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KNSS 220 Athletic Therapy > Elbow to Hand > Flashcards

Elbow to Hand Flashcards

(143 cards)

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1
Q

Medial epicondyle =

A

flexors

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2
Q

Lateral epicondyle =

A

extensors

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3
Q

How many ROM at PIP and DIP?

A

2

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4
Q

How many ROM at wrist?

A

6

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5
Q

How many ROM at elbow?

A

4

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6
Q

How many ROM at MCP?

A
  • 4 at fingers

- 5 at thumb

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7
Q

What is the 5th ROM for the thumb at the MCP?

A
  • Diagonal​ ​motion
  • Opposition
  • What​ ​allows​ ​you​ ​to​ ​make​ ​grips​ ​with​ ​fingertips
  • 5th​ ​ROM
  • Only​ ​done​ ​actively
  • 5​ ​ROM​ ​at​ ​MCP​ ​of​ ​thumb
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8
Q

Flexion of the fingers is…

A

bringing the fingers into the palm

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9
Q

Extension of the fingers is …

A

fingers away from the palm

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10
Q

Adduction of the fingers is…

A

bringing fingers together

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11
Q

Abduction of the fingers is…

A

spreading fingers apart

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12
Q

Muscles​ ​at​ ​front​ ​of​ ​arm​ ​in​ ​anatomical​ ​position​ ​are​…

A

flexors

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13
Q

Wrist​ ​flexors​ ​generally​ ​start​ ​at​ ​the​…

A

​medial​ ​epicondyle​ ​(common​ ​flexor​ ​origin)

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14
Q

Muscles​ ​at​ ​back​ ​of​ ​arm​ ​in​ ​anatomical​ ​position​ ​are​…

A

extensors

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15
Q

Wrist​ ​extensors​ ​generally​ ​start​ ​at​ ​the …

A

lateral​ ​epicondyle​ ​(common​ ​extensor​ ​origin)

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16
Q

Describe the base of the thumb muscles.

A
  • Make​ ​movement​ ​of​ ​thumb​ ​more​ ​controlled:​ ​thenar​ ​eminence
  • 3​ ​muscles
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17
Q

Describe the base of the pinky muscles.

A
  • Hypothenar​ ​eminance

- 3​ ​muscles

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18
Q

What are PAD muscles?

A

Muscles​ ​on​ ​palm​ ​side​ ​of​ ​hand​ ​and​ ​adduct​ ​fingers​ ​together

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19
Q

What are DAB muscles?

A

Muscles​ ​on​ ​dorsal​ ​(back)​ ​of​ ​hand​ ​abduct​ ​fingers​ ​apart

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20
Q

The brachial artery splits into what?

A
  • radial artery

- ulnar artery

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21
Q

Where does the radial nerve run?

A

posterior​ ​surface​ ​of​ ​arm:​ ​triceps,​ ​extensor​ ​etc.

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22
Q

Where does the median nerve run?

A

anterior​ ​surface​ ​of​ ​arm,​ ​down​ ​to​ ​thumb,​ ​index,​ ​and​ ​middle​ ​finger

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23
Q

Where does the ulnar nerve run?

A

medial​ ​surface​ ​of​ ​arm​ ​down​ ​to​ ​pinky​ ​and​ ​ring​ ​fingers

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24
Q

What is the special condition for the elbow and hand?

