrence rates to open surgery

Question 174

why do we prefer to use FDS and extensor indices EIP?

Answer 174

Because they are Independent functions may simplify the postoperative rehabilitation process from a cortical plasticity standpoint.

Question 175

How much the increase in excertion of the with wrist tenodesis?

Answer 175

the excursion of the transfer can be increased by 2 to 3 cm through the tenodesis effect of wrist flexion or extension.

Question 176

In radial nerve palsy why the supination is maintained?

Answer 176

maintained because of the Biceps brachii muscle

Question 177

A patient with a unilateral, nondominant loss of opposition by median nerve palsy may compensate quite well,
how?

Answer 177

Because of the effect of the deep head of flexor polices brevis

Question 178

how you can correct simple clawing?

Answer 178

osseous blocks on the dorsal metacarpal head
volar (Zancolli) MCP joint capsulodesis
free tendon grafts from the deep intermetacarpal ligament, passed through the lumbrical canal, and secured to the extensor mechanism
Fowler and Tsuge popularized a dynamic tenodesis procedure, where a tendon graft is looped
through the extensor retinaculum of the wrist, and each end is split
in half. The four free ends are then routed along the lumbrical canals
and inserted into the lateral bands to provide MCP joint flex.ion and
IP joint extension with wrist flexion42*43 (Figure 79.6). These procedures are best reserved for patients with a positive Bouvier test (simple clawing)

Question 179

which ligaments is responsible for PIP contracture?

Answer 179

Small volar checkrein ligaments arising from the
proximal phalanx volar ridges to the VP are thought to contribute
to flexion contractures

Question 180

in case of extensors, tendon injuries the cut tendon can still be extended, how?

Answer 180

can confuse the diagnosis of tendon disruptions by the ability to extend fingers with ruptured tendons to a neutral posture through the juncturae
tendinae

Question 181

The DIP can extend with extensors only?

Answer 181

The PIP and DIP joints will not extend if the intrinsic
muscles do not contract.

Question 182

what muscle considered the last mucal innervated by the ulnar nerve ?

Answer 182

The first dorsal interosseous muscle is the last innervated muscle by
the ulnar nerve

Question 183

Most Civilian shoot gun are managed conservatively T or F

Answer 183

T

Question 184

Tendon transfers are often paired with arthrodeses in brachial plexus injury

Answer 184

Tendon transfers are often paired with arthrodeses (shoulder
or wrist) for an enhanced functional result

Question 185

Thrombosis of the radial and ulnar artery following catheterization may occur that lead to ischemia
For T

Answer 185

F. Thrombosis of the radial and ulnar artery following catheterization may occur, but it rarely results in hand ischemia

Question 186

Aneurysms often present as a painful, palpable, mass with Ischemia

Answer 186

Aneurysms often present as a painless, palpable, pulsatile mass that occasionally is associated with signs of local nerve compression. Ischemia is uncommon unless there is associated thrombosis and embolism.

Question 187

In hypothenar ulnar syndrome the small finger is always involved.

Answer 187

In some patients, the small finger
is spared because ofthe proper ulnar digital artery to the small finger
arises proximal to the Guyon canal.

Question 188

what is the corkscrew sign>?

Answer 188

Is an early sign of chronic damage to the intima and media leading to progressive fibrosis with ectasia

Question 189

Patients with hypothenar hammer syndrome we can harvest the contralateral side radial artery?

Answer 189

the contralateral radial
artery should not be harvested because of the high incidence of
occlusion or ectasia of the ulnar artery seen in the contralateral
asymptomatic extremity in a study of patients with hypothenar
hammer syndrome

Question 190

In hypothenar syndrom acute attack only we can use fibrinolysis T or F

Answer 190

Fibrinolysis (or thrombolysis) is advocated only for treatment in cases of acute onset of digital ischemia (less than 2 weeks)

Question 191

In glomus tumor the the diagnosis better don with imaging

Answer 191

Clinical examination alone may be sufficient for diagnosis

Question 192

Glomus tumour can be occures in the proximal and distal phalanx?

