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MSK 2 (F22) > Hand Pathologies > Flashcards

Hand Pathologies Flashcards

1
Q

Double Crush refers to…

A

Proximal N compression causes distal N to be more sensitive to impingement

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2
Q

Most commonly compressed N

A

Median (carpal tunnel)

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3
Q

Most commonly injured N

A

Radial

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4
Q

Carpal Tunnel Syndrome: risk factors

A

Fx
pregnancy
diabetic neuropathy
arthritis
tumor
synovitis

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5
Q

Carpal Tunnel Syndrome: possible cause

A

Repeated forceful grip + wrist flex (typing, construction)
But exact MOI not clearly defined

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6
Q

Carpal Tunnel Syndrome: conservative treatment

A

Neutral splint
Steroid injection
Median N glides
FDS/FDP Tendon glides (contraindicated if post-op)

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7
Q

Carpal Tunnel Syndrome: diagnosed with…

A

electrodiagnostic testing

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8
Q

Carpal Tunnel Syndrome: presentation

A

Paresthesia in volar thumb, index, mid.
Loss of dexterity (later stages).

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9
Q

High Radial N Injury: MOI

A

Humerus fx

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10
Q

High Radial N Injury: presentation

A

Radial N Palsy aka “Wrist Drop Deformity”
Still able to supinate (biceps takes over).

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11
Q

High Radial N Injury: treatment

A

Splint to prevent flexion contracture.
Resolves within 4mo.
If no improvement at 6mo = surgery.

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12
Q

Low Radial N Injury: what N is compressed?

A

PIN

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13
Q

Low Radial N Injury: MOI

A

Temporary compression of PIN (motor N).
Radial head fx, tumor, repetitive sup/pro.

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14
Q

Low Radial N Injury: presentation

A

“Saturday Night Palsy”
Sensation intact if only PIN affected

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15
Q

Ulnar N Injury: causes

A

Prolonged severe cubital tunnel.
Ulnar N laceration.

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16
Q

High Ulnar N Injury: presentation

A

Claw Hand
Sensory loss in ulnar N distrib (pinky & ulnar half of ring).
Weak FCU & FDP of pinky & ring.

17
Q

Low Ulnar N Injury: presentation

A

Claw Hand
Sensory loss in ulnar N distrib.
Weak intrinsics.
Thenar & hypothenar musc wasting (Guyon’s Canal Syndrome).

18
Q

Ulnar N Injury: treatment

A

Anti-claw splint.
Elbow ext splint.
Check ROM every other day.

19
Q

Thumb UCL Injury: MOI

A

Hyperext + RD
Skier’s Thumb (rupture) or Gamekeeper’s Thumb (laxity)

20
Q

Thumb UCL Injury: presentation

A

laxity of >15° with valgus stress, lack of firm end feel.

21
Q

Thumb UCL Injury: treatment for complete tear

A

surgery

22
Q

Thumb UCL Injury: treatment for partial tear

A

cast/splint 4-6wks

23
Q

PIP Dislocation MOI

A

Most common = dorsal.
Hyperext + compressive stress.
Volar Plate often ruptures.

24
Q

Boutinnere Deformity

A

Central tdn of extensor mechanism injured.
Hyperextended DIP & flexed PIP.

25
Q

Swan Neck Deformity

A

Volar plate disrupted, lateral bands pull dorsally.
Flexed DIP & hyperextended PIP.

26
Q

Mallet Finger

A

Direct axial load to digit, avulsion of terminal tdn on distal phalanx.
Flexed DIP.

27
Q

Tendon Adhesions

A

Concern with both post-op and non-op tendon injuries.
Scar tissue in sheath from increased protein material.
Most commonly Zone 2 (because lowest vascularity).

28
Q

Dequervain’s Tenosynovitis: MOI

A

Microtrauma of APL + EPB (1st extensor dorsal compartment).
Repeated thumb ABD w/ ulnar deviation (post-partum laxity & repeated picking up kid)

29
Q

Dequervain’s Tenosynovitis: presentation

A

Pain in snuff box

30
Q

How to distinguish OA vs RA

A

OA = unilateral
RA = bilateral

31
Q

OA presentation

A

Grip compensation with CMC flex + MP hyperext + IP flex

32
Q

RA - which side is more commonly affected & how does it present?

A

Radial side
Results in UD

33
Q

Dupuytren’s Disease

A

Fibrosis & eventual contractures of palmar/digital fascia.

34
Q

Trigger Finger

A

Thickening of FDS tendon sheath.
Sometimes nodules - tdn catches as it glides.

35
Q

Ganglion Cyst

A

Synovial cyst
Often dorsal

MSK 2 (F22) (17 decks)

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