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Year 2 MIS > Introduction to common injuries and surgery of the hand > Flashcards

Introduction to common injuries and surgery of the hand Flashcards

1
Q

Where do the extrinsic and intrinsic muscles of the hand enter the hand and originate from?

A
  • intrinsic = originate in hand and do not cross the wrist

- extrinsic = originate outside of the hand and cross the wrist

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2
Q

What is the palmar fascia, also called the palmar aponeurosis?

A
  • a triangular structure in the palm of the hand based distally
  • a continuation of the deep fascia of the forearm, especially the palmaris longus
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3
Q

What is the palmar fascia, also called the palmar aponeurosis, is also called by another name, what is this?

1 - valgus surface
2 - varus surface
3 - skin
4 - volar surface

A

4 - volar surface

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4
Q

There are 3 layers of the palmar fascia, what are they called?

1 - deep, middle and superficial
2 - lateral, medial and deep
3 - deep, anterior and posterior
4 - deep, middle and lateral

A

1 - deep, middle and superficial

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5
Q

There are 3 layers of the palmar fascia, where does the superficial layer attach?

1 - muscles of the hand
2 - epidermis of the skin
3 - dermis of the skin
4 - bones of the hand

A
  • the dermis of the skin
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6
Q

There are 3 layers of the palmar fascia, where does the middle layer attach?

1 - metacarpophalangeal joint with longitudinal fibres
2 - carpal joint with longitudinal fibres
3 - proximal phalangeal joint with longitudinal fibres
4 - distal phalangeal joint with longitudinal fibres

A

1 - metacarpophalangeal joint with longitudinal fibres

- forms spiral bands

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7
Q

There are 3 layers of the palmar fascia, where does the deep layer attach?

1 - metacarpophalangeal joint with longitudinal fibres
2 - flexor and extensor mechanisms
3 - carpal joint with longitudinal fibres
4 - proximal phalangeal joint with longitudinal fibres

A

2 - flexor and extensor mechanisms

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8
Q

The palmar fascia enters the hand proximally from the palmaris longus tendon and merges with a ligament at the wrist. What is this ligament in the image called?

1 - extensor retinaculum
2 - flexor retinaculum
3 - palmar reticulum
4 - palmar aponeurosis

A

2 - flexor retinaculum

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9
Q

The palmar fascia enters the hand proximally from the palmaris longus tendon and merges with a ligament at the wrist. What happens to the palmer fascia when the palmaris longus muscle contracts?

A
  • palmer fascia tightens
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10
Q

What is Dupuytren’s contracture?

1 - thickening of skin in palm of the hand and base of fingers
2 - thickening of palmar fascia in palm of the hand and base of fingers
3 - thickening of skin and palmer fascia in palm of the hand and base of fingers
4 - thickening of muscle tendons in pam of the hand and base of fingers

A

3- thickening of the skin and palmar fascia in the palm of your hand at the base of your fingers

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11
Q

Dupuytren’s contracture is a thickening of the skin and palmar fascia in the palm of your hand at the base of your fingers. Normal palmar fascia bonds thicken forming contracted tissue known as nodules, normally on the ulnar border. As these thicken and become larger they form what?

1 - bows
2 - strings
3 - cords
4 - bands

A

3 - cords

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12
Q

Dupuytren’s contracture is a thickening of the skin and palmar fascia in the palm of your hand at the base of your fingers. Normal palmar fascia bonds thicken forming contracted tissue known as nodules, normally on the ulnar border. As these thicken and become larger they form cords. This causes a progressive flexion contracture of the fingers. What joint in the hand is generally affected first?

1 - metacarpophalangeal joints
2 - proximal interphalangeal joint
3 - distal interphalangeal joint
4 - saddle joint

A

1 - metacarpophalangeal joints

- then spreads to the proximal interphalangeal joint

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13
Q

What fingers are normally affected in dupuytren’s contracture?