Answer 192

all GVMs were located in the distal phalanx and 59% were in the subungual region

Question 193

Can we use meshed graft for hand burn?

Answer 193

For patients
who have an evolving burn wound or whose depth and viability
are uncertain at the time of excision, meshed allograft is indicated

Question 194

why symptoms of radial or ulnar nerve ischemia are not compartment specific.?

Answer 194

The ulnar and radial nerves travel in one compartment first, and then pass through the intermuscular septum into another compartment at the level of distal third of the arm

Question 195

Which nerve most commonly effected by compartment of the forearm?

Answer 195

The median nerve is the most commonly affected nerve in forearm compartment syndrome

Question 196

Can hand compartment occures from single metacarpal fracture ?

Answer 196

Hand compartment syndrome can be caused by multiple metacarpal fractures

Question 197

Closed fracture has mor e incidence of faciatiomy than open fracture ?

Answer 197

patients with open fractures had a higher incidence of fasciotomy than those with closed fractures

Question 198

What are the rare causes of compartments syndrom?

Answer 198

Rarer etiologies of compartment syndrome include muscle overuse, rhabdomyolysis, and systemic sclerosis.

Question 199

Pallor and Pulselessness should present in compartments syndromes ?

Answer 199

Pallor and Pulselessness may not present

Question 200

Radiology and US can be used for compartments syndrome dignosis?

Answer 200

Doppler ultrasound and radiography imaging have been used to evaluate the primary injury and identify the amount of tissue edema, but not helpful for diagnosis of compart-ment syndrome

Question 201

What the difference between low energy and hight energy brachial plexus injury?

Answer 201

Lower-energy mechanisms tend to produce postganglionic nerve ruptures (breakages within the substance of the peripheral nerve, distal to the dorsal root ganglion) as compared with higher-energy mechanisms which tend to produce more preganglionic root avulsions

Question 202

The ventral root of spinal cord is thicker or the dorasl root?

Answer 202

The dorsal root, which contributes sensory nerves only, is thicker and more resistant to avulsion forces

Question 203

Cwphalic traction cuese injury to the lower trunck cuadal traction cause injury to the middle and upper trank. Tor F

Answer 203

T

Question 204

Which site of cord injury associated with anterior dislocation of shoulder?

Answer 204

Anterior shoulder dislocation and scapular fracture are associated with posterior cord damage

Question 205

Hourner syndrom came with upper plexus TorF

Answer 205

F. Come with lower plexus because of the proximity of sympathetic system to lower plexus

Question 206

Allografts can be used in brachial plexus injury ?

Answer 206

Allografts should not be used in this setting.

Question 207

The majority of inheritance pattern of syndyctyle came with which type of syndrom?

Answer 207

Apert and Poland syndrom

Question 208

What the method that we can employ to decrees the incidance of using skin graft in syndactytly?

Answer 208

Extended penragonal dorsal flap and defatting of the digits

Question 209

In type 3 syndactyly in apert syndrom all digits hav complex syndactyly?

Answer 209

False, little finger often doesn’t involve in complex syndactyly only have simple comlete skin only syndactyly

Question 210

Congenital trigger thump is present at birth is it true or false ?

Answer 210

congenital trigger thumb is also a misnomer because studies of newborns have failed to show its presence at birth, suggesting an acquired etiology.

Question 211

Dose splinting has role in congenital trigger thump?

Answer 211

Splinting has not been shown to be of any consistent benefit,

Question 212

Som cases of radial longitudinal deficiency have an associated thumb hypoplasia

Answer 212

F. All cases of radial longitudinal deficiency have an associated thumb hypoplasia

Question 213

What is the standared study for vascular imaging?

Answer 213

Angiography is the standard study for vascular imaging

Question 214

What is the best way to distinguish between primary and secondary Rayunuad phenomenon

Answer 214

Capillaroscop

Question 215

Primary RP considered mor sever than secondary RP

Answer 215

False secondary RP has more sever prognosis with significant morbidity

Question 216

What is the risk factors for RP?

