Uppers Wrist Flashcards
1
Q
structures affected
A
distal radius and ulna carpal bones collateral, palmar, dorsal ligaments traingular fibrocartilage comples (TFCC) neurvascular structures
2
Q
wrist joint sprains
- can be…
- where
- MOI
- S/S
- when to be concerned
A
common can be an exclusion Dx distal radioulnar joint and carpal bones MOI -hyperextension -hyperflexion -FOOSH -"jamming" the wrist S/S -swelling -point tenderness -pain with active and passive ROM -possible weakness when you have a wrist sprain with S/S lasting 2+ weeks, there could be a problem
3
Q
scapholunate instability
- most…
- S/S
- can lead to…
A
most common sprain of the carpals S/S -pain and swelling over the joint line -hypermobility at scapholunate articulation -decreased ROM and grip strength -+ Watson's test can lead to surgical repair
4
Q
Gamekeeper’s Thumb
- AKA
- where
- MOI
- S/S
- > /
A
AKA Skiier's Thumb ulnar/medial collateral ligament, 1st MCP joint MOI -typerextension or hyperabduction S/S -pain -point tenderness over the medial MCP -swelling in the thenar eminence -varying degrees of instability 30 degrees requires surgical repair
5
Q
flexor tendon avulsion
- another name
- MOI
- S/S
- complete rupture S//s
- splint how
A
"Jersey Finger" MOI -forceful extension when the finger is flexed S/S -immediate pain -swelling -point tenderness at attachment site -"Jersey finger sing" complete rupture = inability to flex DIP splint DIP in flexion
6
Q
extensor tendon avulsion
- other name
- MOI
- S/S
- splint in…
A
"Mallet Finger" MOI -extended distal phalanx is suddenly and forcefully flxed S/S -pain -point tenderness over distal attachment -"Mallet finger sign" splint DIP in extension
7
Q
extensor tendor rupture
- other name
- S/S
- what happens
A
Boutonniere Deformity S/S -flexion of the PIP -hyperextension of the DIP -pain at the PIP -swelling -weakness with PIP extension rupture of the extensor digitorum tendon
8
Q
wrist ganglion
- what
- MOI
- more common…
- S/S
- high rate
A
synovial cyst herniation of synovial fluid through the joint capsule may result from sprains/strains more common dorsally S/S -observable and palpable mass -discomfort with wrist extension high rate of reoccurrence unless surgically removed
9
Q
De Quervain’s Disease
- what
- most common…
- MOI
- S/S
- Tx
A
tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons most common in women 20-40 MOI -repetitive stress (radial deviation) S/S -TTP over APL and EPB, thenar eminence, radial styloid -pain with radial deviation -+ Finkelstein's test Tx -conservative -corticosteroids --sometimes the first line of defense -positive results with releasing the tendon sheath (surgery)
10
Q
trigger finger -what most common in... -MOI -S/S
A
tenosynovitis of the flexor tendons thickening of the synovial sheath most common on the 3rd/4th digits MOI -repetitive trauma S/S -finger appears "stuck" in a flexed position -"snap" with active flexion
11
Q
Colles’ fracture
- what
- displacement
- MOI
- S/S
- possible…
- surgery determined by…
A
distal radius/ulna fracture dorsal displacement MOI -FOOSH with wrist extension S/S -immediate pain -rapid swelling -tenderness -deformity possible median nerve involvement surgery determined by degree of displacement and if it affects the joint
12
Q
reverse Colles’ fracture
- other name
- what
A
Smith’s Fracture
distal radius fracture occurring with wrist flexion
palmar displacement
13
Q
scaphoid fracture
- common in…
- MOI
- S/S
- Tx
- other
A
most common wrist Fx common in younger athletes MOI -FOOSH or forced hyperextension S/S -vague symptoms -lateral wrist pain -snuffbox pain and swelling -pain with thumb motion Tx -immobilization --distal and nondisplaced -surgery --proximal Fx -quick RTP poor vascular supply the more distal the fracture, the better the blood supply
14
Q
hamate fracture
- MOI
- S/S
- 5th finger movement
- Tunnel of Guyon
- Tx
A
MOI -fall on the hand -direct blow -axial load to the 4th/5th MC -trauma while gripping --baseball/golf S/S -swelling in the hypothenar eminence -TTP pain with 5th finger movement -active adduction/abduction -resisted flexion and abduction -passive extension Tunnel of Guyon -where the ulnar nerve runs through the carpal bones -between the pisiform and hamate Tx -immobilize in slight flexion -take out hook of the hamate
15
Q
Bennett’s Fracture
- what
- APL tendon
- MOI
- S/S
A
base of the 1st metacarpal APL tendon will likely cuse displacement MOI -axial load S/S -immediate pain -rapid swelling -tenderness and crepitus at the MCP joint -loss of function
16
Q
metacarpal fracture
- MOI
- S/S
- 5th metacarpal name
- Tx
A
MOI -axial load -direct trauma S/S -pain -diffuse swelling (dorsal) -TTP over MC -fingernail rotation -depressed MC head (4th/5th) -increased pain with longitudinal stress and/or percussion -possible crepitus 5th met - Boxer's Fracture Tx -surgical with displacement > 35 degrees -up to 70 degrees with the 5th met -surgical fixation with rotational fracture
17
Q
phalanx fracture
- commonly seen…
- MOI
- S/S
- splint…
A
commonly seen as a secondary injury to a sprain/dislocation MOI -axial load -torsion -indirect trauma -direct trauma S/S -pain -swelling -point tenderness -loss of function -deformity -crepitus -+ long bone compression or percussion splint in the position found can see lots of deformity
18
Q
MCP/IP dislocation
- direction depends on…
- associated with…
- S/S
- check for
A
direction of the dislocation depends on the force associated with 3rd degree ligament/capsule sprain S/S -obvious deformity -pain -rapid swelling -loss of function check for capillary refill
19
Q
carpal tunnel syndrome
- what
- who
- predisposing factors
- S/S
- Tx
A
compression of the median nerve as it passes through the carpal tunnel multiple factors older adults predisposing factors -age -bony structure -posture --typing - wrist flexion S/S -pain -tenderness over palmar aspect of the wrist -sensory changes -motor weakness -+ Tinel's sign -+ Phalen's Tx -can do a surgical release
