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RMSK overall > Hand and Wrist RMSK > Flashcards

Hand and Wrist RMSK Flashcards

1
Q

Wrist joints

A

radiocarpal, midcapal, distal radioulnar

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2
Q

Contents of carpal tunnel

A

Median nerve, FDS, FDP, FPL

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3
Q

Roof of carpal tunnel is the

A

flexor retinaculum

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4
Q

Carpal tunnel inlet

A

scaphoid and pisiform

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5
Q

Carpal tunnel outlet

A

Trapezium and Hamate

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6
Q

Dorsal compartments how many? Name all

A

six 1 (APL,EPB) 2(ECRL,ECRB) 3 (EPL) 4(EDC, EIP) 5(EDMinimi) 6(ECU)

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7
Q

Where does the FDS split and insert

A

splits at PIP joint, inserts at middle phalanx

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8
Q

Insertion of Extensor Digitorum tendon

A

middle phalanx as a central band.

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9
Q

Nerve fascicle appearance

A

hypoechoic fasicle. hyperechoic surrounding connective tissue

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10
Q

Median nerve appearance tunnel vs forearm

A

Hypoechoic at tunnel, hyperechoic forearm

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11
Q

Where does the palmar cutaneous branch of the median nerve go

A

superficial to flexor retinaculum and ULNAR to FCR tendon

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12
Q

Thenar motor branch landmark

A

from palmar ulnar aspect of radial division of median nerve. extending proximal between the APB and FPB.

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13
Q

Palmaris longus

A

directly superficial to median nerve

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14
Q

Nerves found in dorsal extensor compartment 1

A

superficial radial nerve

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15
Q

Nerve found at the 4th dorsal compartment

A

Posterior interosseous nerve

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16
Q

ECU tendon has a normal thin hypoechoic longitudinal cleft

A

not a tear

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17
Q

ECU tendon located outside groove significance?

A

50% of the time is outside.. still normal

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18
Q

Extensor retinaculum measurement

A

1.7mm thick and 23mm wide in Cross section

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19
Q

What plane is the distal radioulnar joint seen?

A

transverse

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20
Q

What plane is the radiocarpal and midcarpal joint recess seen

A

sagittal

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21
Q

Landmark for finding the scapholunate ligament

A

distal to Listers tubercle

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22
Q

Superficial to the dorsal scapholunate ligament what structure?

A

dorsal radiocarpal ligament is seen.. common site for wrist ganglion

23
Q

What comprises TFCC

A

cartilage, meniscus, ECU tendon sheath, ulnar and dorsal radiocarpal ligament

24
Q

vascular landmark near superficial radial nerve

A

cephalic vein

25
Q

Appearance of pulleys on ultrasound

A

trilaminar.. superficial reflectiv surface . hypoechoic pulley, hyper reflective surface of adjacent tendon sheath

26
Q

A1 pulley location

A

MCP

27
Q

A2 pulley location

A

PP

28
Q

A3 pulley location

A

PIP joint

29
Q

A4 pulley location

A

Middle phalanx

30
Q

Where can you find the ulnar collateral ligament of the thumb? landmark

A

MP joint and PP..

31
Q

structure superficial to UCL of thumb

A

adductor pollicis aponeurosis- moves with flexion of IP joint

32
Q

What dynamic test for UCL

A

valgus for ulnar ligaments and varus for radial ligaments

33
Q

Joint recess distention anechoic indicates what pathology

A

simple fluid

34
Q

Joint recess distention NOT anechoic what are your considerations?

A

compelx fluid and synovial hypertrophy

35
Q

Complex fluid characteristics

A

compressible, swirling echoes, NO INTERNAL FLOW ON DOPPLER

36
Q

Synovial hypertrophy characteristics

A

LITTLE compressibility, No displacement. + with internal flow on doppler , hypoechoic or (less frequyently iso or hyper compared to adjacent subdermal fat)

37
Q

typical characteristic of a ganglion cyst

A

MULTILOCULAR & NON COMPRESSIBLE

38
Q

active inflammatory synovitis characteristics

A

hypoechoic with hyperemia on color doppler imaging

39
Q

RA hand and wrist protocol

A

three joints of each wrist ( radioulnar, radio carpal, midcarpal) MCP joints of each index and long fingers PIP of index and long fingers

40
Q

what is paratendinitis

A

inflammation of a tendon that has no tendon sheath

41
Q

Tenosynovitis erosions in RA region in hand

A

ulnar styloid

42
Q

RA early assessment of which tendons

A

ECU and second flexor tendon

43
Q

proximal intersection syndrome involvement and location

A

4-8cm PROXIMAL to listers. APL EPB and ECRB and ECRL (1st and 2nd dorsal)

44
Q

accessory muscles of hand

A

accessory ABDUCTOR DIGITI MINIMI - Ulnar nerve entrapment, Extensor digitorum brevis manus, palmaris longus

45
Q

normal CSA of median nerve

A

< 6 if >12mm CTS…

46
Q

Measurement of bifid median nerve

A

combined CSA has difference of 4mm2 comparing PQ and DISTAL carpal tunnel

47
Q

Hypothenar hammer syndrome cause

A

post- traumatic digital ischemia from thrombusof ulnar artery

48
Q

fatty median nerve mass

A

fibrohamaroma median nerve

49
Q

Compression of superficial radial nerve at distal forearm syndrome

A

wartenburg

50
Q

Appearance of abnormal TFCC

A

abnormal hypoecho, thinning or absence.

51
Q

Interosseous membrance bet. radius and ulna tears called

A

essex-lopresti injury ( comminuted radial head fracture at elbow with interosseous injury and distal radioulnar joint disruption)

52
Q

Difference between fracture and cortical irregularity

A

step-off deformity is specific (radiographic correlation is essential) hyperemia, and point tenderness

53
Q

ganglion cyst echogenic considerations / artifact?

A

usually with increased through transmission

RMSK overall (4 decks)

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