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Hand wrist elbow MDT Flashcards

1
Q

Another name for lateral epicondylitis

A

Tennis elbow

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2
Q

Another name for medial epicondylitis

A

Golfer’s elbow/bowler’s elbow

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3
Q

Gripping and wrist extension
- Lifting
- Turning screwdriver
- Hitting backhand in tennis
- Excessive typing
- Direct blow
What injury do these cause?

A

lateral epicondylitis

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4
Q

Common causes of medial epicondylitis

A

Wrist flexion and forearm pronation
- Golf swing
- Baseball pitching
- Pull-through stroke of swimming
- Weight-lifting
- Bowling

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5
Q

Pt presents with:
Tenderness over common extensor region

A

lateral epicondylitis

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6
Q

Sx of medial epicondylitis

A

Tenderness just distal to medial epicondyle

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7
Q

Special tests for lateral epicondylitis

A

Wrist extension and grip strength is limited by pain

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8
Q

Wrist flexion and pronation limited by pain is a sign of what?

A

medial epicondylitis

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9
Q

Rads for epicondylitis

A

US/MRI if not responding to conservative management

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10
Q

Treatment for epicondylitis

A

Light Duty
NSAIDS/HEP
Tennis elbow strap for comfort
PT/Ortho consult

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11
Q

Pt presents with:
-Sudden infection or gradual swelling
-Pain ranges in severity
-Limited ROM
-As mass diminishes, patient may feel bumps of scar tissue

A

Olecranon bursitis

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12
Q

Labs for olecranon bursitis

A

WBC, crystals gram stain and cultures

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13
Q

Treatment of olecranon bursitis

A

Mild case:
- Light duty
- NSAIDS, Ice, pressure wrap
Moderate case:
- Fluid aspiration, ortho referral

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14
Q

Common or less common sites of nerve compression syndromes?

Cubital Tunnel syndrome
Median Nerve compression
(Carpal Tunnel)

A

Common nerve compression syndromes

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15
Q

Common or less common sites of nerve compression syndromes?
-Posterior interosseous nerve compression
-Pronator syndrome
-Radial tunnel syndrome

A

Less common nerve compression syndromes

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16
Q

Most common site of compression of the ulnar nerve

A

Medial epicondyle (cubital tunnel)

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17
Q

Pt presents with:
-Direct blow
-Nerve stretched from flexed elbow for prolonged periods of time
-Cubital valgus (carrying angle >10 degrees)
-Osteocytes or scar tissues

A

cubital tunnel syndrome

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18
Q

Pt presents with:

-Numbness and tingling in the 4th and 5th digits
-Elbow pain/ache
-Radiate proximally to shoulder and neck
-Inability to do daily activities of living (jars, turning doors are late signs)
-Intrinsic muscle atrophy

A

ulnar nerve compression

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19
Q

Rads for cubital tunnel syndrome

A

EMG/NCV
Radiographs for previous elbow trauma

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20
Q

Treatment of cubital tunnel syndrome

A

Lifestyle mods
Splint elbow
NSAIDS
Surgical decompression if 3-4 months of conservative therapy fails

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21
Q

Baseball pitcher’s injure which ligament of the elbow?

A

UCL

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22
Q

Pt presents with:
-“pop” while throwing
- Progressive medial elbow pain with valgus stress

