Hand and Wrist Flashcards

1
Q

Why is the hand/wrist vulnerable to injury?

A

very little muscle or fat
padding to protect the
underlying bony
structures

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2
Q

most hand/wrist injuries present with?

A

local point tenderness, swelling and reduced function

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3
Q

__ intrinsic and __ extrinsic muscles

A

19; 20

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4
Q

the hand/wrist has ___, ___, ___ and ___ roles

A

expressive
protective
motor
sensory

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5
Q

what four bones make up the proximal row?

A

scaphoid
lunate
pisiform
triquetrum

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6
Q

What 4 bones make up the distal row?

A

trapezium
trapezoid
capitate
hamate

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7
Q

the ___ does not touch the carpal bones

A

carpal

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8
Q

most of the flexors are supplied by the _____ nerve

A

median

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9
Q

most of the extensors are controlled by the ____ nerve

A

radial

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10
Q

blood is supplied by the ___ and ___ arteries

A

radial and ulnar

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11
Q

the ___ nerve innervates the three digits on the palmar side - complaining of carpal tunnel is due to this nerve

A

medial

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12
Q

injury prevention? (3)

A
  1. protective padding
  2. physical conditioning
  3. proper skill technique
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13
Q

chronic injury?

A

wrist ganglion

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14
Q

most common wrist injury?

A

wrist sprain

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15
Q

management of wrist sprain? (3)

A
  • refer to physician for x-ray
  • RICE, splint and analgesics
  • tape for support
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16
Q

Etiology:

  • Direct blow to the finger tip (axial load) or valgus/varus stress
  • May damage DIP, PIP or MCP joint capsule/ligaments
A

phalange sprain

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17
Q

S&S of phalangeal sprain? (5)

A

pain, swelling, point tenderness, instability, loss of ROM

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18
Q

management for phalangeal sprain?

A

RICE, splint, refer if suspecting a fracture

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19
Q

Thumb MCP is forced into abdn /& hyperextension is etioogy for?

A

thumb UCL sprain

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20
Q

S&S:

Pain, swelling, instability, loss of function (cannot pinch grip)

A

thumb UCL sprain

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21
Q

management for thumb UCL sprain?

A

RICE, NSAIDs, splint/tape, refer if suspecting a fracture or instability

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22
Q

Etiology:

Direct blow to the finger tip (axial load) with forced hyperflexion of DIP avulsing extensor tendon

A

strains - mallet finger

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23
Q

S&S:

Pain & swelling at DIP, point tenderness, instability, loss of ROM (cannot extend DIP)

A

strains - mallet finger

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24
Q

management for mallet finger strain?

A

RICE, splint, refer if suspecting a fracture

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25
Q

Boutonniere deformity strain etiology is rupture of ____ tendon at the ___ phalanx

A

extensor; middle

26
Q

S&S:

  • Extensor tendon slides below axis of PIP causing DIP to extend & PIP to flex
  • Pain, swelling, point tenderness, instability, deformity, loss of ROM (cannot extend DIP)
A

Boutonniere deformity strain

27
Q

management for Boutonniere deformity strain?

A

RICE, splint, refer

28
Q

Etiology for jersey finger strain is rupture of the _____ ______ _____ tendon from ____ phalanx. Mechanism is rapid ___ from active _____

A

flexor digitorum profundus; distal; extension; flexion

29
Q

Signs and symptoms of jersey finger?

A

loss of ROM - can’t flex DIP

30
Q

Management for jersey finger?

A

RICE, splint, refer

31
Q

Etiology:

  • Tenosynovitis of ext’r tendons of wrist, fingers, thumb, abductor pollicis
  • Formed nodule or thickened sheath cannot glide uninterrupted
A

trigger finger strain

32
Q

S&S of trigger finger?

A

Locking; painful popping sensation that is palpable & audible

33
Q

management for trigger finger strain?

A

RICE, NSAIDs, immobilization

34
Q

Etiology:

-Stenosing tenosynovitis in thumb extensor and abductor

A

Dequervain’s Tenosynovitis strain

35
Q

S&S of Dequervain’s Tenosynovitis strain:

Point tenderness over ____; aching pain over ____ stylus with ↑ thumb & wrist motion; pain with thumb ________

A

tendons; radial; abduction

36
Q

management for Dequervain’s Tenosynovitis strain?

A

RICE, NSAIDs, immobilization

37
Q

what is tenosynovitis?

A

when the sac around the tendon starts to inflame

38
Q

Etiology:

  • Compression of median nerve in tunnel due to inflammation
  • Compounded by overuse, anatomic anomalies, or direct trauma
A

carpal tunnel syndrome

39
Q

S&S of carpal tunnel syndrome? (3)

A

Sensory and motor deficits; thumb weakness; awakening pain

40
Q

management for carpal tunnel

A

RICE, NSAIDs

May require further medical intervention

41
Q

Etiology -

FOOSH; axial loading forcing radius & ulna into hyperextension

A

fractures - distal radius/ulna

42
Q

“fracture occurs in distal radius, with dorsal displacement of distal segment”

A

Colles’

43
Q

“fracture occurs in distal radius with palmar displacement of distal fragment”

A

Smith’s

44
Q

What do children’s fractures need to be monitored well?

A

because it is bad if there is a disruption to the growth plate – a disruption can cause fusing in the growth plate

45
Q

A “fork” deformity is S&S for what?

A

fractures - distal radius/ulna

46
Q

In children, a distal radius/ulna fracture injury may cause lower ______ separation

A

epiphyseal

47
Q

What is a concern with scaphoid fracture?

A

poor healing

48
Q

S&S of scaphoid fracture? (3)

A
  • Pain
  • swelling & point tenderness in snuff box
  • ↑ pain with wrist extension & radial deviation
49
Q

management for scaphoid fracture?

A

RICE, splint, refer

50
Q

_____ artery circles around the scaphoid so you need to make sure it hasn’t cut off supply

A

radial

51
Q

Pain, swelling & inability to grip; Point tenderness & crepitus - S&S for?

A

metacarpal fractures

52
Q

management for metacarpal fractures?

A

RICE, splint, refer

53
Q

Dislocation (finger) - ____: rare; twist or shear

A

MCP

54
Q

Dislocation (finger) - ____: hyperextension & axial load

A

PIP

55
Q

Dislocation (finger) - ____: usually dorsal

A

DIP

56
Q

S&S of dislocated finger

A

Pain & swelling over joint, point tenderness, obvious deformity

57
Q

management for dislocated finger?

A
  • RICE, splint, refer

- Buddy taping post splint

58
Q

Etiology:

-Direct trauma to nail; compressive force

A

subungual hematoma

59
Q

management for subungual hematoma?

A
  • ice via compression or bath
  • refer if suspect fracture
  • may release pressure via draining
60
Q
Etiology of wrist ganglion: 
\_\_\_\_\_ cyst (herniation of joint capsule or synovial sheath of tendon). May appear following \_\_\_\_ strain or repetitive injury
A

synovial; wrist

61
Q

S&S: Generally appear on back of wrist; palpable soft, rubbery or hard mass. May be painful

A

wrist ganglion

62
Q

management of wrist ganglion?

A

May be self limiting; aspiration, or surgical removal