MRC Hand Flashcards
Testable upper extremity nerve transfers (2).
- Double Oberlin transfer
2. AIN to motor branch of ulnar nerve
Ability of nerve to resist compression neuropathy is related to the amount of this in the nerve.
Collagen.
In NCS, the latency is this.
Time it takes signal to reach point.
In NCS, amplitude is this.
Degradation of signal strength.
Signals of muscle denervations in EMG (3).
- positive sharp waves
- fibrillations
- fasciculations
Impaired axonal transport at this pressure.
30 mmHg.
Reduced epineurial blood flow at this pressure.
20-30 mmHg.
This test measures multiple overlapping peripheral receptive fields.
Innervation density test.
This test measures a single nerve fiber innervating a receptor.
Threshold test.
Inability to detect this in the median nerve distribution is considered positive.
2.83 monofilament.
Innervation density testing is useful for this.
Evaluating functional nerve regeneration after repair.
Which is best for objectively testing for carpal tunnel Semmes-Weinstein or two-point discrimination.
Semmes-Weinstein.
Most sensitive carpal tunnel exam maneuvres (3).
- Durkan’s (most sensitive)
- Phalen’s
- Tinel’s
Abnormal distal motor and sensory latencies (2).
- Motor >4.5 msec
2. Sensory >3.5 msec
Resting pressure of carpal tunnel.
2.5 mmHg
For carpal tunnel syndrome, splint in this position.
Neutral.
Most common cause of failure after carpal tunnel release.
Incomplete release of TCL.
Differentiates carpal tunnel syndrome and pronator syndromes.
Sensation to the palmar cutaneous distribution.
This anomalous structure may predispose to pronator syndrome.
Supracondylar process.
Pronator syndrome is associated with this other condition.
Medial epicondylitis.
Accessory head of FPL.
Gantzer’s muscle.
AIN syndrome may be precipitated by this.
Viral syndrome (Parsonage-Turner).
Most common treatment for AIN syndrome.
Observation.
Anomalous muscle that may contribute to cubital tunnel syndrome.
Anconeus epitrochlearis.
Abducted small digit when asked to adduct fingers.
Wartenberg sign.
Weak thumb adduction with compensatory FPL flexion during pinch.
Froment sign.
Indications of surgical release of cubital tunnel (2).
- Failure of conservative measures 3 months
2. Positive EMG/NCS studies
3 zones of ulnar tunnel syndrome.
- Proximal to nerve bifurcation (ganglion)
- Deep motor branch (motor deficit from hook of hamate fx)
- Superificial sensory branch (ulnar artery thrombosis)
Roof of Guyon canal.
Volar carpal ligament.
If concominant CTS, release of this ligament is sufficient for decompression of ulnar tunnel.
Transverse carpal tunnel ligament.
Wartenberg syndrome.
Sensory radial nerve compression.
Two types of thoracic outlet syndrome (2).
- vascular
2. neurogenic
Exam test to evaluate vascular thoracic outlet syndrome.
Adson test.
C8-T1 brachial plexus root avulsion may result in this syndrome.
Horner’s syndrome.
Primary goal of any brachial plexus reconstruction.
Elbow flexion.
If this muscle return by 2 months then expect full recovery after obstetric brachial plexopathy.
Biceps.
This architectural feature of tendons is best correlated with amplitude (excursion of tendon).
Fiber length.
Force the muscle can generate is propotional to this.
Cross sectional area.
For radial nerve injury, is tendon transfer to ECRL or ECRB preferred?
ECRB more central insertion.
FCR (Brand) transfer (3).
- FCR to EDC
- Pronator teres to ECRB
- Palmaris longus to EPL
APB atrophy tendon transfer.
Palmaris longus transfer (Camitz transfer).
Congenital thenar atrophy transfer.
Abductor digit mini transfer (Huber).
2 transfers for restoration of pinch after ulnar nerve injury.
- ECRB to adductor pollicis
2. FDS to adducotr pollicis
Bouvier’s test evaluates this.
Ability of patient to extend PIP joint when MCP flexed.
2-octylcyanoacrylate.
Dermabond.
In fingertip injuries, granulation can heal this size.
1cm^2
Tight primary nail bed closure may result in this.
Hook nail deformity.
Sequential process of skin graft healing (3).
- Plasma imbibition
- Inosculation
- Revasculariziation
Major causes of early failure of skin grafts (2).
- Shear stress
2. Hematoma
60 deg Z-plasty results in this degree of lengthening.
75% increase.
Cold intolerance of ischemic pain in a roofer or carpenter.
Hypothenar hammer syndrome.
Hypothenar hammer syndrome.
Vaso-occlusive disease at the ulnar artery proximal palm.
Treatment of hypothenar hand syndrome dictated by this.
Digital brachial index less than or greater than 0.7
Hypothenar hammer syndrome treatment with DBI >0.7.
Aneurysm removal and ligation.
Embolic disease to hand usually here.
PIP level at ring finger.
Absolute indication for replant (4).
- thumb
- multiple digits
- wrist or proximal
- child
Replant failure first 12 hours.
Arterial thrombosis.
Replant failure after 12 hours.
Venous congestion.
Leaches excrete this anticoauglant.
Hirudin.
This organism must be covered with abx if using leaches.
Aeromonas hydrophila.
Prophylactic coverage for aeromonas hydrophila.
Ceftriaxone or ciprofloxacin.
Chronic mallet can lead to this deformity.
Swan neck.
Central slip rupture can result in this deformity.
Boutonniere.
Non-operative Zone IV extensor injury treated with this.
Dynamic splints.
Most common surgical correction for chronic boutonneire deformity.
FDS tenodesis.
Intrinsic minus.
MCP hyperextension
IP flexion
Gap formation of ____ mm with tendon repair with a risk factor for rupture.
3mm
Risk of rerupture after tendon repair greatest at this time.
3 weeks after repair.
Failure of tendon repair occurs here.
At the knot.
Minimum number of core sutures in tendon repair.
4 core strands.
For zone II flexor injuries repair of both FDS and FDP inhibits tendon glide (T/F).
False.
Paradoxical extension of IP joint during MCP flexion.
Lumbrical plus finger.
Dental hygenist with finger infection.
Herpetic whitlow (HSV 1)
Antibiotic for animal bite.
Augmentin.
Most important variable in outcomes of high pressure injuries.
Material injected.
Trigger finger is stenosis here.
A1 pulley.
Non-op treatment of trigger finger.
Corticosteroid injection.
Variants of first dorsal compartment (2) in de Quervain’s surgical release.
- Multiple slips of APL
2. Separate compartment of EPB
Lateral epicondylitis involves this tendon origin.
ECRB
This histopathology on lateral epicondylitis.
Angiofibroblastic hyperplasia.