A
  • little and ring finger

- sometimes the middle finger

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14
Q

Is dupuytren’s contracture more common in men or women?

A
  • men

- 10:1 ratio

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15
Q

Which group of people are more likely to have dupuytren’s contracture?

1 - southern europeans
2 - asians
3 - northern europeans
4 - Americans

A

3 - northern europeans (Scandinavians)

- autosomal dominant (only need 1 abnormal allele)

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16
Q

Normal palmar fascia is composed of type I collagen. The disease pathophysiology of dupuytren’s contracture can be divided into proliferation, involutional changes and residual. In the proliferation stage what happens to the composition of the palmar fascia in dupuytren’s contracture pathophysiology?

1 - fibroblasts lay down type II collagen
2 - myofibroblasts lay down new muscle
3 - fibroblasts and myofibroblasts lay down new type 1 collagen
4 - fibroblasts and myofibroblasts lay down type III collagen

A

4 - fibroblasts and myofibroblasts lay down type III collagen

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17
Q

Normal palmar fascia is composed of type I collagen. The disease pathophysiology of Dupuytren’s contracture can be divided into proliferation, involutional changes and residual. In the involutional stage what happens to the palmer fascia once fibroblasts and myofibroblasts lay down type III collagen in the 1st stage (proliferation). What is the next step in the pathophysiology of dupuytren’s contracture?

1 - abnormal type III collagen aligns with skin
2 - abnormal type III collagen aligns with tendinous bands
3 - abnormal type III collagen aligns with muscles
4 - abnormal type III collagen aligns with ligaments

A

2 - abnormal type III collagen aligns with tendinous bands

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18
Q

Normal palmar fascia is composed of type I collagen. The disease pathophysiology of Dupuytren’s contracture can be divided into proliferation, involutional changes and residual. In the residual stage what happens to the palmer fascia once fibroblasts and myofibroblasts lay down type III collagen in the 1st stage (proliferation), which has then aligned with the lines of tension in the palm (2nd stage: involutional changes) forming scar tissue. As this scar tissue remains, what ultimately occurs with it?

1 - scar tissue aligns with flexor tendons, shortens and contracts
2 - scar tissue aligns with lumbricals, shortens and contracts
3 - scar tissue aligns with interossei, shortens and contracts
4 - scar tissue aligns with extensor tendons, shortens and contracts

A

1 - scar tissue aligns with flexor tendons, shortens and contracts
- as it aligns with flexor tendons, it causes flexion of the fingers

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19
Q

Is dupuytren’s contracture normally painful?

A
  • no

- generally affects activities of daily living

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20
Q

Does dupuytren’s contracture affect active and passive flexion?

A
  • yes

- unable to move it all all, or very little

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21
Q

For mild dupuytren’s contracture is there any non-operative treatments?

A
  • no

- most patients will progress within 8 years and need surgery

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22
Q

If a patient is older has a mild version of dupuytren’s contracture, they may receive a percutaneous needle fasciotomy. What is this procedure?

1 - hand is opened up and cords are removed
2 - hand is opened using a small needle and cords are removed
3 - hand is opened using a small needle and cords are divided and cut
4 - hand is opened and tendons are removed to remove cords

A

3 - hand is opened using a small needle and cords are divided and cut
- fascia is divided NOT removed

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23
Q

If a patient is older has a mild version of dupuytren’s contracture, they may receive a percutaneous needle fasciotomy, which is where incisions are made and multiple cords are cut under local anaesthetic. Is this always 100% effective?

A
  • no

- can commonly re-occur

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24
Q

For more serious versions of dupuytren’s contracture, there are a number of surgical options. What is open fasciotomy?

A
  • open surgery
  • bands are cut to be separated BUT not removed
  • they are put in a splint and physio
  • BUT there is a high occurrence rate
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25
Q

For more serious versions of dupuytren’s contracture, there are a number of surgical options. Fasciectomy, which is the GOLD STANDARD is the most common surgery. What is Fasciectomy?