A

carrying angle

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25
Describe carrying angle.
- Carrying​ ​angle - Stand,​ ​put​ ​arms​ ​in​ ​anatomical​ ​position - Arm​ ​straight​ ​down​ ​=​ ​0​ ​degrees,​ ​any​ ​deviation - In​ ​most​ ​people​ ​:​ ​15​ ​degrees - Arms​ ​do​ ​not​ ​run​ ​into​ ​legs​ ​when​ ​walking - Carrying​ ​things​ ​won’t​ ​run​ ​into​ ​body
26
Lateral and medial epicondylitis are considered ______ injuries.
Overuse
27
Medial epicondyle is commonly known as ...
golfer's elbow
28
Lateral epicondyle is commonly known as ...
tennis elbow
29
Why can't we use the terms golfer's elbow and tennis elbow?
they can change based on MOI
30
Wrist​ ​flexors​ ​are​ ​working​ ​too​ ​much​ ​=​
​inflammation​ ​at​ ​medial​ ​epicondyle
31
Wrist​ ​extensors​ ​are​ ​working​ ​too​ ​much​ ​=
inflammation​ ​at​ ​lateral​ ​epicondyle
32
Which epicondylitis is more common?
lateral
33
What are the signs and symptoms of lateral and medial epicondylitis?
- Low​ ​grade​ ​chronic​ ​local​ ​inflammation - Movement​ ​causing​ ​the​ ​muscles​ ​to​ ​contract​ ​will​ ​be​ ​painful - Pain​ ​with​ ​palpating​ ​muscles:​ ​tight​ ​and​ ​sore - Can​ ​get​ ​irritation​ ​of​ ​ulnar​ ​nerve​ ​with​ ​medial​ ​epicondylitis
34
Continued epicondylitis can lead to ...
- Can​ ​gradually​ ​decrease​ ​their​ ​ROM​ ​at​ ​the​ ​elbow - Can​ ​make​ ​it​ ​harder​ ​to​ ​flex​ ​or​ ​extend​ ​the​ ​elbow​ ​fully
35
What are the 4 general stages of overuse injuries?
- Stage​ ​1:​ ​Starts​ ​only​ ​being​ ​painful​ ​after​ ​activities - Stage​ ​2:​ ​Starts​ ​being​ ​painful​ ​at​ ​end​ ​of​ ​event​ ​and​ ​after - Stage​ ​3:​ ​Starts​ ​affecting​ ​their​ ​performance,​ ​painful​ ​during​ ​as​ ​well​ ​as​ ​after - Stage​ ​4:​ ​Hurts​ ​all​ ​the​ ​time
36
Give an example of correcting faulty mechanics that cause epicondylitis.
somebody​ ​who​ ​plays​ ​tennis​ ​and​ ​does​ ​more​ ​wrist​ ​movement​ ​than​ ​arm movement
37
How do we manage lateral or medial epicondylitis?
- correct faulty mechanics - Calm​ ​down​ ​symptoms - Calm​ ​down​ ​swelling,​ ​spasm,​ ​pain
38
Describe the braces that people often wear when they have lateral or medial epicondylitis?
- Straps​ ​that​ ​go​ ​around - Bubble​ ​that​ ​goes​ ​overtop​ ​point​ ​of​ ​pain - Won’t​ ​actually​ ​solve​ ​problem - Designed​ ​to​ ​put​ ​pressure​ ​just​ ​below​ ​where​ ​you​ ​have​ ​pain,​ ​so​ ​that​ ​the​ ​part​ ​above that​ ​is​ ​now​ ​not​ ​working - Solves​ ​pain​ ​issue,​ ​but​ ​not​ ​actually​ ​doing​ ​anything​ ​else - Can​ ​cause​ ​the​ ​next​ ​part​ ​to​ ​be​ ​tight/painful
39
What is the special test for epicondylitis?
stretch the muscles that would be tight
40
Describe the lateral epicondylitis test.
- Extensors - Arm​ ​straight - Flex​ ​wrist - Hand​ ​overtop - Positive:​ ​pain​ ​at​ ​lateral​ ​epicondyle​ ​(not​ ​stretching)
41
Describe the medial epicondylitis test.
- Flexors - Straight​ ​arm - Extend​ ​wrist​ ​and​ ​fingers - Hand​ ​overtop - Positive:​ ​pain​ ​at​ ​medial​ ​epicondyle​ ​(not​ ​stretching)
42
Why is the elbow the strongest joint in the body based on only bone structure? What does this mean for injury to it?
