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MSK > Hand wrist elbow MDT > Flashcards

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
Q

Treatment of ligament injury

A

Light duty
Ice if acute
NSAIDS/HEP

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26
Q

What is the most common dislocation in children and third most common in adults

A

Elbow dislocation

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27
Q

Pt presents with:
-Extreme pain, swelling, inability to bend elbow

A

elbow dislocation

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28
Q

80% of elbow dislocations are in which direction and why

A

posterior due to Fall on outstretched hand

29
Q

Which ligament is always disrupted during dislocation of the elbow?

A

Lateral collateral ligament

30
Q

Rads for elbow dislocation

A

AP and Lat

31
Q

Treatment for elbow dislocation

A

Ice, Splint
Consider emergency reduction

32
Q

Who should elbow dislocation be referred to?

A

Orthopedic surgeon

33
Q

How should elbow reduction be performed?

A
  • 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
Q

What is the most common neuropathy of upper extremity

A

Carpal tunnel syndrome

35
Q

What population is commonly affected by carpal tunnel syndrome

A

Middle aged and pregnant women

36
Q

patients with these conditions are at a higher risk for what?
- Tenosynovitis
- Tumors
- Pregnancy
- DM
- Thyroid dysfuction

A

carpal tunnel syndrome

37
Q

Pt presents with:
-Numbness and tingling of first 3 digits
-Worse at night
-Drops objects/ cannot open jars
-Worse after repetitive tasks

A

carpal tunnel syndrome

38
Q

Special tests for carpal tunnel syndrome

A

Phalen maneuver and tinel sign

39
Q

Treatment of carpal tunnel syndrome

A

Splint in neutral position, especially at night
NSAIDS
Light Duty
Ergonomic mods
Ortho consult

40
Q

Swelling or stenosis of the sheath that surrounds the abductor pollicis longus and extensor pollicis brevis tendon at wrist causes what condition?

A

de Quervain tenosynovitis

41
Q

Pt presents with:

-Pain at radial aspect of the wrist exacerbated by movement of thumb or wrist
-Possible edema

A

de Quervain tenosynovitis

42
Q

Special tests for de Quervain tenosynovitis

A

Finkelstein

43
Q

Treatment of de Quervain tenosynovitis

A

NSAIDS
Thumb spica
Light duty

44
Q

What is the most commonly fracture carpal bone

A

Scaphoid

45
Q

Dorsiflexed wrist injury is likely what fracture

A

scaphoid fracture

46
Q

Rads for scaphoid fracture

A

Scaphoid series
Repeat 2-3 weeks
MRI if still normal

47
Q

Treatment for scaphoid fracture

A

Thumb spica splint
Light duty
Ortho consult

48
Q

What is the most common soft tissue tumor of the hand

A

Ganglion of the wrist

49
Q

What ages are affected by ganglion of the wrist

A

15-40

50
Q

What are Cystic structures that arise from capsule of a joint or tendon synovial sheath

A

ganglion of the wrist

51
Q

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

A

ganglion of the wrist or hand and finger

52
Q

Rads for ganglion cysts

A

US/MRI

53
Q

Treatment for ganglion cysts

A

Splint, NSAIDS
Consult ortho for aspiration or surgical excision

54
Q

How do you tell if it’s a ganglion cyst or a tumor?

A

Transilluminate

55
Q

What is Rupture of flexor digitorum profundus tendon from its distal attachment

A

Jersey finger

56
Q

What sports is jersey finger common in

A

Contact sports

57
Q

Pt presents with:
- Acute pain and swelling of the DIP/distal phalynx
- Inability to actively flex the DIP joint

A

Jersey finger

58
Q

Flexed DIP is suddenly and forcefully hyperextended can cause what

A

Jersey Finger

59
Q

Which finger is involved in 75% of Jersey finger injuries

A

Ring finger

60
Q

RADS for jersey finger

A

Plain films/MRI

61
Q

Treatment for jersey finger

A

Splint, Ortho consult

62
Q

Injury to extensor tendon is called?

A

mallet finger

63
Q

Direct blow to finger causing sudden forced flexion of DIP/distal phalanx

A

mallet finger

64
Q

Rads for mallet finger

A

Plain films

65
Q

Treatment for mallet finger

A

Splint finger in full extension for 6-8weeks

66
Q

Extensor tendon rupture at insertion on middle phalanx

A

Boutonniere deformity

67
Q

Treatment for boutonniere deformity

A

Splint for 3-6 weeks
Ortho consult

68
Q

How should elbow reduction be performed?

A
  • 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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