A
  • fibrous bands excising the bands
  • limited fasciectomy is the gold standard for most cases
  • skin closure can be a challenge.
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26
Q

For more serious versions of dupuytren’s contracture, there are a number of surgical options. What is dermo-fasciectomy?

A
  • used for severe disease
  • overlying skin and fascia are removed
  • requires a skin graft
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27
Q

What is Dupuytren’s Diathesis?

A
  • a very rare aggressive order in younger patients
  • symmetrical affecting flexors on both hands, mainly radial side
  • can affect all but the thumb
  • strong family links
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28
Q

The extensors located in the posterior compartment of the forearm all contain their own tendinous sheaths, which is commonly views as 6 separate compartments of the posterior forearm. What are the 6 extensor compartments of the forearm?

A

1 - Extensor pollicis brevis and abductor pollicis longus
2 - Extensor carpi radialis longus and brevis
3 - Extensor pollicis longus
4 - Extensor indicis & extensor digitorum
5 - Extensor digiti minimi
6 - Extensor carpi ulnaris

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29
Q

The extensor pollicis longus hooks around a bony landmarks in the wrist, acting as a pulley and allows the muscle to extend the thumb. What is this bony landmark called?

1 - hook of hamate
2 - smiths tubercle
3 - lister’s tubercle
4 - guyons canal

A

3 - lister’s tubercle

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30
Q

There are 6 extensor compartments of the hand and forearm that are named based on their location. Compartment 1 is located on the radial border located close to the anatomical snuffbox. What is contained within compartment 1?

1 - abductor pollicis longus + extensor pollicis brevis
2 - extensor pollicis longus + extensor pollicis brevis
3 - abductor pollicis longus + extensor pollicis longus
4 - extensor pollicis longus + extensor digitorum

A

1 - abductor pollicis longus + extensor pollicis brevis

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31
Q

There are 6 extensor compartments of the hand and forearm that are named based on their location. Compartment 2 is located on the radial border deep to the anatomical snuffbox. What is contained within compartment 2?

1 - extensor carpi radialis longus + extensor pollicis brevis
2 - extensor carpi radialis longus + brevis
3 - abductor pollicis longus + extensor pollicis longus
4 - extensor pollicis longus + extensor digitorum

A

2 - extensor carpi radialis longus + brevis

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32
Q

There are 6 extensor compartments of the hand and forearm that are named based on their location. Compartment 3 contains the third muscle of the thumb that is not contained with compartment 1 (abductor pollicis longus + extensor pollicis brevis). What is contained within compartment 3?

1 - extensor carpi radialis longus
2 - extensor carpi radialis longus
3 - abductor pollicis longus
4 - extensor pollicis longus

A

4 - extensor pollicis longus

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33
Q

There are 6 extensor compartments of the hand and forearm that are named based on their location. Compartment 4 is located on the middle of the forearm and contains the extensors of the fingers. What are the 2 muscles contained within compartment 4?

1 - extensor digitorum + extensor pollicis brevis
2 - extensor carpi radialis longus + extensor indices
3 - extensor digitorum + extensor indices
4 - extensor pollicis longus + extensor digitorum

A

3 - extensor digitorum + extensor indices

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34
Q

There are 6 extensor compartments of the hand and forearm that are named based on their location. Compartment 5 is located laterally to compartment 4 and includes 1 muscle. What muscle is contained within compartment 5?

1 - extensor digitorum
2 - extensor carpi radialis longus
3 - extensor digitorum
4 - extensor digiti minimi

A

4 - extensor digiti minimi

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35
Q

There are 6 extensor compartments of the hand and forearm that are named based on their location. Compartment 6 is located laterally to compartment 5 and includes 1 muscle. What muscle is contained within compartment 6?