- Fits​ ​together​ ​like​ ​a​ ​tight​ ​puzzle | - Requires​ ​the​ ​most​ ​violent​ ​force​ ​to​ ​dislocate
43
What is the MOI for elbow dislocation?
- Foosh​ ​when​ ​arm​ ​is​ ​already​ ​in​ ​hyperextension | - Arm​ ​in​ ​flexion,​ ​violent​ ​twist
44
What is the most common direction to dislocate the elbow?
- Most​ ​common​ ​to​ ​pop​ ​ulna​ ​out​ ​backwards | - Can​ ​go​ ​in​ ​any​ ​other​ ​direction​ ​depending​ ​on​ ​force​ ​but​ ​not​ ​that​ ​common
45
Dislocating the elbow usually comes with ...
- Complete​ ​rupture​ ​of​ ​all​ ​of​ ​our​ ​ligaments,​ ​most​ ​of​ ​muscles - Common​ ​to​ ​fracture​ ​radial​ ​head - Dislocation​ ​backwards​ ​means​ ​it​ ​rams​ ​into​ ​humerus
46
Do elbows sublux?
no, ​need​ ​to​ ​go​ ​to​ ​hospital​ ​to​ ​put​ ​back​ ​in​ ​place
47
What are the signs and symptoms of a dislocated elbow?
- Lots​ ​of​ ​bruising​ ​and​ ​bleeding - Lots​ ​of​ ​blood​ ​flow​ ​in​ ​front​ ​of​ ​elbow - Lots​ ​of​ ​swelling - Very​ ​common​ ​to​ ​have​ ​nerve​ ​symptoms​ ​down​ ​the​ ​hand - Tingling - Numbness - No​ ​pulse​ ​=​ ​ambulance - Tingling​ ​and​ ​numbness​ ​=​ ​ambulance - Almost​ ​always​ ​call​ ​ambulance
48
How do we manage elbow dislocations?
- Surgically​ ​repaired - Very​ ​lucky​ ​to​ ​get​ ​them​ ​back​ ​to​ ​80%​ ​ROM​ ​and​ ​80%​ ​strength - 2​ ​years​ ​recovery - 2​ ​seasons​ ​or​ ​career​ ​ending
49
What is the MOI for olecranon bursitis?
- Hit​ ​elbows​ ​lots - Bursa​ ​on​ ​elbow - Using​ ​elbows​ ​as​ ​leverage​ ​tool​ ​at​ ​work - Overuse​ ​injury - ***Exception​ ​of​ ​1​ ​acute​ ​trauma
50
What is the exception of 1 acute trauma for olecranon bursitis?
- Ex.​ ​falling​ ​on​ ​elbow​ ​in​ ​hockey​ ​with​ ​no​ ​elbow​ ​pads - Active​ ​acute​ ​bursitis - Amount​ ​of​ ​trauma​ ​can​ ​almost​ ​rupture​ ​bursa - Needs​ ​to​ ​be​ ​drained
51
What are the signs and symptoms of olecranon bursitis?
- Inflammation​ ​at​ ​bottom​ ​of​ ​elbow - Causes​ ​pain - Every​ ​time​ ​you​ ​hit​ ​elbow​ ​=​ ​pain
52
How do we manage chronic olecranon bursitis?
- Decrease​ ​swelling - Decrease​ ​pain - Current - Laser - Elbow​ ​can​ ​permanently​ ​look​ ​like​ ​that​ ​from​ ​scar​ ​tissue​ ​buildup
53
How do we manage acute olecranon bursitis?
Drain​ ​in​ ​arm​ ​that​ ​continues​ ​to​ ​drain​ ​fluid
54
Fractures are specific to the ...
radius and ulna
55
Where do the radius and ulna fracture?
- can do one or both | - can fracture anywhere along the bone due to the amount of trauma they see
56
Mid shaft fractures of the radius and ulna is a result of a ....
direct blow
57
What can FOOSH do to the radius and ulna?
- can​ ​crush​ ​bones​ ​up​ ​and​ ​down | - fractures at top or bottom
58
Why are the radius and ulna often displaced when fractured?
Lots​ ​of​ ​muscles​ ​that​ ​can​ ​create​ ​lots​ ​of​ ​force​ ​can​ ​displace​ ​bones,​ ​pull​ ​it​ ​out​ ​of​ ​place
59
What are the signs and symptoms of radius and ulna fractures?
- Will​ ​always​ ​see​ ​a​ ​deformity - Arteries​ ​and​ ​nerves​ ​run​ ​right​ ​next​ ​to​ ​the​ ​bones,​ ​can​ ​disrupt​ ​these - Bleeding,​ ​lack​ ​of​ ​pulse - Tingling,​ ​numb
60
How do we splint radius and ulna fractures?
in the position we find them
61
How do we manage radius and ulna fractures?