Answer 216

female gender, family history in a first-degree relative, smoking, and migraines.

Question 217

Dupeytren disease can diagnose by genetic test?

Answer 217

there is currently no genetic test for DD.

Question 218

The cortical control
for placing the limb in space and for strong grasping is developed by
3 year.

Answer 218

The cortical control
for placing the limb in space and for strong grasping is developed by
1 year.

Question 219

percentage of inherited syndactyly?

Answer 219

10% to 40% of cases are familial, inherited
in an autosomal dominant pattern with variable expressivity

Question 220

When should i seek treatment for clinodactyly?

Answer 220

Treatment for clinodactyly is typically considered when there is more than 20 degrees of deviation

Question 221

What is the option of teatment of trigger thump?

Answer 221

Observetion or surgery

Question 222

Splinting can be used with the trigger thump?

Answer 222

Splinting has not been shown to be of any consistent benefit

Question 223

The most common congenital hand anamoly?

Answer 223

Syndactyly, polydactyly, and camptodactyly are the most frequently encountered disorders

Question 224

what is the most common web space involved in syndromic syndactyly?

Answer 224

In syndromic cases, the thumb/index finger
and index/middle finger webspaces are more commonly involved

Question 225

what is the marker for disease progression in RA?

Answer 225

hand disease progression is often
used as a marker of disease severity

Question 226

In RA, synovitis affects the midcarpal
joint more than the radiocarpal joint

Answer 226

In RA, synovitis
typically affects the radiocarpal joint more than the midcarpal
joint

Question 227

patients with RA may be anable to extend their digits why ?

Answer 227

• Attenuation of the radial sagittal band.
• progressive subluxation and volar translation of the proximal phalanx on
  the metacarpal head
• compression on the posterior interosseous nerve

Question 228

What are the “checkrein ligaments”?

Answer 228

?

In flexion contracture of the proximal interphalangeal (PIP) joint, the proximal sliding volar plate becomes attached to the firm assembly line structures by fibrous adhesions called the “checkrein ligaments,” which prevent the volar plate from sliding back distally.

Question 229

Geneticists and pediatricians use the terms malformation, deformation, and

disruption. What do they mean?

Answer 229

In a malformation sequence, poor formation of tissue within the fetus initiates the chain of defects, which may range from minimal to severe. All gradations of radial dysplasia, ranging from absence of the thenar muscles to complete absence of the radius resulting in the club hand posture, are examples. Occurrence rate is in the 5% range. Radial dysplasias also are associated with malformation in other organ systems, such as the VATER association (vertebral anomalies, anal atresia, tracheoesophageal fistula, renal anomalies, and radial dysplasia) and Holt-Oram syndrome (radial dysplasia and congenital heart disease).

• The deformation sequence involves no intrinsic problem with the fetus or embryo; instead, abnormal external mechanical or structural forces cause secondary distortion or deformation. Tethering or constriction of limb parts by anular bands in the constriction ring syndrome is a prime example. The occurrence rate is very low.

• In the disruption sequence, the normal fetus or embryo is subjected to tissue breakdown or injury, which may be vascular, infectious, mechanical, or metabolic in origin. The hand deformities associated with maternal ingestion of thalidomide or alcohol are good examples.

Question 230

Congenital camptoductyly doese involve the thump

Answer 230

F Congenital camptodactyly does not involve the thumb but should be considered with any flexion deformity of a digit

Secret plus

Question 231

What is winblown hand?

Answer 231

The hands are often narrow with prominent ulnar drift. Incomplete, simple syndactyly and varying degrees of PIP camptodactyly are often present. The first web space usually is tight. The descriptive term “windblown hand

Question 232

The most common site for nail melanoma?

Answer 232

The most common site is the thumb, followed by the index finger.

Question 233

camptodactyly or clinodactyly frequently present with functional deficits.

