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PCM1 Final Exam > Elbow, Wrist, and Hand Pain/Exam > Flashcards

Elbow, Wrist, and Hand Pain/Exam Flashcards

1
Q

What is the normal carrying angle of the elbow?

A

5-15 degrees

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2
Q

Nuresmaid’s elbow

A

annular L. slips out of radial head and gets trapped in radiohumeral joint
Presentation: arm close to body w/ elbow slightly flexed
Management: hyperpronation

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3
Q

Medial Epicondylitis

A

aka golfer’s elbow
Presentation: pain on medial side of elbow (medial epicondyle), tenderness w/ passive extension of wrist and resisted flexion of wrist
Management: modified activity, bracing, NSAIDs

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4
Q

Lateral Epicondylitis

A

aka tennis elbow; due to excessive hyperextension
Presentation: pain on lateral aspect of elbow, tenderness w/ resisted wrist extension
Management: modify activity, bracing, NSAIDs

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5
Q

Olecranon Bursitis

A

aka student’s elbow; inflammation of the olecranon bursa
Presentation: pain and swelling on olecranon bursa
Management: RICE, NSAIDs, aspiration of fluid present with analysis

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6
Q

Cubitus Varus

A

<5 degree carrying angle (adduction of ulna)

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7
Q

Cubitus Valgus

A

> 15 degree carrying angle (abduction of ulna)

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8
Q

Elbow Flexion

A

140-150 - biceps brachii, brachialis, brachioradialis, choracobrachialis

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9
Q

Elbow Extension

A

0 - (-5) - triceps brachii, anconeus

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10
Q

Elbow Supination

A

90 - supinator, biceps brachii

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11
Q

Elbow Pronation

A

90 - pronator teres, pronator quadratus

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12
Q

Biceps tendon reflex

A

C5

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13
Q

Brachioradialis tendon reflex

A

C6

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14
Q

Triceps tendon reflex

A

C7

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15
Q

Lateral arm dermatome

A

C5

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16
Q

Lateral forearm and thumb dermatome

A

C6

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17
Q

middle finger dermatome

A

C7

18
Q

Medial forearm and little finger

A

C8

19
Q

Medial Arm

A

T1

20
Q

Valgus Stress Test

A

arm slightly abducted and externally rotated w/ forearm supinated and flexed to 30; slight valgus stress applied to elbow

(+) = pain/tenderness w/ palpation; increased laxity
Indicates: sprained medial (ulnar) collateral L.

21
Q

Varus Stress Test

A

arm slightly abducted and internally rotated w/ elbow flexed to 15; slight varus stress applied to elbow

(+) = pain/tenderness w/ palpation; increased laxity
Indicates: sprained lateral (radial) collateral L.

22
Q

Tinel Test for Ulnar N. Entrapment

A

tap between olecranon and medial epicondyle in ulnar groove

(+) = tingling sensation down forearm within ulnar distribution (4th and 5th digits)
Indicates: ulnar N. entrapment/cubital tunnel syndrome

23
Q

Golfer’s Elbow Test

A

pt’s elbow flexed to 90 and forearm placed in supination; physician places one hand under proximal forearm to stabilize and other over pt’s wrist to resist movement; pt flexes wrist

(+) = pain/tenderness around medial epicondyle
Indication: Medial epicondylitis

24
Q

Tennis Elbow Test (Cozen’s Test)

A

pt’s elbow flexed to 90 and pronated; physician places one hand under proximal forearm to stabilize and other over pt’s hand to resist motion; pt extends wrist

(+) = pain/tenderness around lateral epicondyle
Indicates: lateral epicondylitis

25
Q

Little League Elbow

A

pain over medial epicondyle, initially after throwing
medial apophysitis (childhood)
Medial epicondyle avulsion fracture (adolescence)
Medial collateral L tear (adulthood)

26
Q

Carpal Tunnel Syndrome

A

compression of median N.
Presentation: pain and paresthesias along first 3 1/2 digits
Management: mild = wrist splint at night; moderate to severe = EMG, continued splinting, steroid injections, carpal tunnel release

27
Q

De Quervain Tenosynovitis

A

recurrent inflammation of tendon and synovial sheath covering extensor pollicis brevis and abductor pollicis longus
Presentation: radial wrist pain at base of thumb (with movement of thumb)
Management: thumb spint, NSAIDs, glucocorticoids, surgery

28
Q

Trigger Finger

A

aka stenosing flexor tenosynovitis
Presentation: pain, locking, and clicking of MCP joint
Management: splinting MCP slightly flexed, NSAIDs, corticosteroid injection, surgery for severe cases

29
Q

Dupuytren’s contracture

A

fibrosis of palmar fascia
Presentation: thickening on palmar surface w/ or w/o pain; flexed digits w/ palpable cords
Management: using gloves w/ padding on palm; steroid injections, surgery

30
Q

Scaphoid Fracture

A

Presentation: pain on radial aspect of wrist, reduced grip strength after FOOSH
Management: initial XR (may not show fx), splint for 2 week and repeat XR

31
Q

Boxer’s Fracture

A

fracture of metacarpal neck
Presentation: pain on dorsal of hand after direct trauma
Management: initial splinting, closed reduction

32
Q

Colles Fracture

A

wrist fracture after FOOSH w/ wrist extended
Presentation: wrist pain w/ possible dinner fork deformity; tenderness on radial aspect of wrist
Management: based on degree of fx

33
Q

Rheumatoid Arthritis

A

Presentation: morning stiffness, swelling, pain of MCP and PIP; deformity
Management: NSAIDs, steroids, DMARDs, rheumatologist

34
Q

Wrist Flexion

A

80-90 - flexor carpi radialis, flexor carpi ulnaris, palmares longus

35
Q

Wrist Extension

A

70 - extensor carpi radialis longus and brevis, extensor carpi ulnaris

36
Q

Wrist Adduction (ulnar deviation)

A

30-40 - flexor carpi ulnari, extensor carpi ulnaris

37
Q

Wrist Abduction (radial deviation)

A

20-30 - flexor carpi radialis, extensor carpi radialis longus and brevis

38
Q

OK Sign

A

pt cannot make an “O” with thumb and forefinger

Indicates: anterior interosseous N impingement

39
Q

Tinel’s Sign

A

tap over transverse carpal L./flexor retinaculum

(+) = numbness/tingling, pain radiating to thumb, index and middle finger
Indicates: Carpal Tunnel Syndrome

40
Q

Phalen’s Sign

A

Pt places dorsal aspects of hand together; fingers facing down

(+) = any reproduction of sx
Indicates: Carpal Tunnel Syndrome

41
Q

Finkelstein Test

A

its makes a fist encompassing thumb and ulnar deviate wrist

(+) = increased pain in lateral wrist
Indicates: DeQuervain’s tenosynovitis

PCM1 Final Exam (10 decks)

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