SCS Study Guide- EWH Flashcards
1
Q
where is the A1 pulley in the finger
A
A1 is at the MCP joint, responsible for trigger finger
2
Q
what are the most improtant pulleys for prevention of bowstringing in the finger
A
A3-4
3
Q
what innervates the thenar side of the thumb
A
all of them are median nerves, except adductor pollicus which is the ulnar nerve
4
Q
hypothenar innervation
A
ulnar nerve
5
Q
what innervates the lumbricals, DABS/PADS
A
DABS/PADS are ulnar
lumbricals are the median and ulnar
6
Q
what is a bishop sign
A
ulnar nerve palsy, flexion of the 4th and 5th fingers due to hypothenar eminence wasting
7
Q
drop wrist is a palsy of what
A
radial nerve
8
Q
claw hand is an issue with which nerve
A
ulnar
9
Q
ape hand happens from
A
palsy of the median nerve
10
Q
boutonniere deformity
A
hyperextension at DIP, flexion at PIP
11
Q
swan neck deformity
A
hyperextension at PIP, flexion at DIP
12
Q
dupuytren contracture
A
tightening of fascia in creating claw like hand
13
Q
FCR, PL, FDS, FPL, PQ are innervated by what
A
median nerve
14
Q
FDP (goes to the ??) innervated by what
A
innervated by median and ulnar, and goes to DIP
15
Q
FCU innervated by
A
ulnar nerve
16
Q
ECRL/B
AbPL
EPB
A
innervated by the radial nerve
17
Q
ED, EDM, ECU, EPL, EI innervated by
A
radial nerve
18
Q
finkelsteins
A
dequervains
19
Q
tinel
A
CTS
20
Q
Phalen
A
CTS
21
Q
lunotriquetral ballotment test
A
LT joint instab/dislocation
22
Q
allen;s
A
issue with radial or ulnar arteries
23
Q
MP grind/torsion/compression
A
possible fracture
24
Q
bunnel littler test
A
intrinsic capular tightness. MCP flex and PIP flex, then MCP ext and PIP flex and check for restricitons
25
murphy's sign
dislocated lunate: make a fist and check alignment of knuckles, if 2nd knuckle is in line, then lunate issue. should be higher
26
froment's sign
adductor pollicus paralysis
27
shuck test
shear test
press test
lunotriquetral pathology
28
TFCC grind test
TFCC
29
piano key sign
laxity at radioulnar joint
30
Wartenberg sign
neuritis of superficial radial nerve
31
trigger finger causes and exam and treatment
causes: FDP/FDS unable to glide in teh A1 pulley
exam: painful snapping, triggers after making a fist then extending. tendon at A1 thicker
treatment: injection of corticosteroids
32
jersey finger: causes, exam and treatment of
FDP avulsion from forced extension of the DIP during flexion (caught in jersey)
exam: pain and swelling at volar DIP, unable to flex
treatment: splint and refer
33
how do you splint the wrist after a jersey finger repair
wrist in 30 degrees flexion, MCP at 70 flexion and PIP and DIP in full extension
first 10 days.
after 10 days: to 3 weeks, wrist in neutral and MCP at 50 flexion
34
when can splint be D/c after jersey finger surgery
6 weeks (night splint till 8 weeks)
35
when can tendon gliding and strengthening begin for jersey finger repair
5-10 weeks
36
mallet finger cause, exam and treatment
what zone
cause: extensor injury to zone one.
cause: avulsion of extensor at DIP, forced flexion of finger
exam: extensor lag at the dorsal DIP
treatment: continuous splinting for DIP for 6-10 weeks with PIP free
at 6 weeks: there needs to be night splint for 3+ more weeks. then if at 6 weeks and sports, additional splinting for 6 more weeks
37
if the finger drops into flexion with mallet finger splinting what happens
splinting clock starts over
38
central slip extensor tendon injury (possible _____ deformity)
case, exam, treatment
boutonniere
cause: PIP forcibly flexed while extended.