A

ulnar ligament injury

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23
Q

Special tests for ligamentous injury

A

Valgus stress test
Pain felt between 70 and 120 degrees of flexion

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24
Q

Rads for ligament injury

A

AP and lateral plain film to r/o fracture
MRI w/contrast

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25
Treatment of ligament injury
Light duty Ice if acute NSAIDS/HEP
26
What is the most common dislocation in children and third most common in adults
Elbow dislocation
27
Pt presents with: -Extreme pain, swelling, inability to bend elbow
elbow dislocation
28
80% of elbow dislocations are in which direction and why
posterior due to Fall on outstretched hand
29
Which ligament is always disrupted during dislocation of the elbow?
Lateral collateral ligament
30
Rads for elbow dislocation
AP and Lat
31
Treatment for elbow dislocation
Ice, Splint Consider emergency reduction
32
Who should elbow dislocation be referred to?
Orthopedic surgeon
33
How should elbow reduction be performed?
- extend elbow to 45 degrees - slow, steady downward traction of forearm in line with long axis of humerus - gentle pressure over olecranon tip - repeat neurovascular exam after reduction
34
What is the most common neuropathy of upper extremity
Carpal tunnel syndrome
35
What population is commonly affected by carpal tunnel syndrome
Middle aged and pregnant women
36
patients with these conditions are at a higher risk for what? - Tenosynovitis - Tumors - Pregnancy - DM - Thyroid dysfuction
carpal tunnel syndrome
37
Pt presents with: -Numbness and tingling of first 3 digits -Worse at night -Drops objects/ cannot open jars -Worse after repetitive tasks
carpal tunnel syndrome
38
Special tests for carpal tunnel syndrome
Phalen maneuver and tinel sign
39
Treatment of carpal tunnel syndrome
Splint in neutral position, especially at night NSAIDS Light Duty Ergonomic mods Ortho consult
40
Swelling or stenosis of the sheath that surrounds the abductor pollicis longus and extensor pollicis brevis tendon at wrist causes what condition?
de Quervain tenosynovitis
41
Pt presents with: -Pain at radial aspect of the wrist exacerbated by movement of thumb or wrist -Possible edema
de Quervain tenosynovitis
42
Special tests for de Quervain tenosynovitis
Finkelstein
43
Treatment of de Quervain tenosynovitis
NSAIDS Thumb spica Light duty
44
What is the most commonly fracture carpal bone
Scaphoid
45
Dorsiflexed wrist injury is likely what fracture
scaphoid fracture
46
Rads for scaphoid fracture
Scaphoid series Repeat 2-3 weeks MRI if still normal
47
Treatment for scaphoid fracture
Thumb spica splint Light duty Ortho consult
48
What is the most common soft tissue tumor of the hand
Ganglion of the wrist
49
What ages are affected by ganglion of the wrist
15-40
50
What are Cystic structures that arise from capsule of a joint or tendon synovial sheath
ganglion of the wrist
51
Pt presents with: -Firm nodular swelling in wrist that may vary in size and increase in size -May be painful and pain may increase with wrist motion -May be recurrent -Sensory sx of cyst compresses nerve
ganglion of the wrist or hand and finger
52
Rads for ganglion cysts
US/MRI
53
Treatment for ganglion cysts
Splint, NSAIDS Consult ortho for aspiration or surgical excision
54
How do you tell if it’s a ganglion cyst or a tumor?
Transilluminate
55
What is Rupture of flexor digitorum profundus tendon from its distal attachment
Jersey finger
56
What sports is jersey finger common in
Contact sports
57
Pt presents with: - Acute pain and swelling of the DIP/distal phalynx - Inability to actively flex the DIP joint
Jersey finger
58
Flexed DIP is suddenly and forcefully hyperextended can cause what
Jersey Finger
59
Which finger is involved in 75% of Jersey finger injuries
Ring finger
60
RADS for jersey finger
Plain films/MRI
61
Treatment for jersey finger
Splint, Ortho consult
62
Injury to extensor tendon is called?
mallet finger
63
Direct blow to finger causing sudden forced flexion of DIP/distal phalanx
mallet finger
64
Rads for mallet finger
Plain films
65
Treatment for mallet finger
Splint finger in full extension for 6-8weeks
66
Extensor tendon rupture at insertion on middle phalanx
Boutonniere deformity
67
Treatment for boutonniere deformity
Splint for 3-6 weeks Ortho consult
68
How should elbow reduction be performed?
- extend elbow to 45 degrees - slow, steady downward traction of forearm in line with long axis of humerus - gentle pressure over olecranon tip - repeat neurovascular exam after reduction

MSK (9 decks)

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