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CAM III > Upper Extremity part 1 > Flashcards

Upper Extremity part 1 Flashcards

1
Q

What area of the hand does the median nerve encompass?

A

1st 3.5 fingers

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2
Q

What area of the hand does the ulnar nerve encompass?

A

Last 2.5 fingers

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3
Q

What area of the hand does the radial nerve encompass?

A

Pollicis

2nd and 3rd digits up to DIP joints

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4
Q

Components of ganglion cysts

A

MC soft tissue tumors of the hand
Dorsal and volar (palm) wrists
Fluctuates in size

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5
Q

PE of ganglion cyst

A

Fluid-filled
Transilluminated
Mild tender to palpation

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6
Q

Tx for ganglion cysts

A 
Splint
NSAIDs
Aspiration
Surgery
Aspiration does not fix the problem
When in doubt, choose the conservative option
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7
Q

How does a mallet finger present?

A

Extension of MTP and PIP

Flexion of DIP

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8
Q

When can a mallet finger be seen?

A

RA

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9
Q

How does a boutinniere deformity present?

A 
PIP flexion
(Hyper)extended DIP joint
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10
Q

What is the pathology of boutinniere deformity?

A

Rupture of central slip of extensor tendon

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11
Q

What is the cause of boutinniere deformity?

A

Jammed finger secondary to arthritis

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12
Q

Tx for boutinniere deformity

A

8 wks full extension

8 wks nighttime extension

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13
Q

How does swan neck present?

A

PIP hyperextension

DIP flexion

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14
Q

What is the pathology of a mallet finger?

A

Terminal extensor tendon rupture
Bony or soft tissue
AKA baseball finger

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15
Q

Tx for mallet finger

A

Stack splint

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16
Q

Presentation of Dupuytren dz

A 
Contraction of palmar fascia
"Viking" dz
Painless nodules
Progressive
Ring finger = mc
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17
Q

What is a common complaint of someone with Dupuytrens?

A

Fingers “catching” on things and having trouble putting them in pockets

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18
Q

RF for Dupuytrens

A 
Older
Men
DM
Smoking
FHx
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19
Q

Components of trigger finger

A

A1 pulley
Locking/catching
Painful nodule

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20
Q

What is the definitive tx for Dupuytren?

21
Q

What is the difference between Dupuytrens and trigger finger?

A

Dupuytrens is not painful
Dupuytrens is a cord, whereas trigger finger is a nodule
Trigger finger is not progressive

22
Q

Tx for trigger finger

A

Injection
NSAIDs
Surgery

23
Q

S/sx of carpal tunnel syndrome

A 
Numbness/tingling
Drop things
Can't open jars/lids
Nighttime pain
Thenar atrophy
24
Q

Tests for carpal tunnel syndrome

A

Tinels test
Phalen’s test
EMG

25
Q

Tinels test

A

Tap over transverse carpal ligament

Pos if reproduce the pain

26
Q

How long should the Phalen’s test be held for?

27
Q

What is the purpose of the EMG?

A

Diagnostic procedure to help assess muscles/nerves

Reveal nerve dysfunction, muscle dysfunction or problems with nerve-to-muscle signal transmission

28
Q

Process of the EMG?

A

Uses electrodes taped to the skin (surface electrodes) to measure the speed and strength of signals traveling between two or more points
Needle EMG, a needle electrode inserted directly into a muscle records the electrical activity in that muscle

29
Q

Components of CMC arthritis

A

Pain with pinch/grip
Decreased strength
Pos grind test

30
Q

What is seen on X-ray with CMC arthritis?

A

Cyst
Loss of joint space
White indicates sclerosis

31
Q

Tx of CMC arthritis

A 
Thumb spica splint
NSAIDs
OT
Injection
Referral
32
Q

Where can de Quervain tenosynovitis be found?

A

First dorsal compartment

  • Abductor pollicus longus
  • Extensor pollicus brevis
33
Q

How does de Quervain tenosynovitis present?

A

Pain over radial styloid

Pos Finkelsteins test

34
Q

Tx for de Quervains

A

Thumb spica
Injection
NSAIDs
Surgery

35
Q

Components of gamekeepers thumb

A

AKA skiers thumb
Rupture of UCL
Important stabilizer
Pain/swelling in ulnar aspect of thumb

36
Q

How soon should one perform surgery for gamekeepers thumb?

A

Within first 3 wks of injury

37
Q

What is flexor tenosynovitis?

A

Flexor tendon sheath infection

38
Q

Components of flexor tenosynovitis

A

Fusiform swelling
Tenderness along sheath
Pain with passive stretch
Flexed position when at rest

39
Q

How does a boxer fx occur?

A

With punching

40
Q

S/Sx of boxer fx

A

Pain/swelling

41
Q

Tx for boxer fx

A

Ulnar gutter splint

Refer PRN for sx or reduction

42
Q

Cause of scaphoid fx

A

Most commonly fxed carpal bone

Non-union and osteonecrosis

43
Q

Presentation of scaphoid fx

A

Snuff box tenderness

44
Q

Workup of scaphoid fx

A

Scaphoid views: X-ray

45
Q

Tx of scaphoid fx

A

Thumb Spica/refer

When in doubt- treat

46
Q

Colles fx

A

MC distal radius fx
Dinner fork appearance
Falling on outstretched hand

47
Q

PE of Colles fx

A

Pain
Swelling
Tenderness
Deformity

48
Q

Tx for Colles fx

A

Casting vs open reduction in field…refer

CAM III (12 decks)

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