Wrist and hand overuse Flashcards
1
Q
What can get compressed in carpal tunnel syndrome/what makes up the carpal tunnel
A
- carpal bones
- flexor retinaculum
- FPL, FDP, FDS
- median Nerve
2
Q
Causes of carpal tunnel
A
- OA, RA of carpals
- tenosynovitis of tendons that help tendons glide in the tunnel
- colles fracture: distal radius fracture with the distal portion displaced dorsally in a dinner fork deformity (heals maligned)
3
Q
Altered sensation without palm involvement vs whole palm median nerve distribution
A
- altered sensation without the palm part of the median nerve distribution means that it is carpal tunnel syndrome (there is a branch of median nerve that goes above the carpal tunnel)
- if they have symptoms in the palm = compression of median nerve further up the chain
4
Q
Signs and symptoms of carpal tunnel syndrome
A
- paresthesia > anesthesia median nerve distribution (palm is spared)
- difficulty fine motor = decreased sensation
- median nerve paresis (thumb flexion, abduction, opposition) = thenar
5
Q
Carpal tunnel syndrome examination
A
- sensation in the specific median nerve pattern
- strength of thenars
- ROM: wrist
- Function: how well do they preform fine motor skills
6
Q
Interventions for carpal tunnel syndrome
A
- rest from function
- mobilization (carpals,retinaculum)
- splint
- extension or wrist = Carpal tunnel pressure jumps 16-21
- tendon/nerve glides
- modalities
- surgery
7
Q
Tenosynovitis extensor compartment syndromes types
A
- DeQuervain’s compartment 1 - EPB and APL
- Compartment 2 - ECRL, ECRB
- Compartment 3: EPL
- Compartment 4: ED, EI
- Compartment 5: EDM
- Compartment 6: ECU
8
Q
DeQuervain’s causes/signs and symptoms
A
- overuse
- pain with passive thumb flexion and ulnar deviation
- pain with resisted thumb extension
- tender to palpation
9
Q
finkelstein test
A
- DeQuervains tenosynovitis
- have them flex the thumb (make a fist around thumb) and ulnarly deviate
10
Q
DeQuervain’s intervention
A
- rest from function
- splint
- modalities: US, iontophoresis, transverse friction massage
- gentle exercise
11
Q
dupuytren disease
A
- anatomy: thickening of palmar aponerosis (4th/5th)
- deformity: MCP flexion
12
Q
causes of dupuytren disease
A
- unknown etiology
- genetic?
- 50-70 year old most common
- males > females
- assoicated with ETOH (alcohol use), DM, epilepsy, COPD
13
Q
Signs and symptoms of dupuytren disease
A
loss of passsive and active finger extension
14
Q
dupuytren disease examination
A
- ROM
- palpate cords/nodules
15
Q
dupuytren disease interventions
A
- splints
- stretching (generally unsuccessful)
- surgery
