MRC Hand Flashcards

1
Q

Testable upper extremity nerve transfers (2).

A
  1. Double Oberlin transfer

2. AIN to motor branch of ulnar nerve

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2
Q

Ability of nerve to resist compression neuropathy is related to the amount of this in the nerve.

A

Collagen.

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3
Q

In NCS, the latency is this.

A

Time it takes signal to reach point.

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4
Q

In NCS, amplitude is this.

A

Degradation of signal strength.

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5
Q

Signals of muscle denervations in EMG (3).

A
  1. positive sharp waves
  2. fibrillations
  3. fasciculations
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6
Q

Impaired axonal transport at this pressure.

A

30 mmHg.

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7
Q

Reduced epineurial blood flow at this pressure.

A

20-30 mmHg.

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8
Q

This test measures multiple overlapping peripheral receptive fields.

A

Innervation density test.

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9
Q

This test measures a single nerve fiber innervating a receptor.

A

Threshold test.

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10
Q

Inability to detect this in the median nerve distribution is considered positive.

A

2.83 monofilament.

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11
Q

Innervation density testing is useful for this.

A

Evaluating functional nerve regeneration after repair.

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12
Q

Which is best for objectively testing for carpal tunnel Semmes-Weinstein or two-point discrimination.

A

Semmes-Weinstein.

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13
Q

Most sensitive carpal tunnel exam maneuvres (3).

A
  1. Durkan’s (most sensitive)
  2. Phalen’s
  3. Tinel’s
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14
Q

Abnormal distal motor and sensory latencies (2).

A
  1. Motor >4.5 msec

2. Sensory >3.5 msec

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15
Q

Resting pressure of carpal tunnel.

A

2.5 mmHg

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16
Q

For carpal tunnel syndrome, splint in this position.

A

Neutral.

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17
Q

Most common cause of failure after carpal tunnel release.

A

Incomplete release of TCL.

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18
Q

Differentiates carpal tunnel syndrome and pronator syndromes.

A

Sensation to the palmar cutaneous distribution.

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19
Q

This anomalous structure may predispose to pronator syndrome.

A

Supracondylar process.

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20
Q

Pronator syndrome is associated with this other condition.

A

Medial epicondylitis.

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21
Q

Accessory head of FPL.

A

Gantzer’s muscle.

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22
Q

AIN syndrome may be precipitated by this.

A

Viral syndrome (Parsonage-Turner).

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23
Q

Most common treatment for AIN syndrome.

A

Observation.

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24
Q

Anomalous muscle that may contribute to cubital tunnel syndrome.

A

Anconeus epitrochlearis.

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25
Q

Abducted small digit when asked to adduct fingers.

A

Wartenberg sign.

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26
Q

Weak thumb adduction with compensatory FPL flexion during pinch.

A

Froment sign.

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27
Q

Indications of surgical release of cubital tunnel (2).

A
  1. Failure of conservative measures 3 months

2. Positive EMG/NCS studies

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28
Q

3 zones of ulnar tunnel syndrome.

A
  1. Proximal to nerve bifurcation (ganglion)
  2. Deep motor branch (motor deficit from hook of hamate fx)
  3. Superificial sensory branch (ulnar artery thrombosis)
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29
Q

Roof of Guyon canal.

A

Volar carpal ligament.

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30
Q

If concominant CTS, release of this ligament is sufficient for decompression of ulnar tunnel.

A

Transverse carpal tunnel ligament.

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31
Q

Wartenberg syndrome.

A

Sensory radial nerve compression.

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32
Q

Two types of thoracic outlet syndrome (2).

A
  1. vascular

2. neurogenic

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33
Q

Exam test to evaluate vascular thoracic outlet syndrome.

A

Adson test.

34
Q

C8-T1 brachial plexus root avulsion may result in this syndrome.

A

Horner’s syndrome.

35
Q

Primary goal of any brachial plexus reconstruction.

A

Elbow flexion.

36
Q

If this muscle return by 2 months then expect full recovery after obstetric brachial plexopathy.

A

Biceps.

37
Q

This architectural feature of tendons is best correlated with amplitude (excursion of tendon).

A

Fiber length.

38
Q

Force the muscle can generate is propotional to this.