Answer 233

camptodactyly or clinodactyly frequently present with mild deformities and no functional deficits.

Question 234

Most cases of congenital hand anomaly are inherited /

Answer 234

Approximately 60% of cases occur spontaneously, 20% are inherited, and 20% are secondary to an environmental cause.

Question 235

Upper extremity development takes place between 4-6 week of intrauterine life

Answer 235

Upper extremity development takes place between the fifth and eighth weeks of intrauterine growth.

Question 236

When the apical ectoderml ridg start apoptosis?

Answer 236

apoptosis of specific portions of the AER between 47 and 53 days

Question 237

The incidence between male and female in sundactly are equal ?

Answer 237

Males are affected twice as often as females.

Question 238

10% to 40% of syndactyly cases are familial, inherited in an autosomal dominant pattern with variable expressivity, Tor F

Answer 238

T

Question 239

The most common webspace affected in syndromic syndactyly is the middle/ ring finger. T or false

Answer 239

The most common webspace affected in nonsyndromic syndactyly is the middle/ring finger webspace (57% of cases) followed by the ring/little finger webspace (27% of cases). 9 11 • In syndromic cases, the thumb/index finger and index/middle finger webspaces are more commonly involved

Question 240

Syndactyly surgery can be don before one year ?

Answer 240

Surgery before 1 year of age is associated with higher rates of scar contracture and potential anesthetic complications.

Question 241

Syndactyly of the border digits surgical release should be considered earlier, specifically between 3 and 6 months of age.

Answer 241

T

Question 242

Sequential surgery of syndactyly can be don in 6 between each other

Answer 242

F. 3 month

Question 243

minimize or avoid the need for a skin graft, in syndactyly how?

Answer 243

minimize or avoid the need for a skin graft, some surgeons advocate recruiting excess dorsal tissue with the design of a dorsal pentagonal flap. This requires more proximal dorsal hand incisions leading to a more conspicuous scar.916• Defatting of the dig

Question 244

Symbrachydactyly is caused by a disruption in embryonic formation only?

Answer 244

Symbrachydactyly is caused by a disruption in embryonic formation and differentiation

Question 245

is more common in males, and is often unilateral, affecting the right extremity in two-thirds of cases

Answer 245

is more common in males, and is often unilateral, affecting the left extremity in two-thirds of cases

Question 246

symbrachydactyly may appear similar to amniotic band syndrome how you differentiate?

Answer 246

Hands with symbrachydactyly often have small nubbins with fingernails, whereas with constriction bands the short digits occur as a result of intrauterine amputation and will lack nails. 18 Furthermore, patients with amniotic band syndrome will not only have a visible band on the hand but also on other locations of the body.

Question 247

All type of thump polydactyl are inherited in autosomal dominant fashion?

Answer 247

POLYDACTYLY type vll triphalangeal only

Question 248

Surgery for preaxial polydactyly is generally performed between 15-24 month

Answer 248

Surgery for preaxial polydactyly is generally performed between 9 and 15 months of age, prior to the development of pinch grasp or progressive deviation of the duplicated thumb

Question 249

Camptoductyly occurs only in pip joints

Answer 249

Yes Although hyperextension of the DIP or MCP joints may occur in camptodactyly, flex.ion contracture of these joints would instead suggest a post-traumatic cause

Question 250

The delay ed type, which is more common, presents during adolescence, and affects girls and boys equally

Answer 250

The delay ed type, which is more common, presents during adolescence, and affects girls more often than boys

Question 251

camptodactyly can be transmitted in an autosomal dominant fashion

Answer 251

T

Question 252

More Advanced case of contradictory. Present with swan neck deformity

Answer 252

boutonniere deformity.

Question 253

Camptoductyly occures with apert T or F

Answer 253

CLINODACTYLY can occures with apert syndrom

Question 254

When should considred treatment for clinodactyly

Answer 254

Treatment for clinodactyly is typically considered when there is more than 20 degrees of deviation.

