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msk > Hand Conditions > Flashcards

Hand Conditions Flashcards

1
Q

What is carpal tunnel syndrome?

A

Compression of the median nerve causing pain and numbness in the median nerve distribution of the hand

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2
Q

What is the pathology of CTS?

A

Compression of contents is due to:
- Swelling of contents
- Narrowing of the tunnel

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3
Q

What is the sensory branch of the median nerve?

A

Palmar digital cutaneous branch

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4
Q

What area does the palmar digital cutaneous branch supply?

A

Palmar aspects of:
- Thumb
- Index and middle finger
- Lateral half of ring finger

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5
Q

What is the motor function of the median nerve in the hand?

A

Thenar muscles:
- Abductor pollicis brevis
- Flexor pollicis brevis
- Opponens pollicis brevis

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6
Q

What are some risk factors for CTS?

A

Repetitive strain
Obesity
Perimenopause
RA
Diabetes
Acromegaly
Hypothyroidism

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7
Q

What are some sensory symptoms?

A

Numbness
Paraesthesia
Burning sensation
Pain

Worse at night

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8
Q

What are some motor symptoms?

A

Weakness of thumb movements
Weakness of grip strength
Difficulty with thumb fine movements
Wasting of thenar muscles

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9
Q

What is the management of CTS?

A

Rest and altered activities
Wrist splints to maintain a neutral position
Steroid injections
Surgery

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10
Q

What procedure is done for CTS?

A

Open or endoscopic
Flexor retinaculum is cut to release pressure on median nerve

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11
Q

What is Dupuytren’s contracture?

A

Condition where the fascia of the hand becomes thickened and tight leading to finger contractures

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12
Q

What is a contracture?

A

Shortening of the soft tissues leading to restricted movement in a joint

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13
Q

What causes the thickening of fascia on Dupuytren’s?

A

Inflammatory process in response to microtrauma

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14
Q

What is the presentation of Dupuytren’s?

A

Hard nodules on the palm
Skin thickening and pitting
Finger pulled into flexion
No pain

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15
Q

What finger is most affected in Dupuytren’s?

A

Ring finger

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16
Q

What finger is least affected in Dupuytren’s?

A

Index finger

17
Q

What are the 3 surgical options for Dupuytren’s?

A

Needle fasciectomy- divide and loosen the cord causing the contracture
Limited fasciectomy- remove abnormal fascia and cord
Dermo fasciectomy- removal abnormal fascia and cord and associated skin. Replaced with skin graft

18
Q

What are the non surgical options for Dupuytren’s?

A

Conservative
Radiotherapy- slow down cellular activity that produces collagen

19
Q

What is trigger finger?

A

Stenosing tenosynovitis
Causes pain and difficulty moving a finger

20
Q

What is the pathophysiology of trigger finger?

A

Thickening of the flexor tendons or tightening of the sheaths that they pass through
Causes pain, stiffness or catching symptoms
May be a nodule on the tendon causing the finger to get stuck in the bent position

21
Q

What part of the sheath is most commonly affected in trigger ifnger?

A

First annular (A1) pulley at the MCP joint

22
Q

What is the presentation of trigger finger?

A

Painful and tender
Does not move smoothly
Popping or clicking sound
Gets stuck in a flexed position

Symptoms are worse in the morning

23
Q

What is the management of trigger finger?

A

Rest and analgesia
Splinting
Steroid injections
Surgery to release A1 pulley

24
Q

What is De Quervain’s tenosynovitis?

A

Swelling and inflammation of the tendon sheaths in the wrist

25
Q

Which 2 tendons are most affected in De Quervain’s?

A

Abductor pollicis longus (APL) tendon
Extensor pollicis brevis (EPB) tendon

26
Q

What is the mechanism of injury in De Quervain’s?

A

Repetitive strain injury

27
Q

What is the presentation of De Quervain’s?

A

Symptoms at the radial aspect of the wrist:
- Pain, often radiating to the forearm
- Aching
- Burning
- Weakness
- Numbness
- Tenderness

28
Q

What is Finkelstein’s test?

A

Resisted thumb extension will cause pain in De Quervain’s

29
Q

What is the management of De Quervain’s?

A

Rest and adapting activities
Using splints to restrict movements
Analgesia (e.g., NSAIDs)
Physiotherapy
Steroid injections

msk (20 decks)

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