- X​ ​rayed​ ​multiple​ ​times​ ​to​ ​make​ ​sure​ ​everything​ ​is​ ​back​ ​in​ ​the​ ​right​ ​spot - Might​ ​have​ ​pins​ ​and​ ​plates​ ​if​ ​they​ ​can’t​ ​get​ ​bones​ ​to​ ​stay​ ​together - Likely​ ​to​ ​have​ ​temporary​ ​pins​ ​and​ ​plates,​ ​will​ ​be​ ​removed - Braced​ ​or​ ​casted​ ​for​ ​a​ ​period​ ​of​ ​time - Need​ ​to​ ​get​ ​ROM​ ​and​ ​strength​ ​back
62
What are the complications that can arise from using pins and plates for radius and ulna fractures?
- Pins​ ​and​ ​plates​ ​will​ ​generally​ ​restrict​ ​ROM​ ​(less​ ​active,​ ​less​ ​healing) - ​superficial​ ​pins​ ​and​ ​plates: can​ ​have​ ​problem​ ​with​ ​electric​ ​current​ ​on​ ​it
63
What is the special test for radius and ulna fractures?
- Compression | - Tuning​ ​fork
64
How does the tuning fork work?
- Creates​ ​vibration​ ​that​ ​travels​ ​through​ ​bone | - Helps​ ​find​ ​fractures,​ ​finds​ ​if​ ​they​ ​are​ ​healed
65
What is the MOI for muscle strains and ruptures in the wrist and forearm?
Violent​ ​contractions​ ​or​ ​violent​ ​stretches​ ​of​ ​muscles​ ​beyond​ ​ROM
66
What are the signs and symptoms of a grade 1 muscle strain in the wrist and forearm?
- Mild - Mild​ ​symptoms - Stretching
67
What are the signs and symptoms of a grade 2 muscle strain in the wrist and forearm?
- Damage - Tearing - Loss​ ​of​ ​function​ ​(muscle​ ​contraction)
68
What are the signs and symptoms of a grade 3 muscle rupture in the wrist and forearm?
- Rupture - Very​ ​difficult​ ​to​ ​do​ ​this​ ​because​ ​there​ ​are​ ​so​ ​many​ ​muscles​ ​helping​ ​each​ ​other out - Generally​ ​a​ ​direct​ ​blow​ ​or​ ​avulsion​ ​fracture​ ​(fracture​ ​off​ ​tendon​ ​attachment)
69
What is the special test for muscle strains and ruptures in the wrist and forearm?
resisted ROM
70
What is resisted ROM testing?
- Pain​ ​=​ ​1st​ ​degree - Pain​ ​+​ ​lack​ ​of​ ​strength​ ​=​ ​2nd​ ​degree - No​ ​strength​ ​=​ ​3rd​ ​degree
71
How do you manage muscle strains and ruptures in the wrist and forearm?
- Surgically​ ​repaired​ ​for​ ​ruptures - Work​ ​on​ ​ROM - Work​ ​on​ ​strength - Dexterity
72
Describe dexterity.
- Ability​ ​to​ ​do​ ​pincer​ ​or​ ​whole​ ​hand​ ​grips | - Fine​ ​tuning​ ​of​ ​movement
73
Describe the ligaments of the elbow.
- Annular​ ​ligament​ ​goes​ ​around​ ​the​ ​head​ ​of​ ​the​ ​radius​ ​and​ ​holds​ ​it​ ​to​ ​the​ ​ulna - Ulnar​ ​ligament - Radial​ ​ligament
74
Describe the ligaments of the wrist.
- Most​ ​ligaments​ ​are​ ​called​ ​where​ ​they​ ​are - Ulnar​ ​ligament​ ​(medial​ ​side​ ​in​ ​anatomical​ ​position) - Radial​ ​ligament​ ​(lateral​ ​side​ ​in​ ​anatomical​ ​position)
75
Describe the ligaments of the fingers.
- Ulnar​ ​collateral​ ​ligament​ ​on​ ​medial​ ​side​ ​of​ ​each​ ​finger - Radial​ ​collateral​ ​ligaments​ ​on​ ​each​ ​finger - Ligaments​ ​on​ ​front​ ​and​ ​back​ ​surfaces - Volar​ ​ligaments​ ​on​ ​front​ ​(palm​ ​side) - Dorsal​ ​ligaments​ ​on​ ​posterior​ ​side​ ​of​ ​hand - Can​ ​sprain​ ​any​ ​depending​ ​on​ ​MOI
76
What is the MOI of elbow sprains?
- ​valgus​ ​force​ ​or​ ​varus​ ​force - Valgus​ ​force​ ​more​ ​common - Only​ ​sprain​ ​in​ ​the​ ​body​ ​that​ ​is​ ​related​ ​to​ ​overuse
77
