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Basic Science > Hand > Flashcards

Hand Flashcards

1
Q

Tell me what are in the 6 dorsal compartments of the wrist?

A
  1. Abductor PL, Extensor PB
    2.ECRL, ECRB
  2. Extensor PL
  3. EDC, EIP
  4. EDM
  5. ECU
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2
Q

What structure centralizes the extensor mechanism and attaches to the volar plate at the MCP joint?

A

Sagittal band

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3
Q

What structure helps with PIP extension?

What structure helps with DIP extension?

A

Central slip

Lateral bands

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4
Q

Injury to the transverse retinacular ligament may result in what deformity?

A

Swan neck deformity

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5
Q

Whats in the carpal tunnel?

A

FDS
FDP
FPL
Mediain Nerve

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6
Q

What innervates the interosseous muscles?

A

Ulnar nerve

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7
Q

Limited PIP flexion with MCP extension?

A

Intrinsic tightness

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8
Q

Limited PIP flexion with MCP flexion?

A

Extrinisic tightness

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9
Q

What does the AIN innervate?

A

FPL
Index and long FDP
Pronator quadtraus

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10
Q

Radial nerve proper innervates?

A

Triceps
Anconeus
Brachioradialis
ECRL

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11
Q

The terminal branch of the PIN lies where?

A

Floor of the fourth dorsal compartment

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12
Q

For DRF, what is the average radial height, inclination, volar tilt?

A

Radial Height: 11 mm (accept less than 5 degree change)

Inclination: 22 deg (accept less than 5 degree change)

Volar tilt: 11 deg (accept less than 10 degree dorsal anglulation)

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13
Q

What is the main blood supply to the scaphoid?

A

Dorsal branch of the radial artery distal to waist that flows retrograde

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14
Q

DISI indicates what ligament was injured?

A

SL ligament
CID (Carpal instability dissociative)

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15
Q

Carpal instability adaptive results from ?

A

Malunited distal radius fracture

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16
Q

What are the 4 stages of a perilunate dislocation?

A
  1. SL disruption
  2. CL disruption
  3. LT disruption
    4, Circumferential disruption, short radiolunate remains attached
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17
Q

What is the acceptable angulation for metacarpal neck fractures of the index and long fingers?

A

Less than 15-20 degrees

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18
Q

For metacarpal shaft fracture, what is the acceptable shortening?

A

Less than 5 mm

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19
Q

Every 2 mm of metacarpal shortening leads to how many degrees of extensor lag?

A

7 degrees

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20
Q

How do I reduce a thumb metacarpal dislocation?

A

TAPE: traction, abduction, pronation, extension

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21
Q

In Skiers thumb or gamekeepers thumb, what is injured?

A

The UCL of the MCP

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22
Q

In testing the MCP, what is injured if:

There is instability at 30 degrees

There is instability at neutral

A

30 deg is proper UCl and/or dorsal capsular injury

Neutral is the accessory UCL and/or volar plate injury

(more than 35 degrees of opening overall or 20 degrees more than the contralateral side)

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23
Q

What is a stener lesion?

A

Adductor pollicis is between the avulsed UCL and its insertion site

24
Q

More than what percentage of involvement of the base of the proximal phalanx in a PIP joint fracture dislocation leads to persistent dorsal dislocation?

A

More than 30%

25
Q

When do you repair an extensor tendon?

A

When there is more than 50% involvement

26
Q

What zone extensor injury can cause a boutonniere?

A

Zone 3

27
Q

The Elson test examines rupture of what?

A

Central slip

28
Q

The strength of flexor tendon repair is proportional to what?

A

Number of suture strands that cross the repair site (6-8)

29
Q

When do you release a pediatric trigger thumb?

A

2-4 years of age

30
Q

What compartments are involved in intersection syndrome?

A

One (APL, EPB)
Two (ECRB, ECRL

31
Q

The soft tissues convey how much stability (%wise) to the DRUJ?

A

80%

32
Q

What part of the TFCC is not vascularized?

A

Central portion

Repair of TFCC allows getting 80% of wrist ROM and grip strength by 3 months

33
Q

What finger tip injury size can I allow to heal by secondary intention?

A

No bone exposed, less than 1 cm ^2 area

34
Q

When can I use a cross finger flap?

A

For a volar oblique fingertip injury with exposed bone

35
Q

The lumbricals originated off what?

A

FDP

36
Q

How do I treat a lumbrical plus finger?

A

Release of radial lateral band

37
Q

How do I treat a volar oblique thumb injury?

A

Moberg flap

38
Q

How do I treat a dorsal thumb injury?

A

First dorsal metacarpal artery kite flap or heterodigital island flap

39
Q

Replantation is not recommended for warm ischemia of how many hours and cold ischemia of how many hours?

A

6 warm hours for proximal to carpus and 12 hours for amputated digit

12 cold hours for proximal to carpus and 24 hours for amputated digit

39
Q

What is the operative sequence for amputation attachment?

A

BEFAVNS
-Bone
-Extensor
-Flexors
-Arterial
_Venous
-Nerve
-Skin

Go after index last if multiple fingers

Structure by structure instead of finger by finger is better

40
Q

What is the main contributor to the superficial arch?

A

The ulnar artery

41
Q

Distal sensory latencies of what and distal motor latencies of what are considered abnormal?

A

3.5 ms and 4.5 ms

42
Q

When does grip return after carpal tunnel release?

A

3 months

43
Q

When should i consider Parsonage Turner syndrome?

A

Shoulder pain or after viral illness

44
Q

What is the functional ROM of the elbow?

A

30-130 flexion/extension
50 degrees pronation/supination

45
Q

What is the primary restraint to valgus stress of the functional elbow?

A

Anterior bundle of the MCL (Ulnar collateral ligament)

Originates from the posterior medial epicondyle and inserts onto the sublime tubercle of the medial coronoid process

46
Q

When is the posterior bundle the primary restraint to valgus stress of the elbow?

A

Maximum elbow flexion

47
Q

What is the primary restraint to varus and external rotation stress of the elbow?

A

Lateral ulnar collateral ligment (LUCL)

Originates from the posterior lateral epicondyle and inserts onto the crista supinatoris of the proximal ulna

48
Q

What is the histologic finding for lateral epicondylitis?

A

Angiofibroblastic hyperplasia

49
Q

If distal biceps rupture left untreated how much supination and flexion strength gain by 1 year?

A

50% and 70%

50
Q

What is the risk for treatment of distal biceps rupture:

Single incision?

Double incision?

A

Single - nerve injury with lateral antebrachial cutaneous nerve

Double - radioulnar synostosis

Endobutton has superior strength

51
Q

What is an essex lopresti injury?

A

DRUJ dislocation, interosseous ligament injury and radial head fracture

52
Q

Posterolateral rotatory instability is caused by incompetence of what structure?

A

The LUCL

53
Q

How do I move the arm in a lateral pivot shift test?

A

Supination, axial compression, valgus loading from full extension to 40 degrees of flexion

54
Q

What is at risk with the proximal anteromedial portal within the elbow?

A

Medial antebrachial cutaneous nerve

55
Q

What is the main dynamic stabilizer to elbow valgus stress?

A

FCU

FDS is secondary

56
Q
A

Basic Science (10 decks)

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