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Canadian Exam > MSK- Wrist And Hand > Flashcards

MSK- Wrist And Hand Flashcards

1
Q

Colles #

A

Distal radial fracture resulting in a dorsal displacement
Could compress medial nerve (present like carpal tunnel), CRPS, and arthritis

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2
Q

Colles # etiology

A

FOOSh

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3
Q

Dinner fork deformity

A

Colles #- look like a fork face down

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4
Q

Colles # interventions

A

Post-immobilization’s phase
- mobilization
Strengthening

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5
Q

CRPS- Complex regional pain syndrome

A

Chronic pain disorder caused by sympathetic nervous system (SNS) out of proportion of the original injury

Type 1- occurs after injury to tissue
Type 2- nerve injury

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6
Q

CRPS- S&S

A

Severