Musculoskeletal Day 3

Question 1

which mm are responsible for supination?

Answer 1

biceps

supinator

Question 2

what mm are responsible for pronation at the wrist?

Answer 2

pronator teres

pronator quadratus

Question 3

what does an intrinsic mm mean?

Answer 3

arises from the hand

Question 4

which mm is the “plate carrying muscle”?

Answer 4

lumbricals

Question 5

which mm abduct the fingers?

Answer 5

dorsal interossei

Question 6

which mm adduct the fingers?

Answer 6

palmar interossei

Question 7

what nerve passes through the carpal tunnel?

Answer 7

median nerve

Question 8

what type of injury is carpal tunnel syndrome?

Answer 8

repetitive trauma injury

-usually worse at night

Question 9

what is the median nerve distribution?

Answer 9

thumb, index, 2nd, 3rd and half of 4th digit

Question 10

what indicates a positive Tinel’s sign?

Answer 10

tingling or electric sensation on percussion of the palmer aspect of where the wrist meets the hand

Question 11

what is a positive Phalen’s test?

Answer 11

numbness and tingling is felt when wrists are held in acute flexion for 60 seconds

Question 12

what indicates a positive Grind test?

Answer 12

pain is felt when you apply pressure to thumb and internall and externally rotate the thumb

Question 13

what does a positive Grind test indicate?

Answer 13

degenerative joint dz

Question 14

what are Heberden’s nodes?

Answer 14

nodules on dorsolateral aspects of the DIP

• due to bony overgrowth a/w OA
• usually hard and painless
• affect middle aged to elderly

Question 15

what are Bouchard’s nodes?

Answer 15

found on the PIP joints and are less common than Heberden’s nodes

Question 16

what are typically signs of RA?

Answer 16

tender, stiff joints of both hands

PIP, MCP and wrist joints but NOT DIP

spindle shape swelling of PIP

rheumatoid nodules

symmetrically affects

Question 17

what are signs of chronic RA?

Answer 17

swelling and thickening of PIP and MCP

limited ROM

fingers deviate to ulnar side

interosseous muscle atrophy

swan neck deformities

boutenniere deformities

rheumatoid nodules

Question 18

what is a ganglion?

Answer 18

fluid filled sac that forms by irritation, usually non-tender located along tendon sheaths or joint capsules

-frequently found on dorsum of wrist

Question 19

what is tenosynovitis?

Answer 19

inflammation of flexor tendon sheaths may follow local injury

• tenderness and swelling along course of flexor tendon distal phalynx to MCP w/o joint involvement
• early dx and treatment are important

Question 20

what is a felon?

Answer 20

injury to finger tip that damages finger pad

• severe pain, local tenderness
• early dx is important

Question 21

what is dupuytren’s contracture?

Answer 21

skin puckers in the area of flexor tendon of the ring and maybe the little finger

-flexion of contracture may ensue

Question 22

what is a trigger finger?

Answer 22

painless nodule in a flexor tendon in the palm near the head of the MC

• audible snap is present when nodule tries to move through tendon sheath (can’t back the tendon out)
• watch and listen during flexion and extension and palpate for the nodule and the snap

Question 23

what does thenar atrophy indicate?

Answer 23

carpal tunnel syndrome

Question 24

what does hypothenar atrophy usually indicate?

Answer 24

ulnar nerve injury or neuropathy