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18 ORR > Hand > Flashcards

Hand Flashcards

1
Q

most common injury for the skeletal parts of the hand

A

fracture

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2
Q

treatment for displaced fractures

A

open reduction and internal fixation

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3
Q

test for finger alignment

A
  • normal: all fingers except thumb point towards scaphoid

- not observed = fingers cross on top of each other

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4
Q

what is boxer’s fracture

A
  • force is borne by smallest portion of 5th metacarpal (fracture of neck)
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5
Q

what is gamekeeper’s or skier’s thumb

A
  • avulsion fracture of attachment of ulnar collateral ligament of the thumb
  • caused by hyperextension and valgus force on the interphalangeal joint of thumb
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6
Q

the strongest ligament at the proximal interphalangeal joint

A

volar plate

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7
Q

injury to volar plate

A

rupture of volar plate -> dorsal subluxation of proximal interphalangeal joint

  • reduction of subluxation requires application of traction and volar pressure on middle phalanx
  • splint for 2-3 wks
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8
Q

counterpart of volar plate on dorsal side

A

extensor hood

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9
Q

what is boutonniere deformity

A

the rupture of the extensor hood on the proximal interphalangeal joint

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10
Q

what is mallet finger injury

A

rupture at distal interphalangeal joint

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11
Q

management of extensor hood injuries

A
  • traction and dorsal pressure across joint

- immobilization (splint)

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12
Q

flexor zones

A

1: over distal interphalangeal joint
2: over proximal interphalangeal join and metacarpophalangeal joint
3: over palm
4: over wrist
5: over forearm

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13
Q

what are pulleys

A

4 annular pulleys
3 cruciate pulleys

  • keep tendon close to bone
  • allow more efficient transmission of flexion
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14
Q

most important flexor pulleys

A

a2 and a4

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15
Q

what is a bowstring

A
  • rupture of a2 or a4 = less efficient finger flexion

- bowstring effect: tendons move away from bone

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16
Q

test for intact flexor tendons

A
  • passively extend wrist = fingers will flex
  • passively flex wrist = fingers will extend
  • (+) finding = tenodesis effect
17
Q

radial nerve provides sensation to __

A
  • dorsum of thumb, index, and radial side of long finger up to proximal interphalangeal joint
18
Q

test for radial nerve

A
  • pinch dorsal side of first web space
19
Q

what is median nerve

A
  • sensation to volar side of hand

- from thumb to radial side of ring finger

20
Q

what is ulnar nerve

A
  • sensation to the small finger and ulnar side of the ring finger on both volar and dorsal sides
21
Q

carpal tunnel syndrome is caused by __

A

compression of median nerve

22
Q

symptoms of carpal tunnel

A

numbness and pain on thumb, index finger, long finger, and radial side of ring finger

23
Q

ten structures that pass through carpal tunnel

A
  • 4 flexor digitorum superficialis tendons
  • 4 flexor digitorum profundus tendons
  • flexor pollicis longus
  • median nerve
24
Q

test for median nerve

A

phalen’s test and tinel’s test

25
Q

differentials for carpal tunnel

A

c6-c7 radiculopathy and polyneuropathy in dm

26
Q

diagnosis for carpal tunnel

A
  • emg-ncv
  • msk uts
  • check thenar muscles for atrophy (chronic compression)
27
Q

treatment for carpal tunnel

A
  • conservative treatment: splint
  • pharma: corticosteroid injections
  • tendon gliding exercises
  • median nerve mobilization exercises
  • surgery
28
Q

de quervain’s tenosynovitis affects __

A

extensor pollicis brevis and abductor pollicis longus = pain in area of first dorsal compartment of wrist

29
Q

what is finkelstein’s test

A
  • provocative test to reproduce symptoms of de quervain’s tenosynovitis
30
Q

treatment for de quervain

A
  • anti-inflammatory drugs
  • thumb spica splint
  • corticosteroid injection
  • surgery (incise retinaculum)
31
Q

what is trigger finger

A
  • overuse of flexor tendon = microtrauma
  • produce nodules
  • affect a1 pulley
32
Q

treatment for trigger finger

A
  • corticosteroids
  • rehab exercises
  • surgery (incise a1 pulley)

18 ORR (21 decks)

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