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MSK Final (Fall) > Wrist and Hand Tendon Injuries > Flashcards

Wrist and Hand Tendon Injuries Flashcards

1
Q

Most ADLs require what two movements?

A

Extension and ulnar deviation

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2
Q

Drinking activities require what degree of extension?

A

6 to 24 degrees

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3
Q

Using a phone requires what degree of extension?

A

40 degrees

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4
Q

Turning a doorknob requires what degree of extension, flexion, and ulnar deviation?

A
  • 40 degrees of extension
  • 40 degrees of flexion
  • 30 degrees of ulnar deviation
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5
Q

What are the ideal functional ranges of motion for the wrist? (flexion, extension, radial deviation, ulnar deviation)

A
  • Flexion: 30-50 degrees
  • Extension: 60 degrees
  • Radial Deviation: 20 degrees
  • Ulnar Deviation: 40 degrees
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6
Q

What is the functional/optimal position of the hand?

A
  • Wrist: slightly hyperextended
  • 2nd - 5th fingers: slightly flexed
  • Thumb in opposition
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7
Q

What are the 4 tendon injuries in the wrist/ hand?

A
  • De Quervain’s Tenosynovitis
  • Mallet Finger Deformity
  • Boutonniere Deformity
  • Swan Neck Deformity
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8
Q

What is the etiology of De Quervain’s Tenosynovitis?

A

Repetitive thumb use with ulnar deviation and gripping

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9
Q

De Quervain’s Tenosynovitis is directly related to what daily action?

A

Personal device use

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10
Q

De Quervain’s Tenosynovitis is inflammation and likely thickening of what tendons?

A
  • Extensor Pollicis Brevis
  • Abductor Pollicis Longus
  • Sheath causing pain just proximal to the anatomical snuff box
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11
Q

De Quervain’s Tenosynovitis will cause a decreased what?

A

Grip and pinch strength at the thumb

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12
Q

What are signs and symptoms of De Quervain’s Tenosynovitis?

A
  • Tendinopathy
  • Special tests (+) Finkelstein’s: minimal to no clinical support
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13
Q

What is the PT Rx for De Quervain’s Tenosynovitis?

A
  • POLICED
  • Reduce typing and dictate
  • Tendinopathy MET
  • Tendon Glides
  • Thumb Splint
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14
Q

What is the MD Rx of De Quervain’s Tenosynovitis?

A

Injections are 75% successful but may require two

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15
Q

What is another name for the extensor expansion ligament?

A

Extensor hood

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16
Q

The extensor expansion ligament is what shape?

A

Small triangular shaped aponeurosis of connective tissue

17
Q

Is the extensor expansion ligament wider at the base or the distal end?

A
  • Wider at the base, narrow at the distal end
  • Dorsum and sides of the proximal phalanx of the fingers
  • Inserts distally at the base of the distal phalanx
18
Q

The extensor expansion ligament creates a hood over the MCP joint and holds what?

A

The extensor tendons in midline and close to the bone

19
Q

The extensor expansion ligament is the attachment to the middle and or distal what for many muscles?

A

Phalanx

20
Q

What is the cause of mallet finger?

A

trauma or disease

21
Q

What is mallet finger?

A

Tendon rupture or avulsion fracture of the extensor hood mechanism at DIP

22
Q

What does a mallet finger result in?

A

DIP joint flexion and possible contracture if untreated

23
Q

What is the cause of boutonniere deformity?

A

Trauma or disease

24
Q

What is a boutonniere deformity?

A

Rupture or stretch of extensor tendon at the PIP

25
Q

What does a boutonniere deformity result in?

A

Results in PIP flexion with DIP extension and possible contracture if untreated

26
Q

What is the cause of a swan neck deformity?

A

Trauma or disease

27
Q

What is a swan neck deformity?

A

Rupture or volar plate at PIP

28
Q

What does a swan neck deformity result in?

A

Results in hyper extension at the PIP and flexion at the DIP and possible contracture if untreated

29
Q

What is the general Rx for tendon deformities in the hand/wrist?

A
  • Splinting
  • Address consequences of immobilization
  • Tendon integrity/ proliferation and mobility

MSK Final (Fall) (15 decks)

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