Hand and Wrist

Question 1

what type of joint is the distal radioulnar joint?

Answer 1

pivot joint

Question 2

what type of joint is the radiocarpal joint?

Answer 2

diarthrodial ellipsoid

Question 3

open packed position of wrist

Answer 3

10 degrees of wrist flexion w/ slight ulnar deviation

Question 4

closed packed position of wrist

Answer 4

extension w/ radial deviation

Question 5

CPR of wrist

Answer 5

limited flex>ext

Question 6

closed packed position of midcarpal

Answer 6

extension with ulnar deviation

Question 7

CPR of midcarpal joints

Answer 7

limited flex>ext

Question 8

closed pack position of intercarpal joints

Answer 8

extension

Question 9

CPR of thumb

Answer 9

limited abduction and slight limitation of extension

Question 10

closed pack position of thumb

Answer 10

full opposition

Question 11

open packed position of thumb

Answer 11

mid range between abduction/adduction and flex/ext

Question 12

CPP of MCP/IP joints

Answer 12

MCP full flexion, IP full extension

Question 13

test for carpal tunnel

Answer 13

Tinel’s sign, phalen’s test

Question 14

describe tinel’s sign

Answer 14

tap over carpal tunnel for 20 sec. is there N/T or pain in median nerve distal to point of tapping?

Question 15

phalen’s test

Answer 15

prayer hands or reverse prayer hands, hold for 60 sec. pos. if N/T occurs w/in 45-60 sec. compresses med. nerve

Question 16

Finkelstein’s test tests which tendons for which syndrome?

Answer 16

APL and EPB for DeQuervain’s tenosynovitis.

Question 17

What is froment’s sign and what does it indicate?

Answer 17

inability to graps a piece of paper between your thumb and the side of the proximal phalanx of your pointer finger without flexing the IP joint of your thumb, its a sign of ulnar neuropathy

Question 18

why does froment’s sign indicate ulnar neuropathy

Answer 18

bc its an inhibition sign of adductor pollicis which is innervated by the ulnar nerve.

Question 19

What does a positive allen’s test indicate?

Answer 19

insufficient ulnar or radial AA performance, or reynauds syndrome if both are insufficient``

Question 20

How is a Watson’s sign found?

Answer 20

a.k.a scaphoid shift test, pt passively moved from UD to RD with arm pronated and scaphoid stabilized, + Watson’s sign= dosral movement of bones, clunk or pain

Question 21

what does a + Watson’s sign indicate?

Answer 21

scaphoid-lunate deviation

Question 22

Distal radioulnar joint:

pronation

Answer 22

volar

Question 23

distal radioulnar joint supination

Answer 23

dorsal

Question 24

radiocarpal joint: flexion

Answer 24

dorsal

Question 25

radiocarpal joint: extension

Answer 25

volar

Question 26

radiocarpal joint: ulnar deviation

Answer 26

radial glide

Question 27

radiocarpal joint: radial deviation

Answer 27

ulnar glide

Question 28

CMC joint: flexion extension

Answer 28

volar (ulnar)/dorsal (radial) glides

Question 29

CMC joint: adduction/abduciton

Answer 29

volar and dorsal glide?

Question 30

carpal tunnel compresses what nerve

Answer 30

median N.

Question 31

what is a classic sign of carpal tunnel

Answer 31

"shakes out" their hand

Question 32

PT tx of capral tunnel?

Answer 32

rest, ergonomics, ice, LILT, manual therapy, stretching, US, splinting, median N glides

Question 33

colles fracture diplaces in which direction?

Answer 33

dorsally

Question 34

a colles fracture occurs in which bone?

Answer 34

distal radius, transverse fracture

Question 35

which fracture is also known as the dinner fork deformity?

Answer 35

colles fracture

Question 36

how does a colles fx occur?

