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Clin Med 1 - Exam 5 > Wrist and Hand > Flashcards

Wrist and Hand Flashcards

1
Q

Best physical exam test for carpal tunnel syndrome

A

Durkan’s
- firm pressure over carpal tunnel with thumbs for 30 seconds

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2
Q

Cause of ganglion cysts

A

Degeneration/liquefication of collagen and fibrocytes into a thick, clear liquid

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3
Q

Diagnostic tests used in carpal tunnel syndrome (not physical exam)

A
  • EMG (electromyography)
  • NCV (nerve conduction velocity)

(can also MRI and x-ray)

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4
Q

Most common location of a ganglion cyst

A

Dorsal: scapho-lunate joint

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5
Q

Carpal tunnel syndrome symptoms

A
  • Vague aching in palmar hand occasionally radiating to forearm
  • Numbness/tingling in median nerve (palmar digits 1-4)
  • Night symptoms
  • Dropping items
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6
Q

Are scaphoid fractures more common in children or adults?

A

Adults

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7
Q

Mallet finger treatment

A

Continuous splinting of DIP joint in extension

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8
Q

Trigger finger treatments

A
  • Injection is first line
  • Surgery: A1 release/cut
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9
Q

Most common fracture in adults

A

Distal radius fracture

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10
Q

Describe a Monteggia fracture

A
  • Displaced proximal ulna fracture
  • Proximal radius dislocation
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11
Q

Physical exam test for De Quervain’s tenosynovitis

A

Finklestein

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12
Q

Best imaging for scaphoid fractures

A

MRI best for microscopic fractures

(may be hard to see on x-ray)

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13
Q

De Quervain’s tenosynovitis involves the entrapment of these tendons

A
  • Abductor pollicis longus
  • Extensor pollicis brevis
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14
Q

Treatment for De Quervain’s tenosynovitis

A
  • Thumb spica splint
  • NSAIDs
  • Steroid injection (50% cure first time, 2nd 40-45%)
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15
Q

Mallet finger symptoms

A

Decreased ability to extend distal finger

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16
Q

Symptoms of a scaphoid fracture

A
  • History of dorsiflexion wrist injury
  • Pain near anatomical snuffbox
  • Pain with motion and gripping
17
Q

After diagnosing a wrist fracture, which other joint should be examined?

A

Elbow

18
Q

Who is Dupuytren’s contracture most common in?

A

Northern European men aged 50+

19
Q

Carpal tunnel syndrome is associated with the wasting of these muscles

A

LOAF muscles
- lumbricals
- opponens pollicis
- abductor pollicis brevis
- flexor pollicis brevis

20
Q

Distal radial fragment displacement direction in a Colles fracture

A

Dorsal

21
Q

Pathophysiology of Dupuytren’s contracture

A

Nodular thickening and contracture of palmar fascia, leading to digital contractures
Associated causes:
- Decompensated liver cirrhosis
- Diabetes
- Alcohol/smoking
- Past/repeated trauma

22
Q

Symptoms of trigger finger

A
  • Pain/snapping with digit flexion/extension
  • Digit may lock
23
Q

Two conditions treated with a spica thumb splint

A
  • De Quervain’s tenosynovitis
  • Scaphoid fracture
24
Q

Treatments for Dupuytren’s contracture

A
  • PT early
  • Steroid injections early
  • Surgery if late (contracted more than 30 degrees)
25
Q

Treatment for ganglion cysts

A

Surgical excision much more effective than aspiration

(do not aspirate volar ganglion cysts)

26
Q

Risks associated with scaphoid fractures

A

High incidences of malunion and osteonecrosis due to limited blood supply

27
Q

Carpal tunnel syndrome is caused by the entrapment of this nerve

A

Median nerve

28
Q

A patient presents with these symptoms:
- Pain and swelling over radial styloid
- Pain with movement of thumb or making a fist
- Noticeable creaking as tendon moves
What does she have?

A

De Quervain’s tenosynovitis

29
Q

Pathophysiology of trigger finger

A

Nodule on flexor tendon which can get trapped under pulley (A-1) limiting range of motion

30
Q

Flexion force impact on an extended DIP can lead to this condition

A

Mallet finger

31
Q

Scaphoid fracture treatment

A

Thumb spica splint, even if x-rays are normal

32
Q

What is the most commonly fractured carpal bone?

A

Scaphoid

33
Q

Describe a Galeazzi fracture

A
  • Displaced distal radius fracture
  • Distal ulna dislocation
34
Q

Dupuytren’s contracture and tigger finger are most common in these digits

A

Both in ring finger most often

35
Q

Treatment for carpal tunnel syndrome

A
  • PT
  • Night splint for 3 weeks
  • Surgery: carpal tunnel release/cut

(oral meds don’t work and injections dangerous)

36
Q

Carpal tunnel syndrome is more common in this gender and this age

A

Women aged 45-60

37
Q

Physical exam test for scaphoid fracture

A

Very tender to palpation over anatomical snuffbox

Clin Med 1 - Exam 5 (13 decks)

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