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OCS > Wrist and Hand > Flashcards

Wrist and Hand Flashcards

1
Q

Distal Radius Fracture

A

Break at distal end of radius.

FOOSH

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2
Q

Colles Fracture

A

distal radius fracture with dorsal angulation

FOOSH with wrist extension

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3
Q

Smith fracture

A

distal radius fracture with wrist flexion

FOOSH with wrist flexion

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4
Q

Barton’s fracture

A

radius fracture with dislocation of radio-carpal joint

FOOSH

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5
Q

Distal ulna fracture

A

break at distal ulna

Impact

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6
Q

Scaphoid fracture

A

fracture at scaphoid

FOOSH or rapid radial deviation of wrist

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7
Q

Chauffeur Fracture

A

fracture at radial styloid

FOOSH with wrist extension

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8
Q

Greenstick fracture

A

only in children, mainly in long bones

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9
Q

Ulnar styloid Fracture

A

associated with distal radius fracture or rapid ulnar deviation of wrist

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10
Q

Benediction Sign

A

ulnar neuropathy, hypothenar wasting

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11
Q

Ape hand

A

median neuropathy, thenar wasting

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12
Q

Wrist drop

A

Radial neuropathy

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13
Q

Froment’s sign

A

can’t pinch, ulnar neuropathy

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14
Q

Anterior interosseous nerve palsy

A

can’t do “OK” sign

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15
Q

Wartenberg’s syndrome

A

numbness radial side of dorsum of hand, NO motor loss

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16
Q

Boxer fracture

A

fracture in neck of 5th met

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17
Q

Bennet Fracture

A

partial intra-articular fx of thumb

18
Q

Rolando fracture

A

complete intra-articular fx of thumb

19
Q

Kienbock’s Disease

A

AVN lunate

20
Q

Preiser’s Disease

A

AVN scaphoid

21
Q

Claw fingers

A

MCP ext, IP flex, increased exterinsic ext tone.

Median and Ulnar nerve palsies

22
Q

Scapohid instability testing

A

Scaphoid shift test
Watson catch up clunk
Scaphoid ballottment test

23
Q

TFCC testing

A 
pain with compression and pronation
Limited wrist ext>flex
Ulnomeniscotriquetral doral glide
ulnar fovea sign
piano keys test
TFCC toad test
ulnar compression test
24
Q

Golfer’s fracture

A

hook of hamate fracture

25
Trigger finger
thickened flexor tendon sheath | 3rd and 4th digits
26
Sweater finger
rupture avulsion of flexor tendon | inability to flex distal phalanx
27
Mallet finger
rupture avulsion of ext tendon | inability to extend distal phalanx
28
Swan neck deformity
Volar plate tear at PIP jt | MCP flex, PIP ext, DIP flex
29
Boutonniere Deformity
rupture of central tendon slip of extensor hood | MCP ext, PIP flex, DIP ext
30
Dupuytren's Contracture
contracted palmar fascia | MCP/PIP flex in 4th and 5th digits
31
Contents of carpal tunnel
Median nerve, FDS, FDPS, FPL
32
Carpal Tunnel CPG: Diagnosis
A level: 2.83 or 3.22 monofilament threshold for normal light touch and static 2-pt discrimination on middle finger. More severe use 3.22 B: Katz hand diagram, phalen test, tinel sign, carpal compression test ``` CPR: age >45 shaking hands relieves symptoms sensory loss in thumb wrist ratio index >0.67 Boston Carpal tunnel Q >1.9 ```
33
Carpal Tunnel CPG: Outcome measures - activity limitations/self reported measures
B: CTQ-SSS for symptoms and non surgical management Boston Carpal Tunnel Questionnaire Funcitonal Scale (CTQ-FS) DASH
34
Carpal Tunnel CPG: how to measure activity limitations/performance (dexterity)
C: quantify dexterity: Purde pegboard (PPB) Dellon-modified Moberg pick-up test (DMPUT) After CTR: do not use PPB, jebsen taylor hand function test, 9-hole peg test DO USE DMPUT following surgery
35
Carpal Tunnel CPG: how to measure activity limitations/physical impairment measures: Strength measures
A: do NOT use lateral pinch strength B: do NOT use grip strength for assessing short term changes after CTR surgery C: assess grip strength and 3-pt or tip pinch strength D: conflicting evidence tip and 3-pt pinch strength and abd pollicis brevis m strength testing following CTR surgery
36
Carpal Tunnel CPG: how to measure activity limitations/physical impairment measures: sensory and provocative measures
C: do NOT use thershold or vibration testing for non-surgical pts. C: may use phalen test for long term followup after CTR surgery D: conflicting evidence for use of sensory measures including 2pt discrimination and threshold testing to assess change overtime following surgery
37
Carpal Tunnel CPG: interventions - assistive technology
C: pt ed on effects of mouse use on carpal tunnel pressure, teach them alternatives: arrow keys, touch screens, alternating mouse hand. Can reccomend keyborads with reduced strike force for pts with pain with keyboard use
38
Carpal Tunnel CPG: Interventions: orthoses
B: neutral-positioned wrist orthosis worn at night for short-term symptom relief and functional improvement C: If night use ineffective, try including day time, symptomatic, or full time use. Can add MCP jt immobilization or modify wrist jt position. Pt ed on pathology, risk ID, symptom self management, postures/activities that aggravate symptoms
39
Carpal Tunnel CPG: Interventions: biophysical agents
C: trial of superficial heat for short term relief C: microwave or shortwave diathermy for short term pain relief C: trial of interferential current for short term pain relief B: DO NOT use low level laser C: DO NOT use thermal US D: conflicting evidence for nonthermal US B: do NOT use iontophoresis C: phonophoresis could work B: do NOT use magnets
40
Carpal Tunnel CPG: Interventions: manual therapy
C: may perform manual directed at c/s and UE D: conflicting evidence on neurodynamic mobs
41
Carpal Tunnel CPG: interventinos: therex
C: may use combined orthotic/stretching program for pts without thenar atrophy and who have normal 2pt discrimination.

OCS (21 decks)

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