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Physical Exam Course > Hand and Wrist > Flashcards

Hand and Wrist Flashcards

1
Q

Special Tests: Dequervain’s Tenosynovitis

A

Finkelstein’s Test

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2
Q

Special Tests: Osteoarthritis

A

CMC Grind Test

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3
Q

Special Tests: Carpal Tunnel (4)

A
  1. Phalen’s: at lest 60 seconds
  2. Tinel’s
  3. Hand Elevation: above head for at least 2 min
  4. Durkan’s: carpal tunnel compression for 30 seconds
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4
Q

Special Tests: Durkan’s Test

A

Carpal Tunnel: Compression of carpal tunnel for 30 sec.

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5
Q

Special Tests: Scaphoid lunate instability

A

Watson Test: passive movement from extension and ulnar deviation to flexion and radial deviation + Volar force to scaphoid

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6
Q

Special Tests: Watson test

A

Scaphoid Lunate Instability: passive movement from extension and ulnar deviation to flexion and radial deviation + Volar force to scaphoid

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7
Q

Special Tests: Lunate triquetrum instability

A
  1. Reagan’s Test (Shuck Test): Stabilize triquetrum in one hand, move lunate anterior/posterior w/o other hand
  2. Kleinman Shear Test: Similar to above using only thumbs
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8
Q

Special Tests: Reagan’s Test

A

Lunate Triquetrum Instability: Stabilize triquetrum in one hand, move lunate anterior/posterior w/o other hand

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9
Q

Wrist meniscus

A

TFCC: Triangular fibrocartilage complex

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10
Q

Function of TFCC

A

Primary stabilizer of distal radioulnar joint

Contributes to ulnocarpal stability

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11
Q

Carpal bones (8)

A

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12
Q

Ischemic necrosis of flexor muscles of the forearm

A

Volkmann’s Contracture

  • Brachial artery injury
  • Compartment syndrome
  • Improper tourniquet
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13
Q

Volkman’s contracture

A

Ischemic necrosis of flexor muscles of the forearm

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14
Q

Contraction of palmer fascia due to fibrosis

A

Dupuytren’s Contracture

  • Genetic predisposition
  • Men > 40
  • DM
  • ETOH
  • Epilepsy
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15
Q

Injection treatment for dupytren contracture

A

Clostridium histolyticum

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16
Q

Rheumatoid Arthritis: Common deformities

A
  • Ulnar deviation of finger: ECU weakness → Radial wrist deviation → flex/ext mismatch due to increased torque of ulnar finger flexors → ulnar deviation
  • Boutonniere deformity: Hyperextension of MCP + Flexion of PIP
    • Weakness/rupture of extensor hood → subluxaation of extensor tendons past PIP
  • Swan neck deformity: Flexion of MCP + Hyperextention of PIP + Flexion of DIP
    • Contracture of deep flexor muscles/intrinsic of hand
  • Pseudobenediction Sign: Extensor tendon rupture → inability to extend 4th and 5th digits
  • Floating Ulnar Head: Elevation of ulnar head at dorsum of wrist
    • Distal radioulnar instability due to synovial proliferation
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17
Q

First sign of effusion of radiocarpal joint

A

Loss of full wrist flexion

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18
Q
A
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19
Q

1st Dorsal wrist compartment

A
  1. EPB
  2. APL
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20
Q

2nd wrist compartment

A
  1. ECRB
  2. ECRL
21
Q

3rd dorsal wrist compartment

A
  1. EPL
22
Q

4th Dorsal Wrist Compartment

A
  1. EDC
  2. EIP
23
Q

5th Dorsal wrist compartment

A

EDM

24
Q

6th Dorsal wrist compartment

A

ECU

25
Q

Pathology or 1st dorsal wrist compartment

A

Dequervain’s Tenosynovitis

  • Inflammation/irritation of EPB and APL
    • (+) Finkelstien’s Test
26
Q

Compartments of intersection syndrome

A

1st + 2nd

27
Q

Intersection Syndrome: Cause

A

Repetitive wrist flexion/extension activities

28
Q
  • Swelling and tenderness at intersection of 1st and 2nd dorsal compartments
  • Pain w/ resisted wrist extension
  • Pain/crepitus
A

Intersection syndrome

29
Q

Most common site of hand OA

A

1st CMC joint

30
Q

Bouchard’s nodes

A

PIP

31
Q

Heberden’s nodes

A

DIP

32
Q

Osteonecrosis/AVN of the lunate

A

Kienbock’s disease

33
Q

Kienbock’s disease

A

Osteonecrosis/AVN of lunate

34
Q
  • Pain over ulnar side of wrist on palpation
  • Swelling over dorsal aspect of wrist
  • Decreased grip strength
  • Negative ulnar variance
A

Kienbock’s Disease

35
Q

Scaphoid Fracture: mechanism

A

Fall on dorsiflexed wrist

36
Q

Borders of anatomic snuffbox

A

Radial: EPB, APL

Ulnar: EPL

Base: Scaphoid bone

37
Q

Avulsion to flexor digit rum profundus

Sudden extension on DIP when flexed

A

Jersey Finger

38
Q
  • Sudden extension on DIP when flexed
  • Pt unable to actively flex DIP
A

Jersey Finger

39
Q

Avulsino of extensor tendon to DIP

A

Mallet finger

40
Q
  • Avulsion of extensor tendon to DIP
  • DIP is flexed at rest
  • Pt unable to actively extend
A

Mallet finger

41
Q

Gamekeeper’s thumb/skier’s thumb

A

UCL injury to thumb: Valgus stress

42
Q
  • Tenderness over ulnar side of MCP joint
  • Increased laxity and pain w/ valgus stress
  • Valgus stress to thumb
A

UCL injury

43
Q

Stener lesion

A

aponeurosis of adductor pollicis muscle lies between MCP and distal end of UCL

Prevents spontaneous healing

44
Q

Prevents spontaneous healing of UCL injury

A

Stener lesions

45
Q

Aponeurosis of adductor pollicis muscle lies between MCP and distal end of UCL, preventing spontaneous healing of UCL injury

A

Stener lesion

46
Q

Carpal Tunnel: Risk factors

A
  • CHF/ESRD
  • Thyroid disorder
  • Pregnancy
47
Q
  • Pain on ulnar side of wrist, dorsal aspect, just distal to ulnar styloid
  • Pain + Clicking/catching w/ wrist movement
  • Decreased grip strength
  • Pain w/ axial loading of carpal bones w/ wrist in ulnar deviation
  • Pain w/ resisted radial wrist deviation
A

TFCC injury

48
Q

Risk factor for TFCC injury

A

Postivie ulnar variance

Physical Exam Course (7 decks)

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