What people often sprain their ulnar collateral ligament?
- baseball pitchers - Throwing​ ​a​ ​baseball​ ​is​ ​valgus​ ​force​ ​on​ ​ulnar​ ​collateral​ ​ligament - Can​ ​create​ ​ulnar​ ​collateral​ ​ligament​ ​sprain​ ​from​ ​just​ ​one​ ​trauma,​ ​but​ ​most pitchers​ ​will​ ​see​ ​it​ ​from​ ​multiple​ ​traumas
78
What is Tommy John surgery?
Replacing​ ​and​ ​reinforcing​ ​the​ ​ulnar​ ​collateral​ ​ligament
79
What is the most common MOI of wrist sprains?
fall into hyperextension
80
Describe what is sprained in the wrist when falling into hyperextension.
- Will​ ​sprain​ ​any​ ​ligament​ ​on​ ​the​ ​front​ ​side - If​ ​they​ ​have​ ​a​ ​little​ ​bit​ ​of​ ​radial​ ​or​ ​ulnar​ ​deviation​ ​we​ ​can​ ​see​ ​collateral​ ​ligament sprains​ ​as​ ​well
81
Describe finger sprains.
- Some​ ​sort​ ​of​ ​force​ ​that​ ​looks​ ​like​ ​dislocation​ ​force​ ​(varus,​ ​valgus) - Jammed​ ​straight​ ​down​ ​will​ ​still​ ​create​ ​a​ ​sprain - 1st,​ ​2nd,​ ​3rd​ ​degree
82
How do we manage elbow, wrist, and finger sprains?
- immobilize for a longer period of time - difficult to put modalities on them (esp. finger) - tend to use laser, manual therapy - cross friction to break down scar tissue - normal rehab at elbow and wrist
83
Why do we immobilize elbow, wrist, and finger sprains for a longer period of time?
- to​ ​make​ ​them​ ​scar​ ​down​ ​so​ ​that​ ​they​ ​are​ ​stable​ ​in that​ ​joint - Doesn’t​ ​mean​ ​that​ ​they​ ​are​ ​restricted​ ​from​ ​play - Keep​ ​joint​ ​in​ ​tight​ ​position
84
Why do we use laser and manual therapy for elbow, wrist, and finger sprains?
Want​ ​scar​ ​tissue​ ​to​ ​begin​ ​with,​ ​but​ ​want​ ​them​ ​to​ ​go​ ​down​ ​eventually
85
What will too much scar tissue after elbow, wrist, and finger sprains do?
- decrease​ ​ROM | - If​ ​fingers​ ​can’t​ ​come​ ​together,​ ​they​ ​are​ ​weaker
86
Describe what normal rehab at elbow and wrist look like.
- Make​ ​them​ ​as​ ​strong​ ​as​ ​you​ ​possibly​ ​can - Work​ ​on​ ​ROM - Make​ ​sure​ ​they​ ​have​ ​full​ ​ability​ ​to​ ​do​ ​their​ ​sport - Make​ ​sure​ ​they​ ​still​ ​have​ ​their​ ​dexterity - Make​ ​sure​ ​they​ ​still​ ​have​ ​sensation​ ​in​ ​all​ ​fingers - Tend​ ​to​ ​have​ ​less​ ​impact​ ​on​ ​cardio,​ ​flexibility,​ ​and​ ​proprioception
87
What is the special test for elbow, wrist, and finger sprains?
varus and valgus stress test
88
Describe varus and valgus stress tests.
- Only​ ​done​ ​in​ ​full​ ​extension - 1st​ ​degree:​ ​just​ ​pain,​ ​no​ ​laxity - 2nd​ ​degree:​ ​pain​ ​and​ ​laxity - 3rd​ ​degree:​ ​no​ ​pain,​ ​lots​ ​of​ ​laxity - 3rd​ ​degree​ ​finger​ ​sprain​ ​is​ ​typically​ ​a​ ​dislocation
89
Why are varus and valgus stress tests different in the wrist and fingers?
- because​ ​they​ ​have​ ​that​ ​ROM | - Take​ ​them​ ​to​ ​the​ ​end​ ​of​ ​their​ ​ROM​ ​and​ ​then​ ​do​ ​the​ ​stress​ ​test
90
What is the MOI of carpal tunnel syndrome?
- Overuse​ ​at​ ​the​ ​wrist - ​repetitive​ ​movement​ ​at​ ​the​ ​wrist​ ​(generally​ ​wrist​ ​flexion) - Or​ ​repeated​ ​contusion​ ​trauma
91
Wrist pain is usually diagnosed as ...
carpal tunnel syndrome
92
What is happening anatomically for someone with carpal tunnel syndrome?