1 - extensor digitorum
2 - extensor carpi ulnaris
3 - extensor digitorum
4 - extensor digiti minimi

A

2 - extensor carpi ulnaris

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36
Q

DeQuervain’s tenosynovitis is an inflammatory problem affecting the tendon sheath of compartment 1 of the extensor compartments of the hand. What muscles are therefor affected that are located most radially?

1 - abductor pollicis longus + extensor pollicis brevis
2 - extensor pollicis longus + extensor pollicis brevis
3 - abductor pollicis longus + extensor pollicis longus
4 - extensor pollicis longus + extensor digitorum

A

1 - abductor pollicis longus + extensor pollicis brevis

- 2 most lateral tendons of the anatomical snuffbox

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37
Q

DeQuervain’s tenosynovitis is an inflammatory problem affecting the tendon sheath of compartment 1 of the extensor compartments of the hand, which is abductor pollicis longus + extensor pollicis brevis muscles. Which 4 groups of people are most at risk?

1 - men, pregnant women, repetitive jobs/hobbies, 30-50 y/o
2 - women, pregnant women, repetitive jobs/hobbies, 30-50 y/o
3 - men, pregnant women, labour jobs, >50 y/o
4 - women, pregnant women, repetitive jobs/hobbies, <50 y/o

A

1 - women, pregnant women, repetitive jobs/hobbies, 30-50 y/o

38
Q

DeQuervain’s tenosynovitis is an inflammatory problem affecting the tendon sheath of compartment 1 of the extensor compartments of the hand, which is abductor pollicis longus + extensor pollicis brevis muscles. How do patients most commonly present with this?

1 - pain on ulnar border and impaired opposable movements
2 - pain in anatomical snuff box and extensors of hand impairment
3 - pain in anatomical snuff box and tenderness on pincer movements
4 - pain on ulnar border and tenderness on pincer movements

A

3 - pain in anatomical snuff box and tenderness on pincer movements

39
Q

DeQuervain’s tenosynovitis is an inflammatory problem affecting the tendon sheath of compartment 1 of the extensor compartments of the hand, which is abductor pollicis longus + extensor pollicis brevis muscles. How is this commonly treated?

A
  • rest
  • steroid injections
  • lifestyle adaptation (reduce repetitive injuries)
  • rarely surgical decompression
40
Q

There are 3 muscles that make up the thenar muscles of the hand located on the palmar surface of the hand. Label them using the labels below:

abductor pollicis brevis
flexor pollicis brevis
opponens pollicis

A

1 - flexor pollicis brevis
2 - abductor pollicis brevis
3 - opponens pollicis

41
Q

There are 3 muscles that make up the hypothenar muscles of the hand located on the palmar surface of the hand. Label them using the labels below:

abductor digiti minimi
oponens digiti minimi
flexor digiti minimi

A 
1 = oponens digiti minimi
2 = flexor digiti minimi
3 = abductor digiti minimi
42
Q

What is the name given to the intrinsic muscles of the hand that do not attach to a bone, instead attaching to tendons.

1 - lumbricals
2 - interossei
3 - adductor pollicis brevis
4 - opponens digiti minimi

A

1 - lumbricals

43
Q

The lumbricals are an intrinsic muscles of the hand that do not attach to a bone. Instead where do they attach which gives them a unique action?

A
  • origin = flexor digitorum profundus tendons

- insertion = extensor hood

44
Q

The lumbricals are an intrinsic muscles of the hand that do not attach to a bone. Instead where they begin in the flexor tendons and insert onto the extensor hood. What movements does this assist with?

A
  • flexion at the metacarpophalangeal joint

- extension of the PIP and DIP joints

45
Q

The interossei are intrinsic muscles of the hand and can be divided into the palmar and dorsal muscles. They attach in between adjacent metacarpals facilitating what 2 movements?

A
  • adduction and abduction
46
Q

The interossei are intrinsic muscles of the hand and can be divided into the palmar and dorsal muscles. They attach in between adjacent metacarpals facilitating adduction and abduction. What is the mnemonic for remembering which muscle performs which action?

