Hand

Question 1

In Dupuytren’s, the natatory ligament contributes to…

Answer 1

web space contracture.

Question 2

In Dupuytren’s, the pretendinous cord causes…

Answer 2

MCP contracture.

Question 3

In Dupuytrens, the spiral cord causes…

Answer 3

PIP (and MCP) contracture.

Question 4

In Dupuytrens, the retrovascular cord causes…

Answer 4

DIP hyperextension.

Question 5

Positive NCV study findings for compressive neuropathy

Answer 5

distal motor latency > 4.5 msec

sensory motor latency > 3.5 msec

Question 6

Adson test

Answer 6

diminished radial artery pulse with inhalation. seen in thoracic outlet syndrome 2/2 subclavian vessel compression.

Question 7

What characteristic best correlates to the excursion (or amplitude) of a tendon for transfer?

Answer 7

fiber length

Question 8

The force a muscle can generate is directly proportional to…

Answer 8

the physiologic cross sectional area of all its muscle fibers.

Question 9

The greatest force of contraction is exerted when the muscle is at…

Answer 9

resting length.

Question 10

Tendon transfers for radial nerve deficit

Answer 10

FCR –> EDC
PT –> ECRB
PL –> EPL

Question 11

The deep fibers of the radioulnar ligaments attach to…

Answer 11

the ulnar fovea and this is more important for DRUJ stability than the superficial fibers which attach to the styloid.

Question 12

Role of proper collateral and accessory collateral in thumb MCP joint stability

Answer 12

PCL is primary restraint to radial deviation w/ MCPJ in flexion.

ACL provides restraint to radial deviation w/ MCPJ in extension.

Question 13

Position to immobilize in for stability of subluxing ECU

Answer 13

pronation, extension and ulnar deviation

Question 14

Most common PE finding for midcarpal instability

Answer 14

a clunk as the wrist is moved from neutral and forearm pronation to ulnar deviation with an axial and palmarly directed load.

Question 15

The protein commonly used in synthetic nerve conduits is…

Answer 15

type I collagen.

Question 16

When to use a volar approach to the scaphoid

Answer 16

distal pole fractures

humback deformity

Question 17

When to use a dorsal approach to the scaphoid

Answer 17

proximal pole fractures

*tends to promote more central placement of screw

Question 18

Vascularized bone graft for Scaphoid fracture AVN w/o humpback deformity

Answer 18

1-2 ICSRA

Question 19

Vascularized bone graft for scaphoid fracture AVN w/ humpback

Answer 19

MFC

Question 20

SNAC Stage 1

Answer 20

radial styloid arthritis

tx with styloidectomy but not more than 4 mm due to origin of RSC

Question 21

SNAC Stage 2

Answer 21

radioscaphoid arthritis

Question 22

SNAC Stage 3

Answer 22

scaphocapitate and lunocapitate arthritis

Question 23

SNAC Stage 4

Answer 23

pancarapal DJD

Question 24

Continuing pain with dorsal chip triquetral fracture after SAC, think…

Answer 24

DIC/DRC ligament injury

Question 25

The scapholunate ligament is strongest...

Answer 25

dorsally.

Question 26

The lunotriquetral ligament is strongest...

Answer 26

palmarly.

Question 27

The scaphoid tends to...

Answer 27

palmar flex.

Question 28

The triquetrum tends to...

Answer 28

dorsiflex.

Question 29

The lunate is "along for the ride" so if you have division of the scapholunate ligament, the lunate willl.

Answer 29

extend because it goes with the triquetrum (DISI).

Question 30

Gold standard for dx of schapholunate ligament injury

Answer 30

arthroscopy

Question 31

Division of the lunotriquetral ligament will cause the lunate to...

Answer 31

flex with the scaphoid (VISI).

Question 32

Sequence of events with perilunate dislocation

Answer 32

SL ligament disrupted (can have scaphoid fx) --> capitolunate dissociation --> lunotriquetral disruption (can have triquetral fx) --> failure of dorsal radiocarpal ligaments --> lunate dislocation

Question 33

Treatment of perilunate dislocation

Answer 33

-use dorsal approach to fix SL and volar approach to fix LT and perform CTR

Question 34

The primary blood supply to the scaphoid enters at the...

Answer 34

oblique dorsal ridge.

Question 35

Deforming forces of MC base fractures

Answer 35

2nd CMC: ECRL 3rd CMC: ECRB 5th CMC: ECU

Question 36

There is apex dorsal angulation of MC neck fracutres 2/2...

Answer 36

intrinsic pull.

Question 37

5 degrees of rotation at MC leads to...

Answer 37

1.5 cm overlap

Question 38

MC shortening of 2 mm leads to...

Answer 38

7 degrees extensor lag

Question 39

What ligament prevents dorsal dislocation of the 1st CMC joint?

Answer 39

dorsoradial

Question 40

Treatment of extra-articular (epibasal) thumb MC fractures

Answer 40

< 30 degrees of angulation well tolerated non-op > 30 degrees , CRPP (otherwise can get MCPJ hyperextension)

Question 41

With pinch, force seen at IP, MCP and CMC joints of the thumb

Answer 41

IP 4x MP 6 x CMC 12 x

Question 42

Herbeden's nodes

Answer 42

DIP

Question 43

Arthroplasty of the DIP is associated with...

Answer 43

extensor lag.

Question 44

Schapholunate ligament rupture can be associated with...

Answer 44

gout.

Question 45

Which cord causes contracture of the DIP joint in Dupuytren's?

Answer 45

retrovascular

Question 46

Parona's space lies between...

Answer 46

the fascia of the pronator quadratus and FDP conjointed tendon sheaths.

Question 47

The attachments of the transverse carpal ligament include...

Answer 47

scaphoid and trapezium radially and pisiform and hook of hamate ulnarly

Question 48

The medial femoral condyle vascularized graft is supplied by....

Answer 48

the longitudinal branch of the descending geniculate artery.