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EPHE 344 - Final Exam > Hand and Wrist > Flashcards

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
Boutonniere deformity strain etiology is rupture of ____ tendon at the ___ phalanx
extensor; middle
26
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)
Boutonniere deformity strain
27
management for Boutonniere deformity strain?
RICE, splint, refer
28
Etiology for jersey finger strain is rupture of the _____ ______ _____ tendon from ____ phalanx. Mechanism is rapid ___ from active _____
flexor digitorum profundus; distal; extension; flexion
29
Signs and symptoms of jersey finger?
loss of ROM - can't flex DIP
30
Management for jersey finger?
RICE, splint, refer
31
Etiology: - Tenosynovitis of ext’r tendons of wrist, fingers, thumb, abductor pollicis - Formed nodule or thickened sheath cannot glide uninterrupted
trigger finger strain
32
S&S of trigger finger?
Locking; painful popping sensation that is palpable & audible
33
management for trigger finger strain?
RICE, NSAIDs, immobilization
34
Etiology: | -Stenosing tenosynovitis in thumb extensor and abductor
Dequervain's Tenosynovitis strain
35
S&S of Dequervain's Tenosynovitis strain: | Point tenderness over ____; aching pain over ____ stylus with ↑ thumb & wrist motion; pain with thumb ________
tendons; radial; abduction
36
management for Dequervain's Tenosynovitis strain?
RICE, NSAIDs, immobilization
37
what is tenosynovitis?
when the sac around the tendon starts to inflame
38
Etiology: - Compression of median nerve in tunnel due to inflammation - Compounded by overuse, anatomic anomalies, or direct trauma
carpal tunnel syndrome
39
S&S of carpal tunnel syndrome? (3)
Sensory and motor deficits; thumb weakness; awakening pain
40
management for carpal tunnel
RICE, NSAIDs | May require further medical intervention
41
Etiology - | FOOSH; axial loading forcing radius & ulna into hyperextension
fractures - distal radius/ulna
42
"fracture occurs in distal radius, with dorsal displacement of distal segment"
Colles'
43
"fracture occurs in distal radius with palmar displacement of distal fragment"
Smith's
44
What do children's fractures need to be monitored well?
because it is bad if there is a disruption to the growth plate – a disruption can cause fusing in the growth plate
45
A "fork" deformity is S&S for what?
fractures - distal radius/ulna
46
In children, a distal radius/ulna fracture injury may cause lower ______ separation
epiphyseal
47
What is a concern with scaphoid fracture?
poor healing
48
S&S of scaphoid fracture? (3)
- Pain - swelling & point tenderness in snuff box - ↑ pain with wrist extension & radial deviation
49
management for scaphoid fracture?
RICE, splint, refer
50
_____ artery circles around the scaphoid so you need to make sure it hasn’t cut off supply
radial
51
Pain, swelling & inability to grip; Point tenderness & crepitus - S&S for?
metacarpal fractures
52
management for metacarpal fractures?
RICE, splint, refer
53
Dislocation (finger) - ____: rare; twist or shear
MCP
54
Dislocation (finger) - ____: hyperextension & axial load
PIP
55
Dislocation (finger) - ____: usually dorsal
DIP
56
S&S of dislocated finger
Pain & swelling over joint, point tenderness, obvious deformity
57
management for dislocated finger?
- RICE, splint, refer | - Buddy taping post splint
58
Etiology: | -Direct trauma to nail; compressive force
subungual hematoma
59
management for subungual hematoma?
- ice via compression or bath - refer if suspect fracture - may release pressure via draining
60
``` Etiology of wrist ganglion: _____ cyst (herniation of joint capsule or synovial sheath of tendon). May appear following ____ strain or repetitive injury ```
synovial; wrist
61
S&S: Generally appear on back of wrist; palpable soft, rubbery or hard mass. May be painful
wrist ganglion
62
management of wrist ganglion?
May be self limiting; aspiration, or surgical removal

EPHE 344 - Final Exam (5 decks)

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