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aet: injury prevention > Wrist and Hand > Flashcards

Wrist and Hand Flashcards

1
Q

Why is the wrist and hand vulnerable to injury?

A

very little muscle or fat padding to protect structures;

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2
Q

What are MOI for wrist and hand injuries?

A

Direct impact;

FOOSH

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3
Q

What structures of the wrist and hand can be injured?

A

carpals, metacarpals, phalanges, ligaments, tendons

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4
Q

How many carpal bones are there and what are they?

A

8: trapezoid, trapezium, hamate, capitate, triquetral, pisiform, lunate and scaphoid

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5
Q

What bones are in the proximal row of carpals?

A

scaphoid, lunate, triquetrum, pisiform

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6
Q

What carpal bones make up the distal row?

A

trapezium, trapezoid, capitate, hamate

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7
Q

What are the articulations of the wrist?

A

distal radioulnar joint: immediately adjacent to radiocarpal joint;
radiocarpal joint: radius with scaphoid, lunate, and triquetrum
intercarpal joints
midcarpal joints

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8
Q

What is the triangular fibrocartilage? (TFC)

A

cartilaginous disc that binds end of ulna and radius together

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9
Q

What does the TFC complex do?

A

stabilizer of the distal radioulnar joint. also provides an articular surface for the carpal condyle.

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10
Q

What are the gliding joints that have minimal contribution to wrist movement?

A

intercarpal joints

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11
Q

What joints are between the rows of proximal and distal carpals?

A

midcarpal joints

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12
Q

How many bones make up the hand?

A

19

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13
Q

What are the digits made up of?

A

carpometacarpal joints, metacarpophalangeal joints.

3 phalanges per finger & interphalangeal joints
2 in thumb & 1 IP joint

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14
Q

What are the hypothenar muscles?

A

opponens digiti minimi;
flexor digiti minimi brevis;
abductor digiti minimi

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15
Q

What are the thenar muscles?

A

adductor pollicis
flexor pollicis brevis
abductor pollicis brevis
opponens pollicis

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16
Q

What are the nerves of the wrist and hand?

A

median, radial and ulnar

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17
Q

how is blood supplied to the hand?

A

ulnar and radial arteries with two arterial arches that are superficial and deep to the palmar arches

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18
Q

What are common acute wrist and hand injuries?

A

contusions, sprains, strains (mallet finger, boutonniere deformity)
fractures (colle’s, scaphoid, metacarpals- boxers, bennett’s, phalanges)
dislocations- lunate, MCP, PIP, & DIP

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19
Q

What is a chronic wrist injury?

A

wrist ganglion

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20
Q

What are MOI for contusions?

A

direct impact via falling or being struck by and implement

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21
Q

S&S of contusions of the wrist or hand:

A

pain on palpation, obvious bruising or swelling

22
Q

Management for contusions of wrist/hand:

A

PIER, protect with padding and follow up with physician if it does not resolve within couple of days

23
Q

What are the most common and poorly managed injuries of the wrist?

A

sprains

24
Q

MOI for wrist sprains? S&S of wrist sprains?

A

FOOSH,

pain over ligament & w AROM/PROM, generalized swelling, tenderness, inability to flex or deviate wrist.

25
Q

Management for wrist sprains?

A

PIER, NSAIDs, protect with splinting, taping or bracing, referral to physician to rule out fractures.

26
Q

What is gamekeepers thumb? What is the MOI?

A

a tear of the ulnarcollateral ligament of the MCP joint.

MCP in extension and forceful abduction

27
Q

S&S of gamekeepers thumb:

A

palmar aspect of the joint- pain and swelling and positive abduction stress.

28
Q

Management of a gamekeepers thumb sprain:

A

standard acute: instability: spica cast for 3-6 weeks.

severe: surgical repair

29
Q

What is the MOI for phalange sprains?

A

direct blow to the tip of the finger may injure the DIP, PIP or MCP joint capsule and/or ligaments

30
Q

S&S of phalange sprains:

A

swelling, pain, loss of ROM

- incapacitating to hand function in many cases

31
Q

management of phalange sprains:

A

Ice, splint, refer to medical care if fracture is suspected

32
Q

What are MOI for metacarpal fractures? What types of fractures are there?

A

direct trauma due to striking an object or being struck by implements. Boxers or Bennett’s fracture.

33
Q

S&S of metacarpal fractures:

A

Pain, deformity, crepitus, swelling & abnormal mobility

34
Q

Management for metacarpal fractures:

A

PIER, splint & refer to physician for x-ray and casting (~4-6 weeks)

35
Q

What is a boxer’s fracture?

A

unstable distal metaphysis or neck of the fourth or fifth metacarpals.

36
Q

What fracture has S&S of sudden pain, inability to grip, rapid swelling, and deformity. With point tenderness; crepitus and increased pain with axial compression and percussion

A

Boxer’s

37
Q

what is the management for boxer’s fracture?

A

standard acute; splint and immediate physician referal.

38
Q

What is a bennet fracture?

A

a fracture dislocation to the proximal end of the 1st metacarpal at the carpometacarpal joint

39
Q

What are MOI for phalange fractures?

A

direct blow or FOOSH

40
Q

S&S for phalange fractures:

A

possible deformity, severe pain, crepitus, swelling and loss of function (lack of AROM/PROM)

41
Q

management for phalange fractures?

A

ice, splint, refer to physician

42
Q

What is the MOI for a scaphoid fracture?

A

FOOSH

43
Q

What are S&S of scaphoid fractures?

A

point tenderness in anatomical snuff box, pain with inward pressure along long axis, increased pain with wrist extension and radial deviation?

44
Q

management for scaphoid fracture:

A

standard acute-splint with physician referral

45
Q

what kind of concern is attached to a scaphoid fracture?

A

avascular necrosis

46
Q

What are MOI for phalange dislocations?

A

direct blow to tip of finger
- what joints are involved?
DIP, PIP, MCP
possible tissue damange to capsule, ligaments, nerves, blood vessels and bone

47
Q

What are S&S for phalange dislocations?

A

obvious deformity, severe pain, rapid swelling and loss of function. inability to flex or extend fingers

48
Q

management for phalange dislocation:

A

splint, ice, refer to physician for reduction.

splint for 3 weeks max; longer will lead to severe tissue contracture

49
Q

What is a wrist ganglion?

A

rupture of the tendon sheath or joint capsule

50
Q

What are treatments for wrist ganglions? past and present?

A

breaking them without rupture of skin
as many as 50% may go away on own,
closed rupture with multiple needle punctures;
surgery to remove cyst.

aet: injury prevention (11 decks)

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