Answer 36

FOOSH

Question 37

tx for colles fx

Answer 37

surgery, casting, strength and ROM when out of cast

Question 38

what causes claw deformity

Answer 38

ulnar neuropathy

Question 39

what is it called when there is abduction of the 5th digit secondary to ulnar neuropathy

Answer 39

Wartenburg's sign

Question 40

OE of ulnar neuropahty

Answer 40

dec. grip strength, claw and wartenburg's deformity

Question 41

tx of ulnar neuropathy

Answer 41

ulnar glides, ROM, strength of hand and wrist, cervical and elbow ROM

Question 42

CRPS: type 1

Answer 42

abnormal reaction of the sympathetic nervous system following an injury, trauma or surgery

Question 43

tx for CRPS

Answer 43

desensitization, ther ex

Question 44

TFCC

Answer 44

triangular fibrocartilage disc injury.

Question 45

where is the triangular disc?

Answer 45

between triquetrum and distal ulna

Question 46

TFCC causes?

Answer 46

compression on UD wrist, FOOSH, overuse of repetetive twisting w/ palmar rotation

Question 47

tx of TFCC?

Answer 47

immobilize first, then wrist ROM, inc. circulation, improve circulation

Question 48

TFCC S&S

Answer 48

piano key,

Question 49

What is DeQuervain's associated with?

Answer 49

pregnancy and RA

Question 50

tx for DeQuervain's

Answer 50

friction message, rest from UD/RD, spica splint

Question 51

Gyon's canal in entrapment of which nerve?

Answer 51

ulnar nerve

Question 52

where is guyon's canal?

Answer 52

tween pisoform and hamate

Question 53

guyon's canal syndrome S&S?

Answer 53

N/T in the medial half of 4th digit and whole 5th digit, froment's sign and thenar emincence atrophy

Question 54

causes of guyon's canal

Answer 54

biking, using crutches, vibrations (like when jackhammering)

Question 55

cause of raynaud's phenomenon

Answer 55

constritcion of small blood vv in hands and feet via reversible vasospasm

Question 56

test for raynauds

Answer 56

allen's test

Question 57

tx for raynaud's

Answer 57

exercise to inc. blood flow, vasodilators, lifestyle changes (stop smoking, etc. )

Question 58

Duputryen's contracture

Answer 58

abnormal thickening of palmar and digital fascia of 4th and 5th digits

Question 59

Causes of duputryen's

Answer 59

alcoholism, diabetes, elipesy, idiopathic

Question 60

tx for duyptryen's

Answer 60

friction massage, stretching, sx and injections

Question 61

smith's fx, a.k.a...

Answer 61

"reverse colles fx", fx of distal radius w/ volar displacement

Question 62

MOI of smith's fx?

Answer 62

fall onto back of flexed hand...

Question 63

boxer's fx

Answer 63

5th MC

Question 64

MOI lunate dislocation

Answer 64

fall on extended hand causes lunate to become displaced between capitate and radius

Question 65

tx of lunate dislocation

Answer 65

surgical reduction, immobilization 3-4 wks, limit wrist extension 2 months.

Question 66

complications of lunate dislocation

Answer 66

AVN comprimise, median nerve injury

Question 67

Bennett fx

Answer 67

base of 1st MC

Question 68

what fx is karma for losing your temper and punching a wall

Answer 68

bennett's fx

Question 69

Other MOI for bennett's fx

Answer 69

falling onto your thumb

Question 70

mallet finger (Lou's finger) is an avulsion of which tendon?

Answer 70

extensor digitorum longus tendon from the distal phalanx, leaving the DIP always flexed and unable to extend

Question 71

MOI scaphoid fx

Answer 71

FOOSH, direct trauma

Question 72

S&S scaphoid fx

Answer 72

dorsal wrist pain

Question 73

where is there pain with palpation in the case of a scaphoid fx

Answer 73

over the anatomical snuff box

Question 74

complications with scaphoid fx?

Answer 74

non-union of bone, bone necrosis

Question 75

Keinbock's disease

Answer 75

osteonecrosis/avascular necrosis of lunate following a fx

Question 76

tx of keinbock's disease

Answer 76

thermal modalities to inc. revascularization, ROM/glides

Question 77

Gamekeeper's/Skier's thumb is a sprain of which ligament?

Answer 77

ulnar collateral ligament of 1st MCP joint

Question 78

what injury to you get from hyperextension/abduction of thumb?

Answer 78

Gamekeeper's/Skier's thumb

Question 79

tx of gamekeeper's thumb

Answer 79

taping, possible sx. strengthening