Upper Extremity Condition/Treatment Wrist & Hand

Question 1

De Quervain’s Disease

Answer 1

Tenosynovitis

Question 2

Tenosynovitis definition

Answer 2

Chronic inflammation of the tendon sheaths of EPB (extensor policies brevis) and APL (abductor policies longs)

Question 3

De Quervain’s is what type of injury?

Answer 3

RSI

Question 4

With Tenosynovitis, where is the pain?

Answer 4

Radial styloid process of wrist - LI5

Question 5

When does Tenosynovitis hurt?

Answer 5

• moving thumb & wrist PROM
• thumb ABDuction, EXTension RROM
• forming a fist
• grasping/gripping things
• turning the wrist as in the Finkelstein’s test

Question 6

What is the quality of pain w/Tenosynovitis? When does it occur?

Answer 6

electric, stabbing

with or without movement

Question 7

What is Tenosynovitis difficult to distinguish with ?

Answer 7

Osteoarthritis of the Carpal-Metacarpal Joint

= CMC-Joint

Question 8

Test for Tenosynovitis

Answer 8

Finkelstein

Question 9

What are TCM possibilities for Tenosynovitis Dx?

Answer 9

• Wind-Cold invasion
• Blood Stag. = sharp Pain
• Painful Bi Syndrome

Question 10

For Tenosynovitis Tx needle Ah Shi along

Answer 10

ABD pollicis longus tendon (APL)
EXT pollicis brevis tendon (EPB)
***don’t needle into the tendons!

Question 11

Local LU pts. to needle Tenosynovitis

Answer 11

LU7, LU8, LU9, LU10

Question 12

Local LI pt.s to needle Tenosynovitis

Answer 12

LI4, LI5, LI6

Question 13

Pt to needle for Tenosynovitis to get rid of upper extremity obstruction

Answer 13

SI11

Question 14

If it is not Tenosynovitis but Osteoarthritis of CMC, Tx

Answer 14

periosteal needling of 1st CMC

Question 15

Tenosynovitis APL & EPB IZ

Answer 15

?????

Question 16

CTS

Answer 16

Carpal Tunnel Syndrome

Question 17

Most common form of chronic wrist injury

Answer 17

Carpal Tunnel Syndrome

Question 18

Symptoms of Carpal Tunnel are related to

Answer 18

compression of Median Nerve, which travels through Carpal Tunnel

Question 19

What harm to the synovial membranes around the tendons in the Carpal Tunnel causes compression?

Answer 19

swelling, thickening, irritation

Question 20

Where is numbness felt w/Carpal Tunnel?

Answer 20

1st 3-1/2 fingers, thumb, index, middle & 1/2 ring finger

Question 21

Shaking hands w/Carpal Tunnel Syndrome can

Answer 21

remove the sensation of numbness?

Question 22

Pain w/Carpal Tunnel Syndrome can extend to

Answer 22

forearm, palm, but also up to shoulder

Question 23

What muscle is possible to waste w/Carpal Tunnel Syndrome?

Answer 23

Thenar muscle

Question 24

Odd reason for Carpal Tunnel Syndrome

Answer 24

dampness in pregnancy

Question 25

Carpal Tunnel Syndrome Tests (3)

Answer 25

1-Phalen
2-Carpal Compression Test
3-Pronator Teres Syndrome (R/O)

Question 26

TCM Dx for Carpal Tunnel Syndrome

Answer 26

Q/B Stag. in PC, LU meridian, dampness in pregnancy obstructing wrist

Question 27

General Tx for Carpal Tunnel Syndrome

Answer 27

Remove Stagnation from Meridians

Question 28

Where to look for Ah Shi pts for Carpal Tunnel Syndrome

Answer 28

near end of tunnel, palmaris longs, forearm

Question 29

pt needled at wrist for Carpal Tunnel

Syndrome

Answer 29

PC7 toward hand

Question 30

What distal pt is really important to needle for Carpal Tunnel Syndrome?

Answer 30

SI 11 better treatment than treating wrist alone

Question 31

What IZ is used for Carpal Tunnel Syndrome?

Answer 31

Palmaris longus IZ

Question 32

ST36, LI11, SP9 is needled in Carpal Tunnel Syndrome for what reason?

Answer 32

To remove water in pregnancy

Question 33

What Huatuojiaji for Carpal Tunnel Syndrome?

Answer 33

C6 to T1

Question 34

Forearm pts. for Carpal Tunnel Syndrome?

Answer 34

PC6 & TW5