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CD2203- Mod 5 > Wrist + Hand injuries > Flashcards

Wrist + Hand injuries Flashcards

1
Q

Proximal and distal row of carpals

A

Prox
-Scaphoid, Lunate, Triquitrum

Distal
-Trapezium, trapezoid, capitate, hamate

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2
Q

Is there any ligs holding the pro/distals rows of carpals together

A

No ligs holding proximities and distal rows together, only adjacent carpals

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3
Q

what is in the distal radioulnar jt cavity

A

Fibrocartilagenous articular disk connects the edge of ulnar notch to base of ulnar styloid process

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4
Q

which carpals articulate with the triangular fibrocartilage disk

A

Lunate and triquitrum

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5
Q

With the fibrocartilage disk in place how much of the load does the radius and ulna take

A

radius- 80% of axial load

Ulna- 20% of axial load

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6
Q

How can the fibrocartilage disk be injured

A

during forced extension/pronation

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7
Q

How does the pro row of carpals move on the radius in flex and extension

A

flex- as prox carpal row flexes forward it will also glide post

ext- carpals will glide venrally

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8
Q

@ what joint is flexion and extension greater in the wrist

A

flexion- greater at midcarpal jt

ext- greater at radoiocarpal jt

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9
Q

What 3 mm are supplied by the median n in the hand

A

Flexor pollicis brevis
Abducor pollicis brevis
Oppones pollicis

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10
Q

What mm on the thenar side is supplied by ulnar

A

Adductor pollicis

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11
Q

what supplies the lumbricals

A

Lat 2 supplied by median

med 2 supplied by ulnar

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12
Q

What supplies all interossei

A

ulnar n

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13
Q

mc moi for wrist sprain and how will the pt present

A

MOI: forced flexion–> leads to ligamentous injury on dorm of wrist

pt- will present with swelling and decreased flex/ext with pain @ end ranges

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14
Q

What is the tx for a wrist sprain

A

Rest

Imobalize for 3 days then start progressive wrist curls

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15
Q

What is dequeravains tenosynovitis due to and what is effected

A

Result of repetitive activities of ulnar + radial dev (or trauma into ulnar dev)

-Abductor pollicis longs and extensor pollicis brevis become irratated in their sheath

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16
Q

tx of dequervains tenosynovitis

A

Cryotherapy
splint to immobilize 1st CMC jt
modalities

17
Q

What are the symptoms of keinbocks disease (avascular necrosis of lunate)

A
  • Swelling, pain, stiffness in wrist
  • Clicking in wrist
  • weakened grip strength
  • tenderness over lunate
  • decreased ROM
18
Q

What is the radiological presentation of keinbocks disease + what sign is associated with it

A
  1. No issues present at first on x ray
  2. Change in density of lunate is seen
  3. Collapse of lunate, proximities migration of capitate

Negative ulnar variance

19
Q

tx of keinbocks disease

A

Imobalize wrist for 2-3m to help restore blood flow to the bone (but not prolonged past this point)

20
Q

MOI of scaphoid fx and Signs/Symptoms

A

FOOSH injury driving scaphoid against radius

Signs- Pain on radial side of wrist, flex/ext/dev may be limited

21
Q

Imaging protocol for schaphoid fx

A

may not be able to be seen initially

-immobilize for 2-3 weeks and re take x rays

22
Q

management of scaphoid fx (immobilize times etc)

A

must be in cast for 3 m (in no repair in 3 m than surgical repair is needed)

23
Q

What is the normal Capitate lunate radius alignment and scaphoid to lunate angle

A

CPL should be collinear and scaphoid should be angles 45 degrees

24
Q

What is a SLAC wrist

A

a wrist in which the scaphoid lunate lig is ruptured

25
Q

What occurs in palmar flexion intercalated segmental instability (capitolunate, scapholunate angles)

A

RCL are no longer collinear

-Lunate is palmar flexed and capitolunate angle is >30, schapho lunate <40

26
Q

What occurs in dorsiflexion intercalated segmental instability (capitolunate, scapholunate angles)

A

Lunate is dorsiflexed and capitolunate ange is >15, scaphoid lunate >60

27
Q

What is pos ulnar variance (how does the load change) and associated conditions(3)

A

Distal ulna moves caudal in relation to radius

-60% load now to radius

  1. Ulnar impaction
  2. TFCC tears
  3. Luno triquetral lig tears
28
Q

What is neg ulnar variance (how does the load change) and associated conditions (2)

A

disal ulna move cephalic compared to radius

-95% load thru radius

  1. Kienbocks disease
  2. Ulnar impingement syndrome

CD2203- Mod 5 (11 decks)

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