Hand Surgery Flashcards
Who operates on hands?
Plastic surgeons and orthopedic surgeons
What are the bones of the hand?
Phalanges, metacarpal bones, carpal bones
What is the distal finger joint?
DIP (Distal InterPhalangeal) joint
What is the middle finger joint?
PIP (Proximal InterPhalangeal) joint
What is the proximal finger joint?
MP (Metacarpal Phalangeal) joint
What are the intrinsic hand muscles?
Lumbricals, interosseous muscles
What is adduction and abduction of the fingers?
Adduction is to midline and abduction is separation from midline
Where is “no man’s land” in the hand and what is its significance?
Zone extending from the distal palmar crease to just beyond the PIP joint.
Flexor tendon injuries here have a poor prognosis.
How can the radial nerve motor function be tested?
- Wrist and MP extension
2. Abduction and extension of thumb
How can the ulnar nerve motor function be tested?
- Spread fingers apart against resistance
2. Check ability to cross index and middle fingers
How can the median nerve motor function be tested?
- Touch the thumb to the pinky (distal median nerve)
2. Squeeze examiner’s finger (proximal median nerve)
How can the flexor digitorum profundus apparatus be tested?
Check isolated flexion of the finger DIP joint
How can the flexor digitorum superficialis apparatus be tested?
Check isolated flexion of the finger at the MP joint
Where do the digital arteries run?
On medial and lateral sides of the digit
What hand laceration should be left unsutured?
Lacerations from human bites or animal bites
Should a clamp ever be used to stop a laceration bleeder?
No.
Use pressure and then tourniquet for definitive repair if bleeding does not cease because nerves run with blood vessels.
What is a felon?
Infection in the tip of the finger pad.
Treat by incision and drainage.
What is a paronychia?
Infection on the side of the fingernail.
Treat by incision and drainage.
What is tenosynovitis?
Tendon sheath infection
What are Kanaval’s signs?
Four signs of tenosynovitis:
- Affected finger held in flexion
- Pain over volar aspect of affected finger tendon sheath upon palpation
- Swelling of affected finger
- Pain on passive extension of affected finger
What are the most common bacteria in tenosynovitis and paronychia?
Staphylococcus aureus
How are human and animal hand bites treated?
Debridement, irrigation, administration of antibiotics, leave wound open
What unique bacteria are found in human bites?
Eikenella corrodens
What unique bacteria are found in dog and cat bites?
Pasteurella multocida
