Hand and spine Flashcards
Cubital tunnel syndrome: description
compression of ulnar nerve at elbow.Ulnar nerve between the biceps and triceps. Also between the medial epicondyle and the olecranon.
Cubital tunnel syndrome: SX
numbness and tingling to the 4th and 5th digits
Cubital tunnel syndrome: exam
flexion elbow tst, tinels at elbow
Cubital tunnel syndrome: tests
EMG show reduction of 30% velocity
Cubital tunnel syndrome: TX
behavior modification, (wearing a brace in sleep so arms aren’t flexed), surgical transposition
Carpal tunnel syndrome: description
Compression of median nerve at the wristInside the carpal tunnel: Median nerve, flexor dgitalis superficialis, flexor digitalis profundus, flexor polics longis
Carpal tunnel syndrome: sx
numbness and tingling to 1-3rd digits, night pain
Carpal tunnel syndrome: exam
positive phalens, tinels, compression test
Carpal tunnel syndrome: test
EMG show 30% velocity decrease
Carpal tunnel syndrome: TX
night splints, steroid injections, carpal tunnel release
Trigger finger: DESCRIPTION
inflammation of flexor tendon gets it snapping through pulleys in hands
Trigger finger: symptoms
catching of finger when factively flexing finger
Trigger finger: exam
palpable knot that moves with tendon at distal palm
Trigger finger: tests
none
Trigger finger: TX
NSAID, steroid injections, A1 pulley release
Mallet finger: description
laceration of extensor tendon at base of the DP
Mallet finger: SX
inability to straighten fingertip
Mallet finger: exam
inability to straighten finger tip
Mallet finger: Test
X ray may show avulsion fracture at base of DP
Mallet finger: Tx
Stack splinting
De quervain tenosynovitis: description
Swelling and inflammation fo the tendons taht run throught he 1st dorsal compartment (Extensor policis brevis and abductor policis longus)
De quervain tenosynovitis: SX
pain over radial styloid
De quervain tenosynovitis: exam
finklestein’s test
De quervain tenosynovitis: test
none
De quervain tenosynovitis: TX
Splint, NSAIDs, steroid injection, release of compartment
Dupuytren disease: description
nodular thickening of palmar fascia (northern european descent)
Dupuytren disease: SX
painless nodules that eventually draw the 4th and 5th digits
Dupuytren disease: Exam
cords may form causing flexion of the digits, table top test
Dupuytren disease: Test
none
Dupuytren disease: Treatment
splinting, celleganase injection, fasciotomies
Low back pain: description
80% have no cause
Low back pain: SX
Low back pain with even a trivial event, radiating to buttocks
Low back pain: Exam
diffuse LBP to palpation, stiffROM. Reflexes and neuro exam is normal.
Low back pain:test
no testing for 6 weeks unless atypical pain. Then x ray then MRI
Low back pain:TX
Nsaids, no bedrest, then PT
Herniated nucleus pulposis: description
extrusion of center of disk posteriorly, compressing nerve roots. Most common at L4-5 and L5-S1L4: KneeL5: Big toeS1: pinky toeS1 and S2: achilles reflexT10: belly button
Herniated nucleus pulposis: SX
usually abrupt, but may be insidious. Unilateral radicular pain, worse with activity
Herniated nucleus pulposis: exam
straight leg raise, dermatomal weakness and parasthesias
Herniated nucleus pulposis: test
xrays may demonstrate narrowed disk space. MRI is diagnostic
Herniated nucleus pulposis: TX
NSAIDS, rest, then PT, epidural steroid injections, the discectomy
Spondylolistehesis: description
forward slippage of lumbar vertebral bodyPars defect may increase chance of slippage
Spondylolistehesis: sx
back pain from bending. may cause claudicaton
Spondylolistehesis: exam
dermatomal weakness, may feel spinous process stepoffs
Spondylolistehesis: tests
Flexion/extension x rays of spine who slippage
Spondylolistehesis: TX
NASAIDS, surgical fusion
Spnodylosis: description
degenerative changes in teh facets of discs leading to osteophytes and possible nerve compression
Spnodylosis: SX
achy pain in spine, worse with ROM
Spnodylosis: exam
tender to palpation, stiffness, radicular or myelopathy may be present
Spnodylosis: tests
xrays show osteophytes and sclerosis. MRI can show pinched nerves
Spnodylosis: tx
nsaids, steroids, traction, surgical decompression and fusion
Cervical dermatomes
C6 thumbC8: pinky
Cervical myotomes
C5: deltoidC6: biceps flexors, wrist extensorC7: tricep, wrist flexorsC8: fingers flexT1`: interossei
DISH: description
idiopathic disease characterized by osteophyte formation spanning several vertebra. More than 1
DISH: sx
stiff spine and pain
DISH: exam
stiff spine
DISH: test
xrays show brdiging osteophytes over 4 vertebra, no HLA association
DISH: tx
nsaids
Radiculopathy: description
compression of nerve root
Radiculopathy: SX
unilateral radiating dermatomal paincompress nerve root as it exits
Radiculopathy: exam
ROM cause radiating pain, dermatomal weakness and parasthesias. No upper motor neuron signs
Radiculopathy: test
MRI shows nerve root compression
Radiculopathy: TX
NSAIDS steroid injections, PT traction. Surgical decompression
Myelopathy: description
compression of the spinal cordEdema in the spinal cord.
Myelopathy: SX
bilateral weakness, difficulty with fine motor tasks, wide based gait
Myelopathy: exam
bowel or bladder ysfunction, upper motor neuron signs
Myelopathy: tests
MRI shows cord compression
Myelopathy: TX
epidural injections may help but surgical decompression is recomended due to risk of permanent deficits