Exam 2

Question 1

Inflammation or tendonosis of the sheath of the tendons in the first extensor compartment

Answer 1

DeQuervain’s Tenosynovitis

Question 2

Symptoms of DeQuervain’s Tenosynovitis include pain on which side of the thumb when pinching or grasping objects

Answer 2

radial side

Question 3

What muscles are in the 1st dorsal extensor compartment

Answer 3

Abductor pollicus longus and extensor pollicis brevis

Question 4

Test where you grab the MC and compress/push down and grind the joint

Answer 4

CMC grind test

Question 5

What muscles are in the 2nd dorsal extensor compartment

Answer 5

ECRL and ECRB

Question 6

What muscles are in the 3rd dorsal extensor compartment

Answer 6

EPL

Question 7

What muscles are in the 4th dorsal extensor compartment

Answer 7

EDC and Extensor Indicis Proprius

Question 8

What muscles are in the 5th dorsal extensor compartment

Answer 8

Extensor Digiti Minimi

Question 9

What muscles are in the 6th dorsal extensor compartment

Answer 9

Extensor Carpi Ulnaris

Question 10

Test for 1st compartment tenosynovitis/DeQuervain’s where the pt performs flexion of thumb grasped with fingers and ulnarly deviates

Answer 10

Finkelstein’s Test

Question 11

Causes of DeQuervain’s

Answer 11

Frequently results from repetitive motion
Could also result from blunt trauma to the styloid process
Overuse and improper mechanics of gripping and wringing
PREGNANCY-Prolactin

Question 12

Sxs of DeQuervain’s

Answer 12

Pain with grasp/release activities near base of thumb
Edema near base of thumb
Decreased range of motion: specifically in thumb flexion

Question 13

What type of splint can be used with DeQuervain’s or Intersection Syndrome

Answer 13

Thumb Spica. Wrist 15º extension, thumb MP 10º flexion; thumb MCP midway between palmar and radial abduction

Question 14

Tensosynovitis of second dorsal compartment where the first dorsal compartment crosses it in the radial dorsal 4 arm

Answer 14

Intersection Syndrome

Question 15

Patient education for intersection syndrome should include:

Answer 15

Avoid repetitive wrist flexion and extension with combined power grip

Question 16

what type of ultrasound would you use for acute condition

Answer 16

pulsing

Question 17

what type of ultrasound would you use for chronic condition

Answer 17

continuous

Question 18

what 2 sources supply the tendon nutrition

Answer 18

Intrinsic: Vascular perfusion.

Extrinsic: Diffusion from synovial fluid.

Question 19

intrinsic nutrition for the tendon comes form what artery

Answer 19

common digital artery

Question 20

The vascular supply is mainly on the _____ side of the tendons

Answer 20

dorsal

Question 21

What actually supplies the blood to the tendon intrinsically

Answer 21

vinculi

Question 22

Extrinsic nutrition is provided by ______ diffusion

Answer 22

synovial fluid

Question 23

Name where the profundus comes up through the (forking) bifurcation of the FDS

Answer 23

Camper’s Chiasm

Question 24

Impairment to the pulley system will cause _______

Answer 24

bowstrining

Question 25

How many zones are on the flexor side

Answer 25

5

Question 26

Flexor Zone 1 extends from the ______ to the _____ of the middle phalanx

Answer 26

fingertip, midportion

Question 27

In flexor zone 1, the _____ muscle is involved. A laceration causes inability to bend tip of finger

Answer 27

Flexor digitorum profundus

Question 28

An injury to flexor Zone 1 is called _______

Answer 28

jersey finger

Question 29

laceration of the flexor digitorum profundus (FDP) leading to inability to flex at the DIPJ

Answer 29

jersey finger

Question 30

Flexor Zone 2 extends from the midportion of the ____ phalanx (FDS Insertion) to the ___________

Answer 30

middle, distal palmar crease

Question 31

Flexor Zone 3 extends from the ________ to the distal portion of the ___________

Answer 31

distal palmar crease, transverse carpal ligament

Question 32

Flexor Zone 4 overlies the ________________

Answer 32

transverse carpal ligament

Question 33

Flexor Zone 5 extends from the _____ to the level of the musculotendinous junction of the flexor tendons

Answer 33

wrist crease

Question 34

Flexor Zone 1 of Thumb (T1) contains which muscle

Answer 34

FPL

Question 35

Flexor Zone 2 of Thumb (T2) contains which muscle

Answer 35

PBL and FPB

Question 36

When does primary repair happen for surgical tendon repairs

Answer 36

Within the first 2 weeks

Question 37

What is the optimal time for repair of the flexor tendons

Answer 37

within 24 hours (and definitely within 2 weeks)

Question 38

What type of repair would occur if the tendon ends and tendon sheaths become scarred, The musculotendinous units retract.

Answer 38

secondary repair

Question 39

An immobilized tendon(one that was in a cast) is __% weaker day 5-10 than at day one of repair

Answer 39

50

Question 40

Estimated core suture tensile strength decreases by __% by the end of week one

Answer 40

50

Question 41

Tendon repair is at its weakest day __-___

Answer 41

10-12

Question 42

Ends of a repaired tendon take about __ days to stick together

Answer 42

21

Question 43

3 main approaches to hand rehab

Answer 43

Controlled mobilization Early active mobilization Immobilization

Question 44

Precautions before therapy: instruct patient to NEVER bend ___ by themselves – only bend them using uninjured hand. NEVER make a ____ with injured hand. NEVER ____ anything using injured hand. NEVER ____ fingers using uninjured hand.

Answer 44

fingers, fist, pick up, straighten

Question 45

After 6 weeks, wristband is discontinued. instruct patient NOT to: ___ anything with injured hand. __ any heavy objects.

Answer 45

Push. lift

Question 46

What is the major problem with Kleinert Protocol

Answer 46

PIP Flexion Contractures

Question 47

``` Seddon Nerve classification where: Axon is preserved No wallerian degeneration Local demylenation Local conduction block Full recovery expected ```

Answer 47

Neuropraxia=Myelinopathy

Question 48

Seddon Nerve classification where: Interruption of axons / myelin sheath Wallerian Degeneration Good Prognosis Healing through axonal sprouting guided by the Neural tube

Answer 48

Axonotmesis=Axonopathy

Question 49

Seddon Nerve classification where: Loss of axon and endoneurial tube continuity. Nerve completely severed. Most severe type of nerve injury. May require surgical intervention. In surgery they check to see if they can get firing of the muscle tissue at the end plate for motor nerves. If the muscle doesn’t fire the prognosis is worsened. Muscles atrophy and develop fatty striations and fibrosis.

Answer 49

Neurotmesis: Seddon Stage III=Severance

Question 50

Prognosis better for ____ return than ____

Answer 50

sensory, motor