A
  • DAB = Dorsal interossei = ABduction

- PAD = Palmer interossei = ADduction

47
Q

All intrinsics are innervated by the deep branch of the ulnar nerve except which muscles that are innervated by the median nerve? Use LOAF mnemonic to help

A
  • L = Lumbricals I and II on lateral palm (closest to thumb)
  • O = opponens pollicis
  • A = abductor pollicis brevis
  • F = flexor pollicis brevis
48
Q

If the lumbricals were ruptured where they attach to the extensor hood this can cause the muscle attach to sublux (drop down) and then begins acting as a what?

1 - flexor
2 - extensor
3 - adductor
4 - abductor

A

1 - flexor

- can cause a boutonniere finger as PIP and DIP cannot extend

49
Q

The extensor pollicis longus is a muscle that extends the thumb. It is able to do this as it hooks around listers tubercle at the writs. If this ruptures or is damaged what movements are lost?

1 - adduction of the thumb
2 - abduction of the thumb
3 - flexion of the thumb
4 - extension of the thumb

A

4 - extension and retropulsion of the thumb

- place hand flat on table and try to raise the thumb

50
Q

There are 3 layers of the anterior flexor tendons. Label the 4 muscles of the superficial layer in the image below?

flexor carpi radialis
flexor carpi ulnaris
pronator teres
palmaris longus

A 
1 = flexor carpi radialis
2 = palmaris longus 
3 = pronator teres
4 = flexor carpi ulnaris
51
Q

There are 3 layers of the anterior flexor tendons. What is the 1 muscle of the intermediate layer in the image below?

1 - flexor carpi radialis
2 - flexor carpi ulnaris
3 - flexor digitorum profundus
4 - flexor digitorum superficialis

A

3 - flexor digitorum superficialis

52
Q

There are 3 layers of the anterior flexor tendons. Label the 3 muscles of the deep layer in the image below?

flexor digitorum profundus
pronator quadratus
flexor pollicis longus

A 
1 = pronator quadratus
2 = flexor pollicis longus
3 = flexor digitorum profundus
53
Q

The flexor digitorum superficialis (FDS) and profundus (FDP) tendons both attach to the digits, with the FDP lying deeper in the palm. Where do the FDP and FDS insert onto the fingers?

A
  • FDS = sides of middle phalanges

- FDP = palmar surface of distant phalanges

54
Q

The flexor digitorum superficialis (FDS) and profundus (FDP) tendons both attach to the digits, with the FDP lying deeper in the palm.
These muscles attach as follows:

  • FDS = sides of middle phalanges
  • FDP = palmar surface of distant phalanges

As both of these muscles are trying to attach to fingers, which is a very tight space, what does one of the muscles do, and which muscle does this?

A
  • FDS - divides allowing FDP to pass through

- passing of the FDS and FDP is called chiasma of camper

55
Q

The blood supply to the fingers is contained within what?

1 - vinculae
2 - flexor digitorum superficialis sheath
3 - pulleys
4 - flexor digitorum profundus sheath

A

1 - vinculae

56
Q

As there is a lot contained within the fingers there needs to be something that contains all the tendons within. If not then the tendons could bow string. What is this called in the fingers?

1 - vinculae
2 - flexor digitorum superficialis sheath
3 - annular pulleys
4 - flexor retinaculum

A

3 - annular pulleys

57
Q

As there is a lot contained within the fingers there needs to be something that contains all the tendons within. If not then the tendons could bow string. They are held in place by annular pulleys. What are annular pulleys?

A
  • thickened connective tissue

- role is to keep the flexors from bowing

58
Q

As there is a lot contained within the fingers there needs to be something that contains all the tendons within. If not then the tendons could bow string. They are held in place by pulleys which are thickened connective tissue that keep the flexors from bowing. How many annular pulleys are located digits II-V?

