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Rachel Board Review > Hand questions > Flashcards

Hand questions Flashcards

1
Q

Which gene regulates patterning in limb development

A

HOX

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2
Q

what tissue comprises limb bud

A

mesenchyme covered by ectoderm; limb grows by proliferation mesenchym

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3
Q

When do limb buds appear

A

end of 4th week, (day 26,27)

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4
Q

Critical period for upper extremity development

A

24-36 days

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5
Q

When are finger buds visible?

A

end of week 6

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6
Q

when does UE ossification occur

A

between 8-12 weeks; epiphyses gradually ossify til end of puberty

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7
Q

last bones to ossify

A

carpal bones don’t start until 1st year of life

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8
Q

Sensory or motor innervation first?

A

Motor, sensory axons follow motor

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9
Q

nervous system myelination completed

A

around 2 yrs of age

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10
Q

Proximodistal development

A

AER, FGFR

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11
Q

Radioulnar development

A

ZPA, SHH

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12
Q

dorsoventral dvelopment

A

Wnt, EN-1

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13
Q

Process responsible for syndactyly

A

Failure of apoptosis, bone morphogenic proteins signaling TGF beta

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14
Q

Frequency syndactyly

A

1 in 2200; middle and ring web space most common

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15
Q

which arteries supply early limb buds

A

dorsal intersegmental arteries from aorta

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16
Q

ASSH congenital deformity classifications

A

formation, differentiation, duplication, overgrowth, undergrowth, constriction band syndromes, generalized anomalies and syndromes

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17
Q

Fixed unit of hand

A

distal carpal row + 2nd, 3rd metacarpals

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18
Q

borders snuff box

A

Ant: APL, EPB
Post: EPL
Floor: scaphoid, trapezium

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19
Q

best 2 pt discrimination

A

ulnar digits, 2-3mm, pts in 20s

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20
Q

AIN innervates…

A

PQ, FDP to index and middle, FPL

pronator teres - inn by median nerve before AIN

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21
Q

Median n intrinsics

A

LOAF: radial two Lumbricals, Opponens pollicis, Abductor PB, superficial head of FPB

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22
Q

thenar muscles superficial to deep

A

AbPB, FPB, OP, AdP

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23
Q

Hypothenar muscles

A

palmaris brevis, AbDM, FDMB, ODM

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24
Q

Mobile wad

A

BR, ECRB, ECRL

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25
Q

Giant cell tumor of bone

A

needs CT chest

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26
Q

test EPL function

A

put palm down, lift thumb off table; only EPL can lift dorsal to plane of palm

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27
Q

CRPS type 1 neuron

A

c sensory - respond to physiologic changes in body

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28
Q

darrach procedure

A

istal ulna resection, is a well-established procedure to treat distal radioulnar joint (DRUJ) arthritis and distal ulnar instability such as in caput ulnae syndrome. A dorsal approach is used to gain access to the DRUJ via dorsal fifth extensor compartment approach. The triangular fibrocartilage complex (TFCC) and extensor carpi ulnaris (ECU) sheath are preserved

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29
Q

vein in reverse sural

A

lesser saph

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30
Q

nerve transfer for biceps

A

FCU fascicle of ulnar nerve to biceps

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31
Q

thumb pulp defect, sensate flap

A

FDMA

32
Q

mirror hand gene

A

sonic

33
Q

Bennett fracture, the smaller volar-ulnar fragment is retained by the…

A

anterior oblique (beak) ligament, while the abductor pollicis longus, thumb extensor tendons, and the adductor pollicis combine to distract the base of the larger shaft fragment radially, dorsally, and proximally. These distracting forces create joint incongruity, which is a relative indication for fracture reduction. These forces must be countered to reduce the fracture, thus, requiring axial distraction, pronation, and abduction of the metacarpal shaft, while simultaneously applying external pressure at the radial base of the metacarpal.

