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OCS Exam > Wrist/Hand > Flashcards

Wrist/Hand Flashcards

1
Q

What tenderness should be considered a fracture unless ruled otherwise?

A

Scaphoid

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2
Q

What is a Colles fracture?

A

Distal radius fracture with dorsal wrist displacement

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3
Q

What is a Smith fracture?

A

Distal radius fracture wiht volar wrist displacement

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4
Q

What is a Barton Fracture?

A

Intraarticular fracture of the radius

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5
Q

What is a Boxer’s fracture?

A

4th and 5th metacarpal fracture

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6
Q

What is a Bennett’s fracture?

A

Fracture of the base of the thumb metacarpal, often with dorsal displacement

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7
Q

What is Kienbock’s disease?

A

AVN of the lunate

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8
Q

What is the Schuck test?

A

Flexing the fingers and then extending against resistance; with pain at the carpal row. For Kienbock’s disease

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9
Q

What is Preiser’s disease?

A

AVN of the scaphoid

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10
Q

What are three carpal bones most concerned with AVN?

A

Scaphoid, Lunate, Triquetrum

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11
Q

What are the 4 radial nerve entrapements?

A

-Radial nerve palsy at the spiral groove
-Radial Tunnel syndrome
-Posterior interosseous nerve entrapment
-Superficial radial nerve entrapment

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12
Q

What are 4 Median nerve entrapments?

A

-Pronator teres syndrome
-Carpal Tunnel Syndrome
-Anterior interosseous nerve entrapment
-Bowler’s thumb (distal branch of median sensory nerve)

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13
Q

What are 2 Ulnar nerve entrapments?

A

-Cubital Tunnel Syndrome
-Guyon’s Cannal syndrome

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14
Q

What are the 4 criteria for a positive neurodynamic test?

A

-Reproduction
-Structural Differentiation
-Left/Right Difference
-Supported by history and physical examination

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15
Q

What nerve palsy contributes to claw fingers?

A

Median and ulnar nerve palsies

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16
Q

What nerve palsy contributes to Ape hand?

A

Median nerve palsy

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17
Q

What nerve palsy contributes to benediction sign?

A

Ulnar nerve palsy

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18
Q

What nerve palsy contributes to drop wrist?

A

Radial nerve palsy

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19
Q

What findings make you think
myelopathy hand?

A

+triceps
+Hoffmans reflex

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20
Q

What are the categories of signs and symptoms of complex regional pain syndrome?

A

-Positive sensory abnormalities
-Vascular abnormalities
-Edema, sweating abnormalities
-Motor and trophic changes

21
Q

What are positive sensory abnormalities of complex regional pain syndrome?

A

-Spontaneous pain
-Mechanical hyperalgesia
-Thermal hyperalgesia
-Deep somatic hyperalgesia

22
Q

What are vascular abnormalities of complex regional pain syndrome?

A

-Vasodilation
-Vasoconstriction
-Skin temperature asymmetries
-Skin color changes

23
Q

What are edema, sweating abnormalities of complex regional pain syndrome?

A

-Swelling
-Hyperhidrosis
-Hypohidrosis

24
Q

What are motor and trophic changes of complex regional pain syndrome?

A

-Motor weakness
-Tremor
-Dystonia
-Coordination deficits
-Nail and hair changes
-Skin atrophy
-Joint Stiffness
-Soft tissue changes

25
Q

What are 4 causes of radial wrist pain?

A

-CMC arthritis
-Scaphoid or radius fracture/AVN
-DeQuervain’s tenosynovitis
-Skier’s Thumb

26
Q

What is Skier’s thumb?

A

1st MCP UCL sprain

27
Q

What has the best Sn and Sp for wrist pain?

A

MRI

28
Q

What is the test for DeQuervain’s?

A

Finkelstein’s Test

29
Q

What are treatment options for CMC OA?

A

-Activity modification
-Joint protection
-Splinting
-Exercise
-Injections
-Surgery

30
Q

What to do for PT for DeQuervain’s?

A

-Manual Therapy
-Orthotic
-AROM
-Tendon Glides
-Exercise (APL and EPB stretches)
-Education
-Ionto

31
Q

What is Intersection syndrome?

A

-overuse affecting the radial forearm at the intersection of the APL/EPB and ECRL/ECRBW

32
Q

What are the criteria for Intersection syndrome?

A

-5 points tender in dorsal forearm
-Crepitus, swelling
-Pos Finkelstein’s, Isometric tests

33
Q

How to treat Intersecion syndrome?

A

Mulligan taping technique

34
Q

What are 5 causes of ulnar wrist pain?

A

-TFCC
-Wrist and hand OA
-Carpal Instability
-Ganglion Cyst
-Kienbock’s Disease

35
Q

What are signs of TFCC issues?

A

-Pain with compression/pronation
-Limited wrist ext>flexion
-Painful resisted pronation
-Pain on AP glide of RC joint
-Pain over lunate & lateral wrist

36
Q

What is Murphy’s sign and what does it indicate?

A

A deviation of knuckle pattern - one depressed or sunken in.

Indicated lunotriquetral instability

37
Q

What is treatment for TFCC tear?

A

Splinting and exercise; if chronic or positive ulnar variance - recommend surgery

38
Q

How to manage ganglion cysts?

A

-50% resolve spontaneously
-Watchful wating, nonoperative aspiration/injection
-Surgical excision

39
Q

What are 6 sources of finger pain & deformity?

A

-Trigger finger
-Mallet finger
-Swan neck deformity
-Boutonniere deformity
-Dupuytren’s Contracture
-Fracture

40
Q

What causes mallett finger and what is it?

A

Rupture of avulsion of the extensor tendon

Inability to extend distal phalanx
(think of the area that would be hit with a mallett)

41
Q

What is sweater finger?

A

inability to flex distal phalanx

42
Q

What is trigger finger?

A

Thickening of the flexor tendon sheath causing snapping with flexion/extension

43
Q

What causes boutonniere deformity and what is it?

A

Rupture of the central tendon slip of extensor hood

Extension of the MCP/DIP with flexion of the PIP

44
Q

What causes swan neck deformity and what is it?

A

Volar plate tear at PIP joint with intrisic contracture

Hyperextension of PIP and inability to flex PIP joint actively

45
Q

What is Dupuytren’s contracture

A

Contracture of typically the 4th and 5th MCP and PIP

46
Q

What is the treatment for mallet finger, sweater finger, Boutonniere, and Swan Neck Deformities?

A

-Splinting
-Manual Therapy

47
Q

What is treatment for trigger finger?

A

-Corticosteroid injections
-Splinting

48
Q

What is treatment for Dupuytren’s contracture?

A

Surgical release/fasiotomy

Post-operative splinting and hand therapy

49
Q

Which surgical release has lower rates of minor complications?

A

Endoscopic

OCS Exam (12 decks)

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