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Ortho > Upper Extremity > Flashcards

Upper Extremity Flashcards

1
Q

Lateral epicondylitis (Tennis Elbow) usually occurs in…

A

patients 35 years or older and between the ages of 30-50.

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2
Q

Populations affected by radial head dislocation and have trouble moving in to supination

A

Children- usually occurs when the parent gives the child a strong tug “come along” and dislocates the head of the radius.

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3
Q

Osteoarthritis changes in the hand are more likely to occur over what age?

A

40.

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4
Q

FOOSH can lead to…

A

carpal bone fracture or dislocation, often lunate dislocation, pain with PROM wrist flexion

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5
Q

Pain in the tip of the olecranon can indicate…

A

bursitis

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6
Q

Pain in the anatomical snuffbox can indicate…

A

a scaphoid injury

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7
Q

Carrying angle in males

A

5-10 degrees

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8
Q

Carrying angle in females

A

10-15 degrees

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9
Q

Cubital Vagus

A

> 15 degrees

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10
Q

Cubital Varus

A

<5-10 degrees

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11
Q

Where and what is the triangular space?

A

between the tip of the olecranon, the radial head and the lateral epicondyle, it is a common area of swelling with joint injury

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12
Q

Osteoarthritis

A

Herberden’s nodes: DIP joints

Bouchard’s nodes: PIP

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13
Q

Rheumatoid Arthritis

A

Ulnar drift at the MCP joint

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14
Q

ROM: elbow flexion

A

140-150

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15
Q

ROM: elbow extension

A

0- (-) 10

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16
Q

ROM: elbow supination

A

90

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17
Q

ROM: elbow pronation

A

80-90

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18
Q

ROM: wrist flexion

A

80-90

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19
Q

ROM: wrist extension

A

70-90

20
Q

ROM: Ulnar deviation

A

30-45

21
Q

ROM: Radial deviation

A

15

22
Q

Tip when assessing wrist ROM

A

compare both sides at the same time

23
Q

What is Lateral epicondylitis?

A

This condition may be secondary to failure of the musculotendinous attachment with resultant buildup of fibrous tissue (fibroplasia). The symptoms and chronicity of epicondylitis may be related to a poor repair process.

24
Q

Commonly seen in males 4-5x more than women and in patients between the ages of 30-50 y/o. The dominant arm is most likely to be affected. Onset is usually insidious (no specific mechanism of injury), but a RSI. Pain is usually located over the epicondyle where the lateral extensor attaches. This area will be point tender and lifting even light objects or opening doors. Pain can be sharp stabbing, and/or dull and achy which can radiate proximally or distally. Western tx: cortisone injections.

A

Lateral Epicondylitis (Tennis Elblow)

25
Q

If Lateral Epicondylitis is bilateral check..

A

lower cervical segments which foramina test (C6,C7)

*Remember to also treat the Extensor group!

26
Q

Tests to use when checking for lateral epicondylitis

A

Cozen’s Test
Mill’s Test
Extensor Digitorum

27
Q

TCM diagnosis of lateral epicondylitis

A

LV Blood deficiency, LV Qi stagnation, Local stagnation of Qi and Blood at the epicondyle

28
Q

TX : lateral epicondylitis

A

Build LV Blood, Smooth LV Qi, Move local stagnation of Q/B, relax the sinews

29
Q

Point prescription for lateral epicondylitis

A

Ling Ku, TW 5 Zone, LI10, Ext. Dig. and ECRB IZ, osteoacupuncture at the epicondyle, tuina, kinesiotaping

30
Q

Pain on the medial aspect of the elbow, similar presentation as lateral epicondyle, check biceps, medial head of trice, and pronator trees trigger points. This condition responds much slower to treatment than lateral epicondylitis as the muscles that attach to the medial epicondyle have tendinosus sheaths are are more tubular compared to the extensor groups fan like attachment.

A

Medial epicondylitis (Golfer’s Elbow)

31
Q

Flexor vs. Extensor tendons

A

flexor tendons are rounded and have synovial sheaths and have longer excursions than extensor tendons, for this reason they take longer to heal than extensor tendons which are flat.

32
Q

Most common muscles affected in medial epicondylitis

A

pronator teres, flexor carpi radialis

33
Q

Test for medial epicondylitis

A

Medial epicondylar stretching

34
Q

DX of medial epicondylitis

A

LV Blood deficiency, LV Qi stagnation, Local stagnation of QI and Blood at the epicondyle

35
Q

Tx for medial epicondylitis

A

Build LV blood, smooth LV Qi, move local stagnation or Qi and Blood, relax the sinews

36
Q

Pain near radial styloid process of wrist (LI5) occurs with movement of thumb and wrist, including PROM. Worse with PROM thumb abduction and extension, forming a fist, grasping or gripping things or turning the wrist. Pain can present with or without movement as electric stabbing pain. Difficult to differentiate between this and osteoarthritis of the CMC joint

A

Tenosynovitis (De Quervain’s Disease)

37
Q

De Quervain’s Disease means…

A

A chronic inflammation of the tendon sheath of the extensor pollicis brevis and abductor pollicis longs, this is a RSI

38
Q

Test to use when diagnosing De Quervain’s disease

A

Finkelstein

39
Q

TCM Diagnosis of Finklestein

A

Wind Cold invasion, Blood stagnation and painful Bi

40
Q

TX of De Quervain’s disease

A

Ah Shi: needle along the EPB and EPL (not into) LU7,8.(, LI4, LI5, LI6, SI11,

41
Q

What is carpal tunnel syndrome?

A

most common for of chronic wrist injury. the symptoms of carpal tunnel are related to compression of the median nerve, which travels through the carpal tunnel. ANything that causes compression, swelling, thickening or irritation of the synovial membranes around the tendons in the carpal tunnel can result in pressure on the median nerve.

42
Q

Numbnesss or paraesthesia felt at the palmar aspect of the lateral 3 1/2 fingers. worse with use, wakes them at night, shaking hands remove sensation, pain can extend into the forearm and the palm but also up into the arm and the shoulder. Wasting of the then muscle is possible. RSI can cause this, also dampness during pregnancy

A

Carpal Tunnel Syndrome

43
Q

Tests for Carpal tunnel

A

Phalen’s (a negative test does not rule out condition)
Carpal compression test
Pronator teres syndrome

44
Q

TCM DX of carpal tunnel

A

Qi/Blood stagnation of the PC and LU meridians

45
Q

TX of carpal tunnel

A

remove stagnation from the meridians
Ah Shi near end of tunnel, PC7 in direction of hand
Palmaris Longus IZ
SP9, LI11, ST36 (reduce water retention during pregnancy)
huato’s c6-c11 (prego)

Ortho (4 decks)

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