34
Q

Why does botox work in raynaud’s

A

inhibition of Rho, substance P,

35
Q

thumb pulp defect, less than 2 cm

A

islandiazed moberg flap

36
Q

1st palmar IO muscle inpollicization

A

adductor pollicis

37
Q

EDC in pollicization

A

Abductor PL

38
Q

dorsal IO muscle in policization

A

Abductor PB

39
Q

EIP becomes…

A

EPL

40
Q

radial nerve transfers:

A

Wrist: PT to ECRB
PL to EPL
FCU or FDS to EDC

41
Q

axillary nerve roots

A

C5, C6

42
Q

nerve root to LD and tricepts

A

C7

43
Q

role C8, t1

A

intrinsic hand muscles

44
Q

Mannerfelt lesion

A

FPL rupture 2/2 scaphoid osteophyte

Tx: PL graft + resect osteophyte

45
Q

cleft hand, ectrodactyly

A

failure of formation

46
Q

extensor compartments

A

First - abductor pollicis longus, extensor pollicis brevis

Second - extensor carpi radialis longus, extensor carpi radialis brevis

Third - extensor pollicis longus

Fourth - extensor digitorum communis, extensor indicis proprius

Fifth - extensor digiti minimi

Sixth - extensor carpi ulnaris

47
Q

1st line treatment for Raynaud

A

CCB: nifedipine

48
Q

scaphoid fx view

A

20 degrees ulnar deviation, 20 degrees wrist extension

49
Q

Claw hand pathophys

A

unnopposed long extensors, weak ulnar intrinsics

50
Q

central slip injury but can still extend PIP?

A

interosseous muscle tendon; intrinsic, inserts on dorsal base of P2

51
Q

pedicle for MFC

A

descending genicular or medial superior genicular arterty

52
Q

biggest risk for brachial plexus injury

A

shoulder dystocia

53
Q

myoelectric prostheses

A

more precise; more expensive, less durable

54
Q

Tx volkmann’s contracture

A

selective muscle origin slide

55
Q

view for 5th cmc injury

A

AP view with forarm pronated 30 degress from full supination and Lateral wtih 30 degrees of pronation

56
Q

PT artery peforators

A

between FDL and soleus

57
Q

most distal extensor muscle belly

A

EIP

58
Q

extensor zones

A

1 at DIP, 3 at PIP, 5 at MCP….

59
Q

Type 1 error

A

Falsely rejecting null hypothesis

60
Q

What do you see after nerve transection and wallerian degen?

A

sharp waves and fibrillations

61
Q

fat grafting in Dupuytren’s

A

inhibits myofibroblast proliferation

62
Q

Treatment Blauth IIIb

A

pollicization

63
Q

blauth IIIa vs IIIb

A

IIIa: CMC unstable
IIIb: absent CMC joint, no motion at MCP or IP

64
Q

Blauth grade I

A

Small but normal fxn; no surgical treatment

65
Q

bluath grade II

A

hypoplastic but all bones present; UCL at MCP weak; MCP stabilization, opponensplasty, web space deepening

66
Q

Tibial nerve injury

A

weak plantar flexion, numb plantar surface

67
Q

femoral nerve

A

muscles of anterior thigh

68
Q

peroneal nerve

A

superficial: S to lateral leg, M to lateral compartment (eversion)
Deep: anterior compartment, foot dorsiflexion, 1st web space

69
Q

sural nerve fxn

A

travels btn lateral mal and calcaneus; no motor; sensation to lateral foot

70
Q

deep posterior compartment leg

A

Tib post, FDL, FHL (FHL can be injured wtih fibula harvest), popliteus

71
Q

superficial posterior compartment leg

A

gastroc, soleus, plantaris

72
Q

anterior compartment of leg

A

TA, EDL, EHL, peroneus tertius

73
Q

lateral compartment leg muscles

A

peroneus longus and brevis

74
Q

subungual melanoma concerns

A

age 50 to 70, longitudinal band greater than 3 mm or irregular border, change of lesion size or coloration, extension onto periungual skin (Hutchinson sign), personal or family history of melanoma, and single finger involvement.

75
Q

abx for gustilo 2

A

1st gen cephalosporin

76
Q

constriction band syndrome frequency

A

12% of congenital UE defects (14% of lower), 2/2 low amniotic fluid levels(?), “disruptions”

77
Q

Posterior hillocks

A

2nd arch
Antitragus
Anti helix
Lobule

Rachel Board Review (1 decks)

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