Question 255

Congenital clasped thump can produce snapping like adult tigger finger

Answer 255

The term tri gg er is a misnomer because it is uncommon to see snapping as in adult trigger finger. Instead, children typically present with a fixed flexion contracture of the IP joint averaging 25 to 35 degrees with inability or difficulty with active or passive thumb extension

Question 256

The first line treatment for congenital clasped thump is splinting?

Answer 256

Splinting has not been shown to be of any consistent benefit the first line is observation

Question 257

Constricting band syndrom inherited in autosomal dominant fasion ?

Answer 257

with no known autosomal inheritance pattern or genetic predilection.

Question 258

RADIAL LONGITUDINAL DEFICIENCY result from anteroposterior deficient in zone of polarization

Answer 258

insult to the apical ectodermal ridge during the fourth to seventh weeks of intrauterine development

Question 259

All the cases of RLD is syndromic?

Answer 259

1/3 of cases is syndromic

Question 260

Cleft hand patient suffer from sever functional deformity

Answer 260

Although the cleft itself causes little functional limitation,

Question 261

What the pathological features that occures in cleft hand ?

Answer 261

severe flexion contracture of one or more digits, a malpositioned index finger ray, or syndactyly involving the thumb

Question 262

In gynicomastia Sometimes, a staged approach is necessary to achieve an ideal result.

Answer 262

T

Question 263

Neonatal mastauxe, or breast enlargement of the newborn, is directly correlated to circulating maternal estrogens, and is seen in almost 25% of infants

Answer 263

F 70%

Question 264

All neonates experience a surge of prolactin after birth

Answer 264

some neonates experience a surge of prolactin

Question 265

Most of of males will have persistent gynecomastia beyond this period( adolescence , defined by breast bud enlargement of greater than 4 cm.

Answer 265

Approximately 4% of males will have persistent gynecomastia beyond this period, defined by breast bud enlargement of greater than 4 cm.٠

Question 266

Lateral epicondylitis results from microtears at the origin of the common extensor tendon mass, specifically the extensor carpi radialis longus tendon

Answer 266

F. Lateral epicondylitis results from microtears at the origin of the common extensor tendon mass, specifically the extensor carpi radialis brevis tendon

Question 267

Medial epicondylitis affects the common flexor tendon mass, most often the pronator teres and flexor carpi raclialis.

Answer 267

T

Question 268

Most of patients should be assessed for possible ulnar neuropathy.

Answer 268

F. all patients should be assessed for possible ulnar neuropathy.

Question 269

Intersection syndrome results in pain, swelling and often crepitus over the junction on the first and second extensor compartments

Answer 269

T

Question 270

In trigger finger Corticosteroid injections are not effective in many patients,

Answer 270

F. Corticosteroid injections are effective in many patients,

Question 271

Atypical conditions include tendinopathy of the extensor carpi ulnaris (ECU), flexor carpi radialis (FCR), and extensor pollicis longus (EPL)

Answer 271

T

Question 272

lateral epicondylitis may be precipitated by any activity that results in forceful repetitive motion of the forearm flexors

Answer 272

lateral epicondylitis may be precipitated by any activity that results in forceful repetitive motion of the forearm extensors

Question 273

Manual activities, particularly lifting loads greater than 20 kg, have been associated with the development of lateral epicondylitis

Answer 273

T

Question 274

Lateral epicondalytis occurs in men mor than female?

Answer 274

F. It is equally common in men and women, and prevalence peaks between the ages of 45 and 54 year

Question 275

Changes within the ECRL tendon substance represent the sine q ua non for lateral epicondylitis.

Answer 275

F. Changes within the ECRB tendon substance represent the sine q ua non for lateral epicondylitis.

Question 276

What the hypotheses behind lateral epiocndylates ?