1 - 2
2 - 3
3 - 4
4 - 5

A

4 - 5

59
Q

Trigger finger, also called tenosynovitis is a common condition. What causes trigger finger?

1 - idiopathic
2 - tight muscles
3 - tendon nodule inflammation
4 - infection

A

3 - tendon nodule inflammation

60
Q

Trigger finger, also called tenosynovitis is a common condition and most commonly caused by tendon nodule inflammation. How does present most commonly?

1 - locking/catching of the PIP affects A1 pulley
2 - locking/catching of the DIP affects A3 pulley
3 - locking/catching of the MCP affects A1 pulley
4 - locking/catching of the wrist affects A1 pulley

A

3 - locking/catching of the MCP affects A1 pulley

- patients feel it is in the PIP joint

61
Q

Trigger finger most commonly occurs at which joint and which joint do patients think it occurs in?

1 - PIP
2 - DIP
3 - MCP
4 - wrist

A

3 - MCP

- patients think it is at the proximal interphalangeal joint

62
Q

What are 3 key risk factors for trigger finger?

1 - smoking, hyperthyroidism and middle aged women (30-50 y/o)
2 - alcohol, diabetes and middle aged women (30-50 y/o)
3 - smoking, diabetes and middle aged women (30-50 y/o)
4 - smoking, hypothyroidism and middle aged women (30-50 y/o)

A

3 - smoking, diabetes and middle aged women (30-50 y/o)

63
Q

How is trigger finger most commonly treated?

1 - surgical incision to release the flexor annular pulley system
2 - surgical incision to cut the flexor annular pulley system
3 - surgical incision to remove the flexor annular pulley system
4 - surgical incision to remove flexor muscle

A

1 - surgical incision to release the flexor annular pulley system

64
Q

Although there are exceptions, match the muscle groups below with the nerves that innervate them:

radial, median and ulnar nerve

with:

long extensors
intrinsic muscles of the hand
long flexors

A
  • radial nerve = long extensors
  • median nerve = long flexors
  • ulnar nerve = intrinsic muscles of the hand
65
Q

Splinting is one of the first things that can be tried in a patient with carpal tunnel syndrome. What is the purpose of this and what is the problem with most wrist splints bought commercially?

A
  • splints place wrist in neutral position removing pressure on median nerve
  • most splints place wrist in extension, further stressing the median nerve
66
Q

What medication can be tried in patients with carpal tunnel?

A
  • NSAIDs

- steroid injections

67
Q

In patients with carpal tunnel syndrome who require surgery, what does the surgeon do?

1 - reduces size of flexor tendons
2 - increases size of carpal tunnel
3 - cuts flexor retinaculum
4 - cuts the flexor tendons

A

3 - cuts flexor retinaculum
- the flexor retinaculum, also known as transverse carpal ligament is cut, which releases compression of the median nerve

68
Q

What is common amongst older patients in the thumb?

1 - osteoarthritis of the carpometacarpal joint
2 - RA of the carpometacarpal joint
3 - osteoporosis of the carpometacarpal joint
4 - immune disorder affecting just the carpometacarpal joint

A

1 - osteoarthritis of the carpometacarpal joint

69
Q

Osteoarthritis of the carpometacarpal joint of the thumb is common in older populations. What are the bones that form this joint in the thumb called?

A
  • trapezium which is concave
  • metacarpal bone which is convex
  • together the above form a synovial saddle joint
70
Q

Osteoarthritis of the carpometacarpal joint of the thumb is common in older populations. How can patients present?

A
  • Pain/burning/aching near base of thumb.
  • axial loading painful (grind test)
  • subluxation test.
  • hyperextension deformity
71
Q

Osteoarthritis of the carpometacarpal joint of the thumb is common in older populations. What syndrome is the commonly associated with?

1 - raynauds syndrome
2 - carpal tunnel syndrome
3 - white finger syndrome
4 - guyons tunnel syndrome

A

2 - carpal tunnel syndrome

72
Q

In younger middle aged individuals who are still working, what surgery is most often performed in patients with osteoarthritis of the carpometacarpal joint of the thumb?

