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MSK 1 > Wrist Classification/Diagnoses > Flashcards

Wrist Classification/Diagnoses Flashcards

1
Q

Carpal Tunnel Syndrome

Symptom Location

A
  • compression median N at carpal tunnel
  • pain, N/T palmar surface of hand
  • pain/paresthesia in median nerve distribution
  • can be intermittent
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2
Q

Tendonitis

Symptom Location

A
  • inflam or tender at tendon or tendon-muscle attachment site
  • common in abd pollicis longus, ext pollicis brevis
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3
Q

Dequervain Disease

Symptom Location

A
  • progressive tendon sheath inflammation of the abd pollicis longis and ext pollicis brevis
  • dull ache over radial aspect of wrist
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4
Q

Boutonnier Deformity

Symptom Location

A

-MCP extension, PIP flexion, DIP extension

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5
Q

Mallet Finger

Symptom Location

A

-pain at DIP

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6
Q

Ligament Injury

Symptom Location

A

UCL Sprain of thumb: pain at ulnar side of thumb in web space

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7
Q

TFCC Injury

Symptom Location

A
  • (triangular fibrocartilage complex)

- medial wrist pain, distal to ulna

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8
Q

OA

Symptom Location

A
  • common at 1st CMC joint of thumb

- pain with thumb use

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9
Q

RA

Symptom Location

A

-inflammation, joint pain, deformities of fingers

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10
Q

Raynaud’s Phenomenon

Symptom Location

A

-diffuse, dull pain in hands and fingers

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11
Q

Nerve Lesions

Symptom Location

A
  • Radial nerve entrapment at wrist: loss wrist and finger extension (drop wrist)
  • Wartenberg Syndrome: N/T and pain on radial nerve distribution at hand/wrist
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12
Q

Carpal Tunnel syndrome

Agg Factors

A
  • grip

- decreased corrdination

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13
Q

Dequervain’s

Agg Factors

A
  • thumb movements

- especially in extension, abduction and radial deviation

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14
Q

Boutonnier

Agg Factors

A

-unable to extend PIP

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15
Q

Mallet

Agg Factors

A

-unable to extend DIP

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16
Q

Ligament Injury

Agg Factors

A

-UCL: decreased ability to move thumb or grasp objects

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17
Q

TFCC

Agg Factors

A
  • turning key/door knob
  • pronation/supination
  • gripping
  • ulnar deviation
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18
Q

OA/RA

Agg Factors

A

-writing, typing, using scissors, grasping

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19
Q

Raynaud’s

Agg Factors

A

-using hands in cold climate

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20
Q

Nerve Lesions

Agg Factors

A
  • RNE: can’t grasp/ext wrist

- Wartenberg: sensory symptoms only

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21
Q

Carpal Tunnel Syndrome

Ease Factors

A
  • splinting

- NSAIDs

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22
Q

Tendon Injury/Tenosynovitis

Ease Factors

A
  • NSAIDs
  • Splinting
  • Activity Modification
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23
Q

TFCC

Ease Factors

A
  • Avoid pronation/supination

- splint

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24
Q

OA/RA

Ease Factors

A
  • NSAIDs

- paraffin wax modalities

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25
Q

Raynaud’s

Ease Factors

A
  • Wear gloves

- avoid cold

26
Q

Nerve Lesions

Ease Factors

A
  • NSAIDs

- Splint

27
Q

Carpal Tunnel Syndrome

History

A
  • repetitive trauma/overuse of wrist with wrist flex/ext

- night pain

28
Q

Tendonitis

History

A

-over use of thumb/wrist (grip)

29
Q

Dequervain

History

A
  • progressive inflammation of tendon sheaths of post wrist muscles
  • history of DM or hypothyroid
  • creak in wrist
30
Q

Boutonnier

History

A

-closed trauma to extensor tendon

31
Q

Mallet

History

A
  • jammed finger

- unable to straighten DIP

32
Q

Ligament Injury

History

A

UCL Sprain: common injury in athletics (game keeper’s thumb); can be acute when there is direct blow to thumb into hyperextension and abd at MCP
-repeated trauma of valgus forces to thumb

33
Q

TFCC

History

A
  • hear pop at wrist
  • overuse injury due to chronic rotational loading
  • FOOSH on supinated hand
  • painful click with wrist motion
34
Q

OA

History

A
  • more common in women

- 45 years or older

35
Q

RA

History

A
  • Systemic inflammatory disease that damages soft tissue and articular surfaces of joint
  • women>men
  • hands common
  • ulnar drift
  • swan neck/boutonnier deformity
36
Q

Raynaud’s

History

A
  • women>men
  • cold makes pain worse
  • blanching of fingers followed by redness
  • complain of being cold all the time

-caused by vasospasm of distal vessels in hand/feet leading to decreased blood supply to fingers

37
Q

Nerve Lesions

History

A
  • RNE:overuse in wrist extension

- Wartenburg: compression of superficial radial N (sensory changes in the wrist/hand)

38
Q

Carpal Tunnel Syndrome

Neurological Exam

A

-palm, thumb, 2nd and 1/2 of 3rd fingers

39
Q

Nerve Lesions

Neurological Exm

A

-RNE: paresthesias, numbness on radial aspect of hand/wrist

40
Q

Carpal Tunnel Syndrome

ROM

A

-wrist flexion, extension

41
Q

Dequervain’s

ROM

A

-loss CMC abd

42
Q

Boutonniere

ROM

A

-more than 30* extension lag at PIP

43
Q

Mallet

ROM

A

-loss active extension at DIP

44
Q

OA

ROM

A
  • Abd, ext of 1st CMC
  • restricted ROM in capsular pattern
  • joint crepitus
45
Q

RA

ROM

A
  • finger flexion/extension
  • wrist flex/ext
  • radial/ulnar deviation
46
Q

Nerve Lesions

ROM

A

-RNE: inability to extend wrist or fingers

47
Q

Carpal Tunnel Syndrome

Special Tests

A
  • Phalens

- Tinel’s

48
Q

Dequervain’s

Special Tests

A

-Finklestein’s

49
Q

Ligament Injury

Special Tests

A

-UCL: Valgus stress at MCP

50
Q

TFCC

Special Tests

A

-UMTDG

51
Q

Raynaud’s

Special Tests

A

-Allen’s test

52
Q

Carpal Tunnel Syndrome

Palpation

A

-compression over flexor retinaculum reproduces symptoms

53
Q

Dequervain’s

Palpation

A

-swelling/tenderness of radio-styloid region

54
Q

Mallet

Palpation

A

DIP

55
Q

Ligament Injury

Palpation

A

-UDL: ulnar side of thumb, near web space, pain

56
Q

TFCC

Palpation

A

-at styloid process of ulna, pain

57
Q

OA

Palpation

A

-1st CMC: compression + rotation through joint

58
Q

Raynaud’s

Palpation

A

-cold, blanching with compression of fingers/hand

59
Q

Nerve Lesions

Palpation

A

-pain at radial hand/wrist

60
Q

Carpal Tunnel

Mm Length/Strength

A

-stiff or short finger flexors

61
Q

OA/RA

Mm Length/Strength

A

-short add pollicis and or FPB

MSK 1 (15 decks)

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