Introduction to surgery of the hand Flashcards Preview

Module 204 Theme 2 > Introduction to surgery of the hand > Flashcards

Flashcards in Introduction to surgery of the hand Deck (32):
1

What is the palmar fascia?

Tough layer anchoring skin to skeleton

Extension of forearm fascia

2

What is the palmar fascia tightened by?

palmaris longus

3

Give the clinical disorder of the palmar fascia

Dupuytren’s disease

4

What is Dupuytren’s disease?

Thickening of fascia
Contracture

5

List some risk factors for Dupuytren's disease

Genetic
Smoking
Alcohol
Diabetes/epilepsy

6

What is the clinical relevance of the flexor tendons?

Traumatic rupture
Trigger fingers

7

Describe trigger fingers

Catching of tendons at A1 pulley
Degenerate nodule
Thickening of sheath

8

What causes trigger fingers?

Overuse
Degeneration
Change of direction of tendon

9

Name some nerve problems

Injury
Compression neuropathies

10

Where is the median nerve tested?

Index finger

11

Where is the radial nerve tested?

Web between d1 and d2

12

Where is the ulnar nerve tested?

Little finger

13

What is the carpal tunnel?

Osseous/ligamentous tunnel
Tendons and median nerve pass through

14

What is the clinical significance of the carpal tunnel?

Carpal tunnel syndrome

15

What is carpal tunnel syndrome?

Median nerve compression at wrist

16

What are the effects of carpal tunnel syndrome?

Nerve function. 3 of thenar muscles & sensory symptoms in the radial half of the hand.

17

List the thenar muscles

Abductor brevis
Opponens
Flexor brevis
Adductor (ulnar)

18

What is the function of the thenar muscles

Fine control
Species advantage

19

List the signs of carpal tunnel

Thenar wasting

Loss of abduction

Loss of opposition

20

What is cubital tunnel syndrome?

Ulnar nerve compression at elbow
Fascial compression @ 3 sites

21

What is the effect of cubital tunnel syndrome?

Nerve function. Forearm & hand muscles, sensory symptoms ulna half of hand.

22

What muscles are involved in cubital tunnel syndrome?

Flexor digiti quinti
Abductor
(opponens)

Interossei

FCU, FDP (m/r/l)

23

Describe the interosseous muscles

Palmar/dorsal
Insertion to proximal phalanx
Adduction/abduction

Insertion to extensor hood
Interphalangeal extension

24

Which nerve innervates the interosseous muscles?

Ulna nerve

25

List the signs of compression of the ulna nerve

Wasted hypothenar web spaces

Paradoxical wasting thenar

Forearm wasting

Clawing of digits

26

Describe the extensor tendons

Extend MCP joints of fingers
Thumb tendons
Wrist tendons
Retinaculum

12 in all
Some multistranded (APL/EDC/EDQ)

27

Describe de Quervain's disease

Triggering and pain of thumb extensors

28

What causes de Quervains disease?

Degeneration
Overuse
Ciprofloxacin - antibiotic
Anastrazole - breast cancer

29

Describe ruptures of the dorsal extensors

Lacerations
Fracture

Synovitis
Arthritis

No triggering

30

Describe the digital extensor hoods

Long extensors
Interossei
Lumbrical

Finely balanced

Complex multibundle flat tendon

31

State the number of different bones within the hand

3 phalanges in fingers
2 phalanges in thumb
5 metacarpals
2 sesamoids in thumb
8 carpal bones

32

Name some bone problems

Radial fracture
Scaphoid fracture

1st CMC osteoarthritis

Rheumatoid arthritis