- Happens​ ​specifically​ ​at​ ​the​ ​carpal​ ​tunnel - At​ ​crease​ ​in​ ​wrist - Carpal​ ​bones - Sheath​ ​of​ ​muscle​ ​around - Bones​ ​and​ ​muscle​ ​form​ ​tunnel​ ​with​ ​nerves​ ​and​ ​vessels​ ​passing​ ​through
93
Describe the inflammation that blocks the carpal tunnel.
- One​ ​or​ ​more​ ​of​ ​the​ ​tendons​ ​are​ ​inflamed | - Or​ ​inflammation​ ​because​ ​of​ ​some​ ​sort​ ​of​ ​contusion
94
What nerves come through the carpal tunnel?
- Ulnar​ ​nerve | - median​ ​nerve​
95
What are the signs and symptoms of carpal tunnel syndrome?
- Pins​ ​and​ ​needles​ ​or​ ​numbness​ ​in​ ​hand​ ​from​ ​inflammation - Nerve​ ​symptoms​ ​can​ ​be​ ​sensory​ ​or​ ​motor​ ​(can’t​ ​move​ ​or​ ​decreased​ ​strength) - Pain​ ​at​ ​the​ ​tunnel - Generally​ ​gets​ ​to​ ​the​ ​stage​ ​where​ ​they​ ​have​ ​decreased​ ​sensation​ ​or​ ​motor​ ​function​ ​at the​ ​hand
96
How do we manage carpal tunnel syndrome?
- Correct​ ​faulty​ ​biomechanics - Decrease​ ​inflammation​ ​that​ ​is​ ​causing​ ​the​ ​symptoms - Current - Laser - Ultrasound - Usually​ ​can’t​ ​stop​ ​the​ ​inflammation/action
97
Describe carpal tunnel surgery.
- Designed​ ​to​ ​relieve​ ​the​ ​symptoms​ ​but​ ​not​ ​necessarily​ ​correct​ ​the​ ​problem - Cut​ ​retinaculum​ ​at​ ​top​ ​to​ ​relieve​ ​pressure - Loosen​ ​anything​ ​that​ ​is​ ​stuck​ ​together - Doesn’t​ ​actually​ ​solve​ ​the​ ​problem​ ​why​ ​they​ ​have​ ​it​ ​in​ ​the​ ​first​ ​place - Doesn’t​ ​get​ ​rid​ ​of​ ​the​ ​inflammation - Decrease​ ​scar​ ​tissue​ ​from​ ​where​ ​they​ ​did​ ​surgery
98
What is the special test for carpal tunnel syndrome?
phalens test
99
Describe the phalens test.
- Wrists​ ​together​ ​so​ ​they​ ​flex​ ​carpal​ ​tunnel - Hold​ ​this​ ​position​ ​for​ ​a​ ​minute - Positive:​ ​Pain​ ​in​ ​the​ ​wrist - Positive:​ ​Sensory​ ​of​ ​motor​ ​symptoms​ ​into​ ​hands
100
What is false carpal tunnel syndrome?
- Pain​ ​at​ ​front​ ​of​ ​forearm​ ​and​ ​wrist - Can​ ​give​ ​you​ ​neurological​ ​symptoms​ ​down​ ​arm - Not​ ​caused​ ​by​ ​MOI​ ​directly​ ​to​ ​the​ ​wrist - Tightness​ ​in​ ​neck,​ ​shoulder,​ ​traps​ ​that​ ​presses​ ​on​ ​a​ ​nerve​ ​can​ ​send​ ​symptoms​ ​down arm - Referred​ ​pain - Ex.​ ​concert​ ​pianist,​ ​secretary
101
What is the most common fracture in the wrist?
- scaphoid fracture | - Very​ ​common​ ​in​ ​skiers​ ​and​ ​snowboarders​ ​(thumbs​ ​down​ ​first)
102
Describe the location and shape of the scaphoid.
- Bone​ ​in​ ​the​ ​middle​ ​of​ ​anatomical​ ​snuff​ ​box - Scaphoid​ ​is​ ​shaped​ ​like​ ​a​ ​bowtie - 2​ ​different​ ​pieces:​ ​easy​ ​to​ ​fracture​ ​down​ ​the​ ​middle - very difficult to see on x ray - less blood supply to that part of the bone (thin bone)
103
What is the MOI of a scaphoid fracture?
- FOOSH - Generally​ ​more​ ​of​ ​their​ ​weight​ ​on​ ​the​ ​front​ ​side - Putting​ ​pressure​ ​on​ ​the​ ​scaphoid​ ​bone
104
Why is having a thin scaphoid a problem?
- Decreased​ ​healing​ ​ability​ ​=​ ​necrosis​ ​(tissue​ ​break​ ​down) - Bone​ ​physically​ ​breaks​ ​down​ ​between​ ​2​ ​pieces​ ​of​ scaphoid​ ​=​ ​scaphoid permanently​ ​in​ ​2​ ​pieces
105
What are the signs and symptoms of a scaphoid fracture?
