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Regional Orthopedics > Wrist/Hand Slides > Flashcards

Wrist/Hand Slides Flashcards

1
Q

What are the expected ROM for the wrist?

A

ext 70*
flex 80*
radial deviation 20*
ulnar deviation 30*

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2
Q

1st metacarpal mainly articulates with…

A

trapezium

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3
Q

2nd metacarpal mainly articulates with…

A

trapezoid, also trapezium/capitate a bit

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4
Q

3rd metacarpal mainly articulates with…

A

capitate

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5
Q

4th metacarpal mainly articulates with…

A

hamate, also capitate

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6
Q

5th metacarpal mainly articulates with…

A

hamate (4th MC)

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7
Q

Which 2 fingers are more mobile than the other 2?

A

1st & 5th

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8
Q

What is the volar plate?

A

multilayered condensation of fibrocartilagenous tissue originating from the proximal phalanx and inserts onto the middle phalanx

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9
Q

What passes through the carpal tunnel?

A

4 FDP tendons
4 FDS tendons
1 FPL tendon
median nerve

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10
Q

The median nerve travels between which two muscles in the forearm?

A

FDS and FDP

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11
Q

Once the median nerve reaches the carpal tunnel, the ____ goes anterior to the flexor retinaculum to innervate the palm.

A

palmar cutaneous branch

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12
Q

The radial nerve is a continuation of the ____ cord, composed of nerve roots __ to ___. It emerges from between the ___ and ___ heads of the triceps, continuing through the spiral groove of the humerus.

A

posterior cord

C5-T1

long and medial

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13
Q

The ulnar nerve originates from the ___ cord, composed of nerve roots __ to __.

It follows along the __ wall of the axilla beneath the ___ muscle

A

medial

C8-T1

posterior wall

beneath pec minor

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14
Q

The ulnar nerve travels between which two muscles in the forearm?

A

FCU and FDP

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15
Q

Ganglion cysts tend to develop where?

A

areas of high friction, especially along tendons of the hand/wrist

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16
Q

Risk factors for ganglion cysts include…

A

being female
age 20-40
OA or RA
wrist injury hx

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17
Q

What ROM clue would you have when a dorsal ganglion is still developing?

A

pain on pROM ext of wrist

or sense of pressure within the joint

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18
Q

It’s important to ddx Dequervain’s from…

How would you do so?

A

OA of trapezium/1st MCP

joint play will be painful and restricted

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19
Q

What is flexor tenosynovitis?

A

nodule on flexor tendon becomes entrapped behind thickened tendon sheath, usually at MCP joint, causing finger to become stuck in a flexed position

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20
Q

Digital tenovaginitis stenosans is also called…

A

trigger finger or flexor tenosynovitis

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21
Q

A Galeazzi fracture of the radius is accompanied by a dislocation of the ___, while a Monteggia fracture of the ulna results in a dislocated ___

A

ulna

radius

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22
Q

With FOOSH injuries, the lunate is commonly dislocated in what direction?

A

palmarly

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23
Q

Colles Fractures were named for WHO?

A

Abraham Colles, who first described the condition in 1814

24
Q

The most common fracture in older people is the…

A

Colles fracture (of the distal radius)

25
Q

“Boxer’s fractures” =

A

metacarpals, M/C 4th or 5th

26
Q

Which carpal bone is the most commonly fractured? What % does it account for?

A

scaphoid, 85%

27
Q

The more proximal the scaphoid fracture, the more likely ___ is - which occurs in what percentage of proximal scaphoid fractures?

A

avascular necrosis

99%

28
Q

Displaced scaphoid fractures have a non-union rate of approx…

A

60%

29
Q

Differentiate type 1 vs. type 2 TFCC injuries.

A

type 1: direct trauma

type 2: repetitive overuse

30
Q

General degeneration of the TFC begins at age __, but most people over age __ have some degeneration

A

30

50

31
Q

Type 1 TFCC injuries are often d/t…

A

FOOSH or oversupination/pronation when using tools like a drill

32
Q

What is: a progressive disease of genetic origin resulting in contracture of palmar fascia and fixed flexion deformity of the MCP and PIP joints?

A

dupuytren’s contracture

33
Q

True or false: Bouchard’s nodes are distal, Heberden’s are proximal

A

false, it’s the reverse

34
Q

What are the MC deformities in RA?

A

ulnar drift
palmar subluxation of MCP joints
Swan Neck & Boutonniere deformities

also Bouchard’s & Heberden’s nodes

35
Q

What is: rupture of central band of extensor hood leading to flexion of PIP and extension of DIP?

A

Swan neck deformity

36
Q

What is: laxity of PIP joint with bowstringing of lateral bands of the extensor hood leading to hyperextension of PIP and flexion of DIP?

A

boutonniere deformity

37
Q

What causes the zigzag deformity of the thumb commonly seen in arthritis?

A

mm imbalance and ligament laxity with adductor pollicis tension

38
Q

What is Sweater/Jersey finger?

A

the inability to flex the affected DIP joint due to rupture of the FDP tendon

common in football/rugby players

39
Q

Which is more common: extensor or flexor tendon ruptures?

A

extensor d/t superficial location and thinness

40
Q

What is mallet finger?

A

flexion deformity at the DIP d/t extensor tendon avulsion from distal phalanx

41
Q

CTS usually sees paresthesia to which fingers?

A

1-3, sometimes 4

42
Q

The following are all symptoms of?
clumsiness with fine motor skills of the hand
pain/paresthesia awakens patient at night
usually insidious

A

CTS

43
Q

What testing would you use for carpal tunnel syndrome?

A

thenar mm weakness
Phalen’s
Tinel’s
Carpal compression

44
Q

How would you ddx between CTS and C6-7 nerve root involvement?

A

C6-7 involvement:
use of hand will NOT increase symptoms
no nocturnal pain

45
Q

Loss of thumb function affects what percentage of total hand function?

A

40-50%

46
Q

Where is the surgical ‘no man’s land’ of the hand?

A

between the distal palmar crease and mid portion of the middle phalanx

47
Q

Ape hand deformity is characterized by ____ and is d/t ___ nerve palsy

A

thenar eminence atrophy

median nerve

48
Q

Bishop’s hand is characterized by ___ and is d/t ____ nerve palsy

A

hypothenar eminence wasting, flexion of fingers 4&5

ulnar nerve

49
Q

Pulp to pulp pinch would be a functional assessment for the __ nerve. Tip to tip would be a functional assessment for the ___ nerve.

A

ulnar

median

50
Q

If pt c/o pain on wrist flexion, lesion is probably in the…

A

midcarpal joints

51
Q

Flexion sees more movement at the ___ joints and extension sees more movement at the ___ joints

A

flexion: greater at intercarpal
extension: greater at radiocarpal

52
Q

Wrist flex/ext AND radial/ulnar deviation primarily happen through which carpal?

A

capitate

53
Q

True or false: scaphoid moves more in relation to the radius than to lunate or triquetrum

A

true

54
Q

What is the volar plate/its function?

A

limiting hyperextension

tough fibrocartilage on the palmar side of the fingers

55
Q

Which branch of the median nerve goes anterior to the flexor retinaculum?

A

palmar cutaneous branch

56
Q

The EPL tendon passes around what bony landmark?

A

Lister’s tubercle

Regional Orthopedics (6 decks)

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