Hand Surgery, C69 P578-585 Flashcards Preview

Section III Subspecialty Surgery P517 > Hand Surgery, C69 P578-585 > Flashcards

Flashcards in Hand Surgery, C69 P578-585 Deck (50)
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1

Who operates on hands?
P578

Plastic surgeons and orthopaedic surgeons

2

What are the bones of the
hand?
P578

Phalanges (fingers)
Metacarpal bones
Carpal bones

3

What is the distal finger joint?
P578

Distal InterPhalangeal (DIP) joint

4

What is the middle finger joint?
P578

Proximal InterPhalangeal (PIP) joint

5

What is the proximal finger
joint?
P578

Metacarpal Phalangeal (MP) joint

6

What are the “intrinsic”
hand muscles?
P578

Lumbricals, interosseous muscle

7

What is ADDuction and
ABDuction of the fingers?
P578 (picture)

ADDuction is to midline and ABDuction
is separation from midline

8

What are the trauma zones
of the hand?
P579

(see picture)

9

Where is “no man’s land”?
P579 (picture)

Zone extending from the distal palmar
crease to just beyond the PIP joint (zone 2)

10

What is the significance of
the “no man’s land”?
P579 (picture)

Flexor tendon injuries here have a poor
prognosis; a hand expert needs to repair
these injuries

11

SENSORY SUPPLY TO THE HAND
What is the ulnar nerve
distribution?
P579 (picture)

(see picture)

12

SENSORY SUPPLY TO THE HAND
What is the radial nerve
distribution?
P580 (picture)

(see picture)

13

SENSORY SUPPLY TO THE HAND
What is the median nerve
distribution?
P580 (picture)

(see picture)

14

SENSORY SUPPLY TO THE HAND
How can the radial
nerve motor function be
tested?
P580

1. Wrist and MCP extension
2. Abduction and extension of thumb

15

SENSORY SUPPLY TO THE HAND
How can the ulnar nerve
motor function be tested?
P580

1. Spread fingers apart against
resistance
2. Check ability to cross index and
middle fingers

16

SENSORY SUPPLY TO THE HAND
How can the median nerve
function be tested?
P580

1. Touch the thumb to the pinky (distal
median nerve)
2. Squeeze examiner’s finger (proximal
median nerve)

17

SENSORY SUPPLY TO THE HAND
How can the flexor
digitorum profundus
(FDP) apparatus be tested?
P581 (picture)

Check isolated flexion of the finger
DIP joint

18

SENSORY SUPPLY TO THE HAND
How can the flexor
digitorum superficialis
(FDS) apparatus be tested?
P581 (picture)

Check isolated flexion of the finger at the
MP joint

19

SENSORY SUPPLY TO THE HAND
Where do the digital
arteries run?
P581

On medial and lateral sides of the digit

20

SENSORY SUPPLY TO THE HAND
What hand laceration should
be left unsutured?
P581

Lacerations from human bites or animal
bites

21

SENSORY SUPPLY TO THE HAND
Should a clamp ever be used
to stop a laceration bleeder?
P581

No; use pressure and then tourniquet for
definitive repair if bleeding does not cease
because nerves run with blood vessels!

22

SENSORY SUPPLY TO THE HAND
What is a felon?
P582

Infection in the tip of the finger pad
(Think: felon = fingerprints = infection
in pad); treat by incision and drainage

23

SENSORY SUPPLY TO THE HAND
What is a paronychia?
P582

Infection on the side of the fingernail
(nail fold); treat by incision and drainage

24

SENSORY SUPPLY TO THE HAND
What is tenosynovitis?
P582

Tendon sheath infection

25

SENSORY SUPPLY TO THE HAND
What are Kanavel’s signs?
P582

Four signs of tenosynovitis:
1. Affected finger held in flexion
2. Pain over volar aspect of affected
finger tendon sheath upon palpation
3. Swelling of affected finger (fusiform)
4. Pain on passive extension of
affected finger

26

SENSORY SUPPLY TO THE HAND
Most common bacteria in
tenosynovitis and paronychia?
P582

Staphylococcus aureus

27

SENSORY SUPPLY TO THE HAND
How are human and animal
hand bites treated?
P582

Débridement/irrigation/administration of
antibiotics; leave wound open

28

SENSORY SUPPLY TO THE HAND
What unique bacteria are
found in human bites?
P582

Eikenella corrodens

29

SENSORY SUPPLY TO THE HAND
What unique bacteria are
found in dog and cat bites?
P582

Pasteurella multocida

30

SENSORY SUPPLY TO THE HAND
What is the most common
hand/wrist tumor?
P582

Ganglion cyst