Wrist&Hand Flashcards
Fracture type: MOI: Flexion plus compression
Smith’s
Q: What does compression of the median n. lead to? (4)
- Ischemia 2. Edema 3. Reduced nerve gliding 4. Eventually fibrosis
Q: In which direction does lunate typically dislocate?
Volarly
Anatomy: stabilizes the RU joint and protects against compressive forces
Triangular fibrocartilage complex (TFCC)
Q: What is the most important part of the SE?
The body chart
Content: Scaphoid-Lunate Disassociation: Watson’s test/scaphoid shift test (5)
- Seated, elbow flexed 90 2. forearm pronated 3. Passively move from UD to RD while stabilizing scaphoid 4. + = increase movement, pain or clunk into dorsal direction 5. 70% sensitivity and specificity
CPR: MCP/IP
Equal loss of flexion/extension
CPR: CMC Thumb
Limitation of ABD and slight limitation of extension
Content: Carpal tunnel syndrome: Manual therapy
carpal bone mobilization
Describe: Ulnar border of carpal tunnel
Hook of hamate
Closed pack position: MCP
full flexion
Content: Complex regional pain syndrome - Differential diagnosis (3)
- RA 2. Peripheral neuropathy 3. Vascular disease
Arthrokinematics: CMC Thumb flexion
CMC glides volarly/ulnar
Content: Acute or traumatic MOI (2)
- FOOSH 2. Radius, ulna, or carpal fx
Content: OE (fracture) (4)
- Deformities (ex. dinner fork) 2. Girth measurement (edema) 3. PROM/AROM 4. Functional tests (ex. grip strength)
Fracture type: OE: deformity of DIP
Mallet finger
Content: SE (6)
- Age 2. Occupation 3. Recreation 4. History/MOI 5. Past History 6. Special questions
Content: Description: Median n. compression in carpal tunnel
Carpal tunnel syndrome
Content: Carpal tunnel syndrome: Exercises
nerve and tendon glides
Q: Where do IP joints have the least force?
When the wrist is in fexion
Closed pack position: IP
full extension
Content: OE (7)
- Observation 2. ROM 3. Strength 4. Palpation 5. Special tests 6. Neuro/segmental exam 7. Nerve mobility
Q: What is the difference between intrinsic and extrinsic hand muscles
Intrinsic = originate and insert within hand Extrinsic = originate in forearm and insert on wrist/hand
Arthrokinematics: MCP/IP extension
surfaces glide dorsally
Arthrokinematics: Radiocarpal UD
Carpals glide radially
Content: Scaphoid-Lunate Disassociation: Symptoms (4)
- Localized pain, 2. Swelling 3. Clicking 4. Pain with extension
Joint type: CMC Thumb
Saddle/Sellar
Content: SE questions (6)
- ADL’s 2. Hand dominance 3. Lifting/pushing/pulling 4. Opening a door 5. Writing 6. N/T and pattern
Arthrokinematics: CMC Thumb ADD
CMC glides volarly
Content: Scaphoid-Lunate Disassociation: MOI (2)
- Fall 2. Trauma
Idenfity the stage of CRPS: continue skin changes, worsening pain, hair loss, limited joint mobility, muscle weakness
Stage 2; 3-6 mo
Q: What is the main goal of hand interventions?
Function, function, function
Content: Lunate dislocation Intervention (3)
- Surgical reduction 2. Immob 3-4 wks 3. Limit wrist extension ~2mo
CPR: Radiocarpal
Equal loss of flexion and extension
Fracture type: Description: Fx of neck of 5th MC
Boxer’s
Arthrokinematics: CMC Thumb ABD
CMC glides dorsally
Fracture type: Description: Fracture of distal radius with volar displacement
Smith’s
Q: What is the intervention for Mallet finger?
Volar splint or surgical fixation with exercises
Arthrokinematics: Radiocarpal flexion
Carpals glide dorsally
Fracture type: MOI: Fall with extension plus RD
Scaphoid