Wrist & Hand Flashcards
pro & cons of wrist/hand injuries
pro: easy to assess
con: vulnerable to injury & used extensively (makes everyday living harder and possibly sport)
MOI of wrist & hand injuries
-direct impact
-FOOSH
injured structures of the hand
-carpals
-metacarpals
-phalanges
-ligaments (MCL/LCL of elbow
-tendons
name the joints of the hand/fingers (3)
- Metacarpo-phalangeal joint (MCP joints).
- Proximal Interphalangeal joints (PIP joints)
- Distal Interphalangeal Joints (DIP joints)
name the hypothenar muscles (3) & the side of hand they are on
- adbuctor digiti minimi
- flexor digiti minimi
- opponens digiti minimi
fat pad of hand on pinky side
name the thenar muscles (3) & the side of hand they are on
- abductor pollicis brevis
- flexor pollicis brevis
- opponens pollicis
fat pad of hand on thumb side
what are the extensor (dorsal) hoods
intrinsic muscles that perform complex delicate movements of the digits that cannot be completed by the long flexor & extensor muscles alone
name the ligaments of the hand (2)
- ulnar collateral ligament
- readial collateral ligament
name the 3 major nerves of the hand/wrist
- ulnar nerve (ring & pinky side of hand. Palmar side
- median nerve- thumb, pointer & index side of hand. palmar side.
- radial nerve- extensor muscles (posterior side)
blood supply of hand/wrist
2 aterial arches- superficial & deep palmar arches
chronic wrist & hand injury
ganglion cyst
acute common hand/wrist injuries: strains, fractures, dislocations
- contusions
- sprains
- fractures
-colle’s
-scaphoid
-metacarpals (boxers)
-bennetts
-phalanges - dislocations
-lunate
-DIP/PIP
-MCP - Strains
-mallet finger
-boutinniere deformity
Contusions: Etiology & S/S
etiology:
-direct impact to the hand by any object
-must rule out any fractures
s/s:
-pain on palpation
-obvious bruising/swelling
contunions: management
PEIR
protect w/padding
f/u with physician if does not resolve in a couple days
Wrsit sprains: Etiology/MOI
-hyperextension/hyperflexion (load on palm of outstretched hand)
-lifting/catching/tossing heavy objects
-hyperflexion & rotation
wrist sprains: S/S
-pain over ligament in passive & active ROM
-general tenderness/swelling
-specific findings determine on which ligament has been damaged
wrist sprains: management
PIER/NSAIDs
protect with splinting/taping or bracing
refer to doc. to rule out fracture
what ligament is damaged with valgus stress at the wrist
ulnar collateral ligament
-pain/laxity over UCL compared bilaterally
what ligament is damaged with varus stress at the wrist
radial collateral ligament
-pain/laxity over RCL compared bilaterally
Interphalangeal collateral ligament sprains: Etiology/MOI
-direct blow to tip of finger to injury DIP,PIP or MP capsule/ligament
Interphalangeal collateral ligament sprains: S/S
-swelling, pain, loss of ROM
-incapacitating to hand function in many cases
-may have positive varus/valgus stress test
Interphalangeal collateral ligament sprains: managemnt
ice
splint (buddy tape)
refer to medical care if fracture suspected
metacarpal fractures: etiology/MOI
direct trauma due to striking an object or struck by an object
metacarpal fractures: S/S
pain
deformity
crepitus
swelling
abnormal mobility
metacarpal fractures: management
PEIR
splint
refer to doctor (x-ray/cast)
what is boxer fracture
break in the neck of 5th metacarpal
what is bennetts fracture
break in the base of a thumb (1st metacarpal)
phalange fractures: MOI
direct blow
FOOSH
phalange fractures: S/S
deformity
severe pain
crepitus
loss of function (AROM/PROM)
phalange fractures: management
ice
splint
refer to doc
what is Colle’s fractures
result of a FOOSH
radius fracture & moves to palmar side
-known as dinner fork deformity (dorsally displaced)
what is Smiths fracture
fall onto flexed wrist & radius moves up into dorsal side
Phalange dislocation: Etiology/MOI
-direct blow to tip of finger could involve DIO,PIP or MCP joint
-forced hyperextension causing anterior capsule tear
-most commonly occers at PIP
-could involve nerves/vessels
Phalange dislocation: S/S
-obvious deformity
-severe pain at joint line
-rapid swelling
-loss of function (cannot flex or extend fingers)
Phalange dislocation: management
-splint & seek medical attention for reduction
-ice
Wrist ganglion cyst: MOI/etiology
-benign synovial masses
-dorsal aspect of wrist
-caused by repetative microtrauma to the wrist capsule & ligamnets
-3x more common in women than men
-unknown cause
Phalange dislocation:S/S
-asymptomatic
-associated with tissue sheath degeneration
-occurs spontaneously
-generally no pain or loss of motion
Phalange dislocation: management
(PAST)- breaking them without rupturing the skin. slam a book on it
(NOW)- can go away by themselves or doc. will surgically remove it.