- Decreased​ ​ROM​ ​in​ ​all​ ​planes - Pain​ ​in​ ​snuff​ ​box​ ​with​ ​movement​ ​in​ ​thumb - Bruising​ ​on​ ​base​ ​of​ ​thumb​ ​(palm)
106
How do we manage scaphoid fractures in a cast?
- Forearm​ ​cast​ ​up​ ​to​ ​thumb - Cast​ ​for​ ​generally​ ​6​ ​weeks - No​ ​movement​ ​in​ ​thumb​ ​or​ ​only​ ​at​ ​IP​ ​joint - Get​ ​bones​ ​lying​ ​close​ ​as​ ​they​ ​can - Re​ ​x​ ​ray​ ​every​ ​couple​ ​of​ ​weeks​ ​for​ ​6​ ​weeks​ ​to​ ​make​ ​sure​ ​that​ ​healing​ ​is​ ​proper
107
How do we manage scaphoid fractures once the cast is off?
- Once​ ​cast​ ​is​ ​off,​ ​increase​ ​ROM,​ ​increase​ ​strength​ ​in​ ​wrist​ ​as​ ​well​ ​as​ ​both​ ​of​ ​their​ ​thumb joints - Do​ ​all​ ​regular​ ​modalities​ ​once​ ​out​ ​of​ ​cast - Generally​ ​do​ ​not​ ​ultrasound​ ​over​ ​fractures​ ​or​ ​healed​ ​fractures​ ​for​ ​at​ ​least​ ​a​ ​year
108
What would having 2 separate pieces of scaphoid do?
could​ ​decrease​ ​some​ ​ROM​ ​but​ ​won’t​ ​affect​ ​lifestyle​ ​too much
109
What is the special test for scaphoid fractures?
long bone pressure
110
Describe the long bone pressure test.
- Bend​ ​thumb​ ​and​ ​mcp​ ​and​ ​push​ ​down | - Positive:​ ​pain​ ​where​ ​scaphoid​ ​is
111
Fractures of MCP, PIP, and DIP joints =
- broken | - little pieces of bone could be floating around
112
Dislocation of MCP, PIP, and DIP joints =
separation
113
_____ and ______ of MCP, PIP, and DIP joints usually come together.
fractures and dislocations
114
______ are easier to deal with in the hand than _______.
dislocations, fractures
115
What is the MOI of MCP, PIP, and DIP dislocations?
- generally​ ​a​ ​force​ ​to​ ​any​ ​one​ ​of​ ​sides | - Biggest​ ​dislocations​ ​with​ ​varus​ ​or​ ​valgus​ ​force​ ​at​ ​one​ ​joint
116
What is the MOI of MCP, PIP, and DIP fractures?
- ​axial​ ​load | - Load​ ​going​ ​straight​ ​down​ ​through​ ​the​ ​bone
117
What is the MOI of MCP, PIP, and DIP dislocations and fractures?
rotation
118
Pushing on a fractured bone in the hand usually...
moves fracture
119
How will most people try to relocate their own fingers?
- One​ ​pull​ ​from​ ​the​ ​end - Still​ ​need​ ​to​ ​go​ ​to​ ​the​ ​hospital​ ​to​ ​make​ ​sure​ ​nothing​ ​is​ ​fractured,​ ​everything​ ​is​ ​in the​ ​right​ ​place
120
How do we manage MCP, PIP and DIP dislocations?
- Put​ ​bones​ ​back​ ​together,​ ​stabilize​ ​until​ ​it​ ​scars - not​ ​necessarily​ ​be​ ​mandatory​ ​stabilized
121
How do we manage MCP, PIP and DIP fractures?
- mandatory​ ​immobilization | - Usually​ ​plastic​ ​splints​ ​(used​ ​to​ ​be​ ​metal)
122
Why do we use plastic splints?
- Easier​ ​to​ ​not​ ​have​ ​to​ ​take​ ​off​ ​if​ ​they​ ​have​ ​to​ ​x​ ​ray​ ​again - Protects​ ​whole​ ​finger
123
What are the rules for finger taping?
- Can’t​ ​leave​ ​pinky​ ​out​ ​by​ ​itself - Must​ ​be​ ​taped​ ​4-5,​ ​2-3 - Can​ ​put​ ​3-4-5​ ​if​ ​needed - Not​ ​allowed​ ​to​ ​tape​ ​finger​ ​by​ ​himself​ ​for​ ​6-8​ ​weeks
124
How long does the MCP, PIP, and DIP joints take to heal?
- Average​ ​of​ ​6​ ​weeks​ ​to​ ​heal​ ​joint - Can​ ​be​ ​8​ ​weeks​ ​if​ ​more​ ​complicated - Must​ ​tape​ ​their​ ​fingers​ ​together​ ​or​ ​wear​ ​brace​ ​for​ ​this​ ​period - Can​ ​take​ ​it​ ​off​ ​and​ ​work​ ​on​ ​ROM​ ​after​ ​week​ ​2-3 - Tend​ ​to​ ​be​ ​long​ ​standing​ ​because​ ​people​ ​don’t​ ​tend​ ​to​ ​rehab​ ​or​ ​take​ ​care​ ​of​ ​them