exam: will be no active extension
treatment: splint for 6 weeks, but if after 6 weeks cannot extend, see MD
39
collateral ligament injuries are usually ______, at the ___
cause, exam and treatment
jammed fingers, at the PIP
cause: forced UD/RD at IP joints
exam: pain at ligament and inc valgus/varus
Treatment: buddy tape
40
T or F: radiographic healing lags behind clinical presentation
true
41
after a MC of phalange fracture, MCP joints are positioned how
in flexion to avoid extension contractions
42
after a MC of phalange fracture, IPjoints are positioned how
full extension
43
how long does a metacrapal fx take to heal
6 weeks due to good blood supply
44
splinting for metacarpal fractures
in position of function
wrist 30-60 extension, MCP 70 flexion, IP 0-10 degree flexion
45
is wrist positioned functionally for boxer fractrue
no, usually in ulnar gutter, 3 weeks (MCP at 80 flex, PIP straight, DIP free)
46
what degree of displacement means surgery for boxers fracture
over 40 degrees displacement
47
post ORIF for boxer, how long in a splint
3 weeks
48
Causes and exam and imaging for boxers
cause: punch that doesnt land on 2nd/3rd MC
exam: malposition with fist
x-ray: lateral view
49
coaches finger is a dislocation at the ____ and is usually a ___ direction dislocation
at the PIP, usually dorsally
TTP at volar plate and reduced and splinted in flexion and extension
50
CMP dislocation cause, exam and treatment
cause: foce dorsally or volarly, pain and swelling, and splint to avoid full extension
51
bennet fracture cause, exam and treatment
cause: add or sligthly flexed finger, fall. lateral x-ray, treat with open or closed reduction and casting
52
gamekeeper thumb cause, exam and treat
cause: valgus at thumb, exam, weakened key pinch and valgus stress test and imaging would be plain x-ray and treat with 30-35 degree RD
53
what is a stenner lesion
aponeuosis and UCL is entrapped
54
structures that provide ulnar stability of the thumb
adductor aponeurosis, Adductor pollicus, UCL, volar plate
55
UCL is splinted how
in arm spice cast with IP free
56
how long to splint UCL if on contact situations
2 months
57
when can you start A/PROM and gripping in UCL
ROM at 3-4 weeks gripping at 6 weeks
58
after a thumb UCL repair, when ca you start PROM of thumb
6 weeks
59
when to d/c splint with UCL-R/r
8 weeks
60
UCL thumb repair RTS
3-4 months
61
CTS cause, exam and treatment
cause: inflammation of tendons and synovial sheaths in the wrist with repeated flexion
exam: phalen, tinel, medial compression test, sensory changes and paresthesia
treatment: non op: wrist splint in neutral, op: release
62
CT release timeline for ROM/ADL/strengthening/gripping and RTW/RTP
ROM at 2 weeks
ADLs 7d-14d
pinch/grip 2-4 weeks
RTP/RTW 2-4 week
63
bowler's thumb
digital nerve compression from bowling ball
64
hamate fracture
cause exam and treatment
cause: contact while athlete is holding sport club/rqchuet into ulnar side of hand
wrist will be painful and weak
casting and immob for 6-8 weeks
65
scaphoid fracture
cause, exam and treatment
hypertext and RD wrist
TTP snuffbox, tubercle tenderness, compression pain
imaging with posterolateral, oblique and ulnar flex, PA, MRI
treatment varies
66
stable scaphoid fracture treatment
6 week sugar tong/long arm thumb splica by 6 weeks short arm thumb splica
67
minimally displaced scaphoid fracture
percutaneous fixation with scres
68
displaced scaphoid fx treatment `
ORIF
69
RTS after scaphoid fracture
18 weeks
70
colles fracture
radius, dirsal angulation of distal part
71
smith fracture
distal radius is palmarly displace
72
silver fork
hand dorsally displaces
73
how to treat a radius fracture
braced 4-6 weeks
74
DeQuervain's cause, exam, treatment
cause: grasp with UD (tennis)
exam: pain at radial ascpect wrist, finkelstein's pain with turning
immobilize with a radial thumb splica
75
TFCC cause, exam, treatment
FOOSH, rotational injury, repeated axial loading
exam: ulnar wrist pain, crepitus, pain with gripping and RD, shuck/shear/grind/press test
imaging: PA/lateral oblique with sho ABDwrist brace 4-6 weeks, RTS 3 months
76
RTS for TFCC issues
3 months
77
Keinboch's disease
AVN lunate, maybe fall, pain like a sprained wrist, stiff, decreased grip strength, pain with turning hand upwards,
immobilized in cast early on!
