Week 7 Flashcards
What are the acronyms to remember the wrist bones?
So Long To Pinky
Here Comes the Thumb
What finger flexors and nerve run through the carpal tunnel?
Why does pregnancy cause an increase in carpal tunnel syndrome?
Muscles: Flexor Digitorum Superficialis Flexor Digitorum Profundus Flexor Pollicis Longus Median Nerve
Increase during pregancy because there is a build up of fluid.
What are signs and symptoms of tendonitis/ Tendonosis/ Tenosynovitis?
Inflammation Limited motion Pain Tenderness Crepitus- snapping/ clicking
Describe the treatment method - IONTO.
That is the method of transferring medication below skin surface to the muscle through electricity. It is done for anti-inflammatory purposes.
What are mechanisms for forearm fractures?
Why can you not always ice a fracture?
Fall on outstretched arm and direct blow. Can’t always ice because will cause shooting pain if too much pressure.
What is the difference between a Colles vs. Smith Fracture? Which is more common?
Colles is when the radius is displaced dorsally while Smith is there is a volar angulation towards the palm. Colles is more common (90% of radial fractures).
Scaphoid Fracture - mechanism, special tests- why is it problematic?
M- compression against radius and direct contact.
ST- palpation of the anatomical snuff box and scaphoid compression test.
Problematic - poor blood supply- harder to heal - inhibits the inflammatory process.
What are some signs and symptoms of a hamate fracture?
Pain, Swelling - Tenderness on ulnar side: may feel pain along the flexor carpi ulnaris. May experience parasthesia as the ulnar nerve runs through this area.
What is the mechanism of a wrist dislocation?
Axial Load - FOOSH
What is the mechanism for a lunate dislocation? Is there any special tests (why or why not)?
Forced Hyperextension
There is no special tests because there are no muscles that attach onto the lunate.
Describe the 2 special tests for carpal tunnel syndrome.
Phalen’s Test- bend arms at the elbow and touch the dorsal parts of both hands together. Positive- any tingling or numbness.
Tinel’s - touch area where median nerve runs down.
What is unique about the mechanism for ligament sprains and muscle strains?
Can be caused by either hyperextension or hyper-flexion.
Describe the valgus and varus special tests for a ligament sprain and a muscle strain of the wrist.
Valgus- radially deviating the wrist- testing the integrity of the ulnar collateral ligament.
Varus- ulnar deviation of the wrist- testing the integrity of the radial collateral ligament.
What is the function of the Triangular Fibrocartilage Complex (TFCC)?
Functions like the meniscus in the knees.
- Gliding surface for distal area of radius and ulna.
- flexibility for lunate and triquetrium bones to rotate around ulnar axis.
-
What is the mechanism and signs and symptoms of a TFCC tear?
Mechanism- hyperextension and torque of the wrist.
Signs and symptoms - pain distal to the ulna- clicking sensation.
How do you treat a ganglion cyst?
If it is not painful and doesn’t restrict movement- then do nothing.
What is the role of Volar Plates in our hands?
Prevent hyperextension
What is deQuervain’s syndrome?
Mechanism?
Tenosynovititis of the thumb and 2 of the tendons that run through the anatomical snuff box - extensor pollicis brevis and abductor pollicis longus.
Lots of repetitive wrist motion.
What is Trigger Finger
Tenosynovitis of the tendon sheath at the base of the finger known as the A1 pulley.
When finger is then stuck in a bent position.
What is different and simliar among boxer and bennett fractures?
Both can be caused by punching and an axial/compressive load. Tests can be compression or percussion tests.
Ben- injury to the palmar aspect of the base of the 1st metacarpal.
Box- injury to the neck of the fifth metacarpal.
What is the mechanism for phalanx fracture?
Avulsion
Crushing, longitudinal compression or rotation.
PIP and DIP dislocation/sprain or strain.
Varus and Valgus
Xray
Varus- testing integrity of the lateral collateral ligament,
Valgus- testing integrity of the medial collateral ligament.
X ray before reduction- need to ensure that nerve or artery is not pinched.
What is Game Keeper’s Thumb? Why is it important to treat?
Spain of ulnar collateral ligament of the thumb.
Interferes with activities of daily living.
What is a Boutonniere Deformity?
Difference between this and Pseudo Boutionniere deformity.
Forced flexion of the PIP- causing a deformity bump.
Pseudo- passive flexion of the DIP is possible, not possible in the other.
What is a Swan Neck Deformity - compare and contrast to Boutonniere Deformity.
Same joint PIP but BD = forced flexion and DIP is hyperextension.
What is the mechanism and signs and symptoms of mallet finger.
M- extended DIP forced into flexion.
S/S- unable to actively extend DIP and pain in distal phalanx.
What is Jersey Finger?
Flexed finger that is forced into extension.
Rupture of the flexor digitorum profundus tendon from its insertion on the distal phalanx.