A
  • trapeziectomy
73
Q

What is the most commonly fracture bone in the wrist?

A
  • scaphoid bone
74
Q

What bone in the hand is commonly damaged in a brawlers fracture?

1 - distal phalanx
2 - metacarpals
3 - proximal phalanx
4 - carpal bones

A

2 - metacarpals

- mainly on the ulnar border of the hand

75
Q

Is morning hand stiffness more common in the RA of osteoarthritis?

A
  • RA
76
Q

In RA which joints are predominantly affected?

1 - MCP, PIP, DIP
2 - DIP only
3 - MCP, PIP
4 - PIP only

A

3 - MCP, PIP

  • metacarpophalangeal and proximal interphalangeal joints
  • distal interphalangeal joint are spared
77
Q

In RA, what happens to the metacarpophalangeal joints?

1 - sublux and we get radial deviation
2 - sublux and we get flexion
3 - sublux and we get extension
4 - sublux and we get ulnar deviation

A

4 - sublux and we get ulnar deviation

78
Q

In RA, patients can present with swan neck deformity. What is this?

A
  • DIP is permanently flexed

- PIP is hyperextended

79
Q

What does the term paronychia mean?

A
  • greek meaning around the nail
80
Q

Paronychia refers to the nails of the hands. What happens in patients who have infections in the nails?

A
  • pus forms under the nails at the eponychial fold (where skin meets the nail)
  • most common cause is staphylococcus aureus
81
Q

Paronychia refers to the nails of the hands. When infected pus forms under the nails. How is this commonly treated?

1 - patients are given antibiotics
2 - incision is made, infection is drained and then given antibiotics
3 - incision is made and infection is drained
4 - infection is drained using a needle and then given antibiotics

A

2 - incision is made, infection is drained and then given antibiotics

82
Q

Felon is an infection of the fingers. What occurs here?

A
  • infection of deep pulp space of the finger
  • infection collects in septa of the finger
  • treatment includes an incision of all compartments containing pus
  • then give antibiotics
83
Q

What is a fight bite?

A
  • cut to the skin of the hand after punching someone
84
Q

Fight bites are when there is a cut to the skin of the hand after punching someone. What can this cause if not treated?

1 - scar
2 - infection
3 - septic arthritis at affected joint
4 - inflammation of metacarpal bone

A

3 - septic arthritis at affected joint

85
Q

Fight bites are when there is a cut to the skin of the hand after punching someone. This can cause septic arthritis if not treated properly. How is this commonly treated?

A
  • washed and debridement
86
Q

What is flexor sheath infection?

A
  • the palmar aponeurosis of the hand becomes infected

- can spread on palm or on individual flexor tendon sheaths

87
Q

Flexor sheath infection is when the the palmar aponeurosis of the hand becomes infected. This can spread on palm or on individual flexor tendon sheaths. What are the 4 cardinal signs of this if a patient comes into A&E?

A

1 - finger is in flexed position
2 - finger that is flexed is swollen
3 - extreme pain in extension
4 - extreme tenderness on tendon sheath

88
Q

Flexor sheath infection is when the the palmar aponeurosis of the hand becomes infected. This can spread on palm or on individual flexor tendon sheaths. Is this dangerous?

A
  • medical emergency

- needs surgery

89
Q

Flexor sheath infection is when the the palmar aponeurosis of the hand becomes infected. This can spread on palm or on individual flexor tendon sheaths. This is a medical emergency and requires surgery. How is this treated?

A
  • skin opened, cleaned and debridement
90
Q

What does volar refer to clinically?

A
  • palm or sole of the hand and foot, respectively
91
Q

Prior to giving a patient with an infection of the hand and/or fingers antibiotics, what must be done 1st?

A
  • pus must be drained

- leave wound open

Year 2 MIS (48 decks)

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