Answer 276

repetitive contact between the capitellum and the ECRB tendon may be the causative problem

Question 277

Radiographic aid significantly in the diagnosis of lateral epicondylitis. T. F

Answer 277

F. have not been found to aid significantly in the diagnosis of lateral epicondylitis

Question 278

MRI is often the modality of choice, with a higher sensitivity of 90% to 100% for lateral epicondylates T. F

Answer 278

T

Question 279

In lateral epicondilytes the severity of disease present on MRI does not necessarily correlate with symptoms,

Answer 279

T

Question 280

activity modification continues to be the mainstay of treatment for lateral epicondylitis, with up to 90% of patients improving

Answer 280

T

Question 281

Injections into and around the lateral epicondyle considered the mainstay of treatment

Answer 281

F. Injections into and around the lateral epicondyle remain highly controversial.

Question 282

With open approach greater possibility of radial nerve injury.in lateral epiconylitis

Answer 282

F. The arthroscopic approach

Question 283

MEDIAL EPICONDYLITIS less prevalence than lateral epicondylitis

Answer 283

T

Question 284

In medial epicondylitis The PT and FCR are most frequently affected.

Answer 284

T

Question 285

Ulnar neuritis is especially important as 23% to 61% of patients with medial epicondylitis

Answer 285

Ulnar neuritis is especially important as 23% to 61% of patients with medial epicondylitis

Question 286

medial epicondylitis Ultrasound can be used to assist in the diagnosis, as it has been shown to be both specific and sensitive

Answer 286

T

Question 287

the MCL and the medial antebrachial cutaneous nerves are all key components of this operation.in medial epicondylitis

Answer 287

T

Question 288

DE QUERVAIN DISEASE occurs in men and female equally. T. F

Answer 288

F. DE QUERVAIN DISEASE six times more common in women than men. In 50-60 %

Question 289

E QUERVAIN DISEASE. Mor common in hypothyrodism patients. T. F.

Answer 289

F. In pregnant and lactating women

Question 290

Patients present with a rapid onset of radial-sided wrist pain and tenderness to palpation over the radial styloid.

Answer 290

F. Patients present with a gradual onset of radial-sided wrist pain and tenderness to palpation over the radial styloid.

Question 291

high success rate of corticosteroid injections alone or in conjunction with splinting in de Quervain patients, that 80% had complete and lasting reliefofsymptoms

Answer 291

T

Question 292

Splinting alone was observed to be less successful, but when combined with corticosteroids, is likely more successful than injections alone.in de qruvian

Answer 292

T

Question 293

Studies have shown that a separate subsheath is present in 44% ofnormal cadavers versus 62% in de Quervain disease

Answer 293

T

Question 294

intersection syndrome is an common cause of wrist pain

Answer 294

F. intersection syndrome is an uncommon cause of wrist pain

Question 295

Because of the locking or popping sensation noted in trigger finger , it is not uncommon for patients to localize the problem to the proximal interphalangeal (PIP) joint rather than the Al pulley.

Answer 295

T

Question 296

patients with diabetes, hyp oth yr oidism, rheumatoid arthritis, gout, and renal failure develop trigger fingers at higher rates.

Answer 296

T

Question 297

patients with diabetes, hyp oth yr oidism, rheumatoid arthritis, gout, and renal failure develop trigger fingers at higher rates.

Answer 297

T

Question 298

association with specific
occupations has not been found in trigger finger

Answer 298

t

Question 299

In trigger finger The PIP joint can also be
splinted, instead of the MCP joint, with similar effect

Answer 299

t

Question 300

Corticosteroid has proven effective in treating trigger fingers and
can be the first line intervention.

Answer 300

t

Question 301

injection for trigger finger before surgical release in patients without
comorbidities such as diabetes and hypothyroidism is preferable

Answer 301

F Diabetic patients often experience a transient elevation in blood glucose levels after a corticosteroid injection.

Question 302

trigger finger and de Quervain disease are the most common tendinopathies of the hand and wris

Answer 302

T

Question 303

treatment of EPL tendinitis is often medical
with complete release of the third dorsal compartment

Answer 303

F treatment of EPL tendinitis is often surgical
with complete release of the third dorsal compartment