A

Cross sectional area.

39
Q

For radial nerve injury, is tendon transfer to ECRL or ECRB preferred?

A

ECRB more central insertion.

40
Q

FCR (Brand) transfer (3).

A
  1. FCR to EDC
  2. Pronator teres to ECRB
  3. Palmaris longus to EPL
41
Q

APB atrophy tendon transfer.

A

Palmaris longus transfer (Camitz transfer).

42
Q

Congenital thenar atrophy transfer.

A

Abductor digit mini transfer (Huber).

43
Q

2 transfers for restoration of pinch after ulnar nerve injury.

A
  1. ECRB to adductor pollicis

2. FDS to adducotr pollicis

44
Q

Bouvier’s test evaluates this.

A

Ability of patient to extend PIP joint when MCP flexed.

45
Q

2-octylcyanoacrylate.

A

Dermabond.

46
Q

In fingertip injuries, granulation can heal this size.

A

1cm^2

47
Q

Tight primary nail bed closure may result in this.

A

Hook nail deformity.

48
Q

Sequential process of skin graft healing (3).

A
  1. Plasma imbibition
  2. Inosculation
  3. Revasculariziation
49
Q

Major causes of early failure of skin grafts (2).

A
  1. Shear stress

2. Hematoma

50
Q

60 deg Z-plasty results in this degree of lengthening.

A

75% increase.

51
Q

Cold intolerance of ischemic pain in a roofer or carpenter.

A

Hypothenar hammer syndrome.

52
Q

Hypothenar hammer syndrome.

A

Vaso-occlusive disease at the ulnar artery proximal palm.

53
Q

Treatment of hypothenar hand syndrome dictated by this.

A

Digital brachial index less than or greater than 0.7

54
Q

Hypothenar hammer syndrome treatment with DBI >0.7.

A

Aneurysm removal and ligation.

55
Q

Embolic disease to hand usually here.

A

PIP level at ring finger.

56
Q

Absolute indication for replant (4).

A
  1. thumb
  2. multiple digits
  3. wrist or proximal
  4. child
57
Q

Replant failure first 12 hours.

A

Arterial thrombosis.

58
Q

Replant failure after 12 hours.

A

Venous congestion.

59
Q

Leaches excrete this anticoauglant.

A

Hirudin.

60
Q

This organism must be covered with abx if using leaches.

A

Aeromonas hydrophila.

61
Q

Prophylactic coverage for aeromonas hydrophila.

A

Ceftriaxone or ciprofloxacin.

62
Q

Chronic mallet can lead to this deformity.

A

Swan neck.

63
Q

Central slip rupture can result in this deformity.

A

Boutonniere.

64
Q

Non-operative Zone IV extensor injury treated with this.

A

Dynamic splints.

65
Q

Most common surgical correction for chronic boutonneire deformity.

A

FDS tenodesis.

66
Q

Intrinsic minus.

A

MCP hyperextension

IP flexion

67
Q

Gap formation of ____ mm with tendon repair with a risk factor for rupture.

A

3mm

68
Q

Risk of rerupture after tendon repair greatest at this time.

A

3 weeks after repair.

69
Q

Failure of tendon repair occurs here.

A

At the knot.

70
Q

Minimum number of core sutures in tendon repair.

A

4 core strands.

71
Q

For zone II flexor injuries repair of both FDS and FDP inhibits tendon glide (T/F).

A

False.

72
Q

Paradoxical extension of IP joint during MCP flexion.

A

Lumbrical plus finger.

73
Q

Dental hygenist with finger infection.

A

Herpetic whitlow (HSV 1)

74
Q

Antibiotic for animal bite.

A

Augmentin.

75
Q

Most important variable in outcomes of high pressure injuries.

A

Material injected.

76
Q

Trigger finger is stenosis here.

A

A1 pulley.

77
Q

Non-op treatment of trigger finger.

A

Corticosteroid injection.

78
Q

Variants of first dorsal compartment (2) in de Quervain’s surgical release.

A
  1. Multiple slips of APL

2. Separate compartment of EPB

79
Q

Lateral epicondylitis involves this tendon origin.

A

ECRB

80
Q

This histopathology on lateral epicondylitis.

A

Angiofibroblastic hyperplasia.