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pathology Flashcards

1
Q

Leddy type 1 jersey finger

A

FDP tendon retracted to palm, disruption of vascular supply

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2
Q

Leddy type 2 jersey finger

A

FDP retracts to level of PIP joint

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3
Q

Leddy type 3 jersey finger

A

large avulsion fracture limits retraction to level of DIP joint

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4
Q

Leddy type 4 jersey finger

A

osseous fragment and simultaneous avulsion of tendon from fragment, tendon retracts into palm

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5
Q

what tendon can be transferred to repair a chronic EPL rupture?

A

EIP

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6
Q

when are tendon repairs weakest?

A

POD 6-12

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7
Q

what is mallet finger?

A

disruption of the terminal extensor tendon distal to the DIP joint

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8
Q

what is an absolute indication for ORIF or CRPP of a mallet finger?

A

volar subluxation of distal phalanx

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9
Q

what exam finding is typical in sagittal band rupture

A

ability to maintain MCP extension after passive extension

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10
Q

what is the first disruption in lunate dislocation?

A

scapholunate ligament disrupted

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11
Q

what is a Mayfield 1 lunate dislocation?

A

scapholunate dissociation

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12
Q

what is a Mayfield 2 lunate dislocation?

A

scapholunate dissociation + lunocapitate disruption

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13
Q

what is a Mayfield 3 lunate dislocation?

A

scapholunate dissociation + lunocapitate disruption + lunotriquetral disruption

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14
Q

what is a Mayfield 4 lunate dislocation?

A

scapholunate dissociation + lunocapitate disruption + lunotriquetral disruption + lunate dislocation

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15
Q

which direction does the lunate usually dislocate and what is it associated with?

A

volar, a/w median nerve compression

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16
Q

what is the best xray view to see a hook of hamate fracture?

A

carpal tunnel view

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17
Q

what is a milch type 1 fracture?

A

hook of hamate fracture

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18
Q

what is a milch type 2 fracture?

A

body of hamate fracture

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19
Q

why should you avoid longitudinal traction during closed reduction of an MCP dislocation?

A

could pull the volar plate in and make it irreducible

20
Q

which muscles provide deforming forces in base of thumb fractures?

A

APL, EPL, adductor pollicis

21
Q

bennett fracture

A

intra-articular fracture with a palmar radial fragment

22
Q

rolando fracture

A

Y or T shaped complete intra-articular fracture

23
Q

what structure is damaged in a thumb CMC dislocation?

A

dorsoradial ligament torn, anterior oblique ligament is intact but peeled off the first metacarpal base

24
Q

what is a felon?

A

subcutaneous abscess of the fingertip pulp

25
Q

what bug is most common in a felon?

A

staph aureus, gram negative in immunosuppressed, eikenella in diabetics who bite their nails

26
Q

what are the kanavel signs?

A

signs of flexor teno

  1. flexed posturing of involved digit
  2. TTP over tendon sheath
  3. marked pain with passive extension
  4. fusiform swelling of digit
27
Q

what are primary indications for finger replantation?

A

thumb at any level, multiple digits, through the palm, wrist level or proximal to the wrist, almost anything in children

28
Q

what is the blood supply in a medial gastroc flap?

A

medial sural artery

29
Q

what is the blood supply in a gracilis flap?

A

medial femoral circumflex artery

30
Q

what is the blood supply and nerve at risk in a groin flap?

A

blood supply = superficial circumflex iliac artery, nerve = lateral femoral cutaneous nerve

31
Q

what are the potential sites of entrapment in pronator syndrome?

A

supracondylar process, ligament of struthers, lacertus fibrosus, between ulnar and humeral heads of pronator teres, FDS aponeurotic arch

32
Q

what nerve is compressed in pronator syndrome?

A

median

33
Q

most common sites of entrapment in cubital tunnel syndrome

A

between 2 heads of FCU/aponeurosis, within Arcade of Struthers, between Osborne’s ligament and MCL

34
Q

most common cause of ulnar tunnel syndrome

A

ganglion cyst

35
Q

what are the possible sites of compression in PIN syndrome?

A

between brachialis and brachioradialis, Leash of Henry, edge of ECRB, Arcade of Frohse, distal edge of supinator

36
Q

what is radial tunnel syndrome?

A

compressive neuropathy of the PIN with only pain, no sensory/motor dysfunction

37
Q

where is the point of max tenderness in radial tunnel syndrome?

A

3-5 cm distal to lateral epicondyle

38
Q

what is wartenberg’s syndrome?

A

compressive neuropathy of the superficial radial sensory nerve

39
Q

what can cause intrinsic minus hand?

A

ulnar or median nerve palsy, charcot-marie-tooth

40
Q

what is the mechanism of a boutonierre deformity?

A

rupture of the central slip over the PIP joint

41
Q

what is the primary lesion in a swan neck deformity?

A

lax volar plate that allows hyperextension of PIP

42
Q

what causes the quadrigia effect?

A

functional shortening of the FDP tendon (FDP of long, middle, and ring finger share a common muscle belly, excursion is equal to shortest tendon)

43
Q

what causes trigger finger?

A

entrapment of the flexor tendon at the A1 pulley

44
Q

what is the inheritance pattern of dupuytrens?

A

autosomal dominant with variable penetrance

45
Q

what is the dominant cell type in dupuytrens?

A

myofibroblasts

46
Q

what is intersection syndrome and what causes it?

A

inflammation at crossing points of 1st and 2nd dorsal compartments, repetitive wrist motion

hand (2 decks)

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