125
What ROM exercises should we do for MCP, PIP, and DIP joints?
- Both​ ​flexion​ ​and​ ​extension - More​ ​concerned​ ​about​ ​full​ ​extension​ ​(muscles​ ​that​ ​do​ ​this​ ​are​ ​not as​ ​strong) - More​ ​flexion​ ​activities​ ​with​ ​hand,​ ​but​ ​have​ ​big​ ​impact​ ​on​ ​life​ ​if​ ​they can’t​ ​extend​ ​fingers - Use​ ​elastic​ ​band​ ​for​ ​exercises
126
What is the special test for dislocations of the MCP, PIP, and DIP joints?
no special test
127
What is the special test for fractures of the MCP, PIP, and DIP joints?
- Palpating | - Tuning​ ​fork
128
What happens in jersey finger?
strain to the flexor tendon
129
What is the MOI for jersey finger?
finger​ ​gets​ ​caught​ ​and​ ​pulled​ ​into​ ​extension
130
What are the signs and symptoms of a grade 1 jersey finger?
- Mild - Stretch - Can​ ​physically​ ​move​ ​it - Pain​ ​in​ ​palm​ ​surface​ ​of​ ​finger​ ​that​ ​was​ ​affected
131
What are the signs and symptoms of a grade 2 jersey finger?
- Torn​ ​part​ ​of​ ​it | - Decreased​ ​ability​ ​to​ ​flex​ ​finger
132
What are the signs and symptoms of a grade 3 jersey finger?
- Rupture - Usually​ ​ruptures​ ​from​ ​top​ ​of​ ​proximal​ ​phalange - Physically​ ​can​ ​not​ ​flex​ ​finger - Gets​ ​surgically​ ​repaired
133
How do we manage jersey finger?
- 3rd​ ​degree​ ​held​ ​in​ ​a​ ​brace​ ​in​ ​almost​ ​dislocation - 2-3​ ​weeks​ ​then​ ​exercises​ ​ROM,​ ​but​ ​put​ ​brace​ ​back​ ​on​ ​after
134
What is gamekeeper's thumb also known as? What is happening?
- skier's thumb - Ex.​ ​ski​ ​poles​ ​get​ ​stuck,​ ​hands​ ​keep​ ​going​ ​forward - Sprain​ ​to​ ​ulnar​ ​collateral​ ​ligament​ ​of​ ​MCP​ ​of​ ​thumb - On​ ​web-side​ ​of​ ​thumb​ ​at​ ​MCP​ ​joint
135
What is the MOI of gamekeeper's thumb?
abduction​ ​of​ ​MCP​ ​at​ ​thumb
136
What are the signs and symptoms of a grade 1 gamekeeper's thumb?
- Mild - Pain - Local​ ​inflammation
137
What are the signs and symptoms of a grade 2 gamekeeper's thumb?
- Tearing | - Laxity
138
What are the signs and symptoms of a grade 3 gamekeeper's thumb?
- Rupture | - Rare​ ​to​ ​surgically​ ​repair​ ​because​ ​web​ ​will​ ​make​ ​sure​ ​thumb​ ​doesn’t​ ​go​ ​too​ ​far
139
How do we manage gamekeeper's thumb?
As​ ​much​ ​strength​ ​in​ ​thenar​ ​eminence​ ​as​ ​we​ ​can​ ​so​ ​that​ ​we​ ​can​ ​make​ ​thumb​ ​movements as​ ​strong​ ​as​ ​possible
140
What is the special test for gamekeeper's thumb?
valgus stress test
141
Describe the valgus stress test for gamekeeper's thumb.
- 1st​ ​degree:​ ​Pain - 2nd​ ​degree:​ ​Pain​ ​with​ ​laxity - 3rd​ ​degree:​ ​Only​ ​laxity
142
Why do we avoid metal for splints?
- On​ ​route​ ​to​ ​hospital:​ ​needs​ ​to​ ​be​ ​removed​ ​for​ ​x-rays​ ​=​ ​uncomfortable - Comfort:​ ​metal​ ​gets​ ​cold - Usually​ ​only​ ​taped​ ​or​ ​plastic - We​ ​can​ ​melt​ ​and​ ​mold​ ​plastic
143
What are we concerned about in rehab of the hand?
- grip strength | - finger dexterity

KNSS 220 Athletic Therapy (14 decks)

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