wrist and hand Flashcards
Which orientation of ulnar variance puts the TFCC at risk for load bearing injury?
positive
The inclination of the distal radius has implications for the direction for joint mobilizations. When performing mobilizations to improve wrist extension, you want to mobilize in which direction at the proximal carpal row?
volar/prox
The roof of the carpal tunnel, which consists of the flexor retinaculum, attaches to which of the following 4 bony landmarks? f
hamate
pisiform
scaphoid
trapezium
What pathology do we see when a flexor tendon pulley is torn?
bowstring
Along with the ligaments in the carpal region, what contributes to stability to the wrist?
intrinsic musculature
A cyclist who presents with pain in the ulnar hand, weakness with grip, and a positive Wartenberg Sign, likely has which diagnosis?
Guyon canal syndromwe
describe a Colles fracture?
distal radius fracture with dorsal displacement of the fracture segment
A patient presents with radial wrist pain after a fall. what is indicative of a scaphoid fracture?
-tenderness in snuff box
-pain w longitudinal compression of thumb
-tender over scaphoid tubercule
Why are metacarpal fractures casted with the metacarpal phalangeal joints in 70 degrees of flexion?
to prevent contractures in collateral ligaments
Which joint in the hand is most commonly affected by osteoarthritis?
DIP
De Quervain’s tenosynovitis affects which 2 tendons?
abductor pollicis longus and extensor pollicis brevis
what would you see with a negative ulnar variance?
increase load thru radius
avascular necrosis of lunate
what does the extensor mechanism do
creates a pulley system to extend MCPs and IPs
-allows intrinsics to assist in ext
what does the flexor retinaculum/transverse carpal ligament do
-roof of carpal tunnel
-protects median nerve
-prevents bowstrinigng
-helps preserve transvesre arch
what does the extensor retinaculum do
-creates 6 ext comparemnts
-prevents bowstringin of extensor tendons
what is the wrist relationship wtih the elbow?
-hand/wrist extrinsic muscles reinforce elbow joint capsule and compress articular surfaces of elbow
-prox elbow stability=stable platofrm for hand to function
what is the wrist relationship w the shoudler
-regional interdepencen
-provides stable platform for hand tor funciton
what is a smith fracture
volar displacement of distal radius fragment
mechanism: fall on back of hand
what is a galeazzi fracture
fracture of distal radius shaft from FOOSH w ext and extreme pronatoin
what is the most common carpal fracture
scaphoid
where is the msot common location of a scaphoid fracture
waist
what is de quervain tenosynovirtis
-thickening of extensor retinaculum
-compression/entrapment of tendons
-affects tendon sheats of 1st dorsal compartment
what is trigger finger
-tenosynovitis of flexor tendon sheath
what is mallet finger
distal tear or avulsion of extesnor tendon from distal phalanx
what is skiers thumb
pain in web space
hard to grasp objects
what does the TFCC do
stabilizes distal ulna to radius and carpals
what is a TFCC MOI
-fall on supinated outstretched hand
-chronci repetivie roational loading
-injiruw ith DRUJ disruption
what should you not do with carpal tunnel?
-assess lateral pinch strength
-assess grip strength <3 months post post
-use theraml US, low level laser or ionto
what is guyon canal syndrome
ulnar nerve entrapemnt in guyon canal
caused by pressure or trauma or hook of hamate fx
