Common Hand Conditions Flashcards

1
Q

which condition causes an outpouching of synovial fluid from DIP joint?

A

mucous cyst

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2
Q

why do you get outpouching of fluid in the DIP joint?

A

it is very small so there is nowhere for the fluid to go

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3
Q

what are nail changes caused by a mucous cyst?

A

nail ridges

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4
Q

treatment for a mucous cyst?

A

left alone

excision

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5
Q

why are ganglions most common on the wrist?

A

they occur in synovial cavities so will be prominent in places with a high conc of synovial joints

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6
Q

what is contained in a ganglion?

A

synovial fluid

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7
Q

are ganglions or mucous cysts painful?

A

mucous cysts

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8
Q

treatment for ganglions?

A

will resolve over time

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9
Q

do ganglions stay constantly or come and go?

A

come and go

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10
Q

management of ganglions?

A

aspiration

excision

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11
Q

what does the flexor tendon sheath do?

A

holds tendons on to bone rather than letting them bowstring

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12
Q

clinical presentation of trigger finger?

A

patient cant bend finger, cant extend it then it just triggers

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13
Q

how do dupuytrens and trigger finger differ in presentation?

A

trigger finger will move

dupuytrens doesnt

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14
Q

how to examine if a patient does/doesnt have trigger finger?

A

feel over nodule and get them to move finger, if sore over nodule its trigger finger

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15
Q

pathology of trigger finger?

A

swollen tendon = irritation
tendon gets caught on edge of A1 pulley
triggering starts

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16
Q

what happens to a severe trigger finger?

A

may need to use other hand to extend the finger or cant extend it at all

17
Q

management of trigger finger?

A

leave it
splint to prevent flexion
injected steroid
surgery to divide A1 pulley

18
Q

where should you inject steroids for trigger finger?

A

base of finger between tendon and fibrous sheath

19
Q

what pulley is essential for finger function?

20
Q

is dequervains tenosynovitis painful?

21
Q

treatment for dequervains?

A
NSAIDs
splint
rest
steroid injection
decompression surgery
22
Q

what does dupuytrens start as?

A

palmar pit/nodule

23
Q

causes of dupuytrens

A
genetics
alcohol/cirrhosis
smoking
epilepsy
diabetes
24
Q

examination of dupuytrens?

A

feel cords
MCP/PIP joint involvement
table top test

25
treatment for dupuytrens?
stretches fasciectomies amputation collagenase injection
26
pathology of dupuytrens?
metaplasia of aponeurosis which causes fibroblasts to turn into myofibroblasts causing them to contract
27
what does the aponeurosis of the palm do?
stops palm moving around eg when gripping it stops skin sliding over palm
28
what is paronychia
infection within nail fold
29
who gets paronychia?
children
30
causative factors of paronychia?
nail biting
31
management of paronychia
antibiotics elevate incise and drain pus
32
is a flexor tendon sheath infection common?
no
33
is a flexor tendon sheath infection a surgical emergency?
yes
34
where can a flexor tendon sheath infection go?
palm then arm
35
what tendons run in the digit?
FDS | FDP
36
why would a dupuytrens contracture reoccur after treatment?
some myofibroblasts are left over
37
why should you check the lymph nodes of the arm in flexor tendon sheath infection?
to see if infection has spread there