Hand and Wrist

Question 1

Most of the forearm flexors are supplied by what nerve?

Answer 1

Median

Question 2

Most of the forearm extensors are supplied by what nerve?

Answer 2

Radial

Question 3

What arteries supply the forearm?

Answer 3

Ulnar and radial

Question 4

Where do ganglion cysts develop?

Answer 4

In the extensor tendons

Question 5

What is the functional carrying angle?

Answer 5

The palm is turned in with 20-30 degrees of finger flexion with about 15 degrees of wrist extension

Question 6

What is the MOI of mallet finger?

Answer 6

Blow to the tip of the finger

Question 7

What is mallet finger?

Answer 7

Avulsion of the extensor tendon

Question 8

What does the patient present with a mallet finger?

Answer 8

Pain at the DIP and they can’t actively extend the DIP

Question 9

What degrees does someone with a mallet finger carry their DIP at?

Answer 9

30 of flexion (they can’t extend)

Question 10

What does the x-ray show in the case of a mallet finger?

Answer 10

Avulsed bone on the dorsal proximal distal phalanx

Question 11

Which is more acute, a mallet finger or boutonniere deformity?

Answer 11

Mallet finger

Question 12

Which is more chronic, a mallet finger or boutonniere deformity?

Answer 12

Boutonniere deformity

Question 13

What is a boutonniere deformity?

Answer 13

A rupture of the extensor tendon (central slip) at the middle phalanx–it forces the DIP into extension and the PIP into flexion

Question 14

Why does a boutonniere deformity force the PIP into flexion and the DIP into extension?

Answer 14

The lateral bands are still pulling on the joint

Question 15

What causes a boutonniere deformity?

Answer 15

The bones slip into the space where the tendon used to be and then they get stuck.

Question 16

What are the signs and symptoms of a boutonniere deformity?

Answer 16

Severe pain, obvious deformity, and an inability to extend the PIP…there is also swelling and point tenderness

Question 17

What is the immediate treatment of a boutonniere deformity?

Answer 17

Splint the PIP

Question 18

How long will a boutonniere deformity be immobilized?

Answer 18

6 weeks

Question 19

What is the treatment for a mallet finger?

Answer 19

Splint the DIP in extension–it will have to be splinted for about 6 weeks

Question 20

What is a jersey finger?

Answer 20

A rupture of the flexor digitorum profundus tendon from its insertion on the distal phalanx.

Question 21

What causes a jersey finger?

Answer 21

An eccentric load on the DIP joint

Question 22

What finger does a jersey finger typically affect?

Answer 22

Ring finger

Question 23

What is a common MOI of jersey finger?

Answer 23

An athlete trying to grab a jersey and putting an eccentric load on the DIP

Question 24

What is the treatment for jersey finger?

Answer 24

Surgery

Question 25

What happens with the athlete with a jersey finger?

Answer 25

The DIP cannot be flexed so the finger remains extended

Question 26

What is more chronic of an injury? Jersey finger or swan neck deformity?

Answer 26

Swan neck deformity

Question 27

What happens with a swan neck deformity?

Answer 27

A distal tear of the volar plate

Question 28

What happens with a pseudoboutonniere deformity?

Answer 28

A proximal tear of the volar plate

Question 29

What does the volar plate do?

Answer 29

Prevents hyperextension and creates a firm endfeel when the fingers are extended

Question 30

With a swan neck deformity or pseudoboutonniere deformity, what happens with the middle phalanx?

Answer 30

It slides down where the volar plate would be--so it causes hyperextension at the PIP and flexion at the DIP. This creates extra stress to be placed on the tendons

Question 31

What does a white line running through a nail indicate?

Answer 31

A past trauma (3-4 months prior) to the nail bed while it was growing

Question 32

What do clubbed nails indicate?

Answer 32

Cardiovascular disease

Question 33

What do spoon nails indicate?

Answer 33

A fungus or vitamin deficiency

Question 34

What do scaling or ridging of nails indicate?

Answer 34

Psoriasis

Question 35

What do ridging and more development of nails indicate?

Answer 35

Hyperthyroidism

Question 36

What is an acute injury, swan neck deformity or jersey finger?

Answer 36

Jersey finger

Question 37

True or false: | The radius and ulna typically fracture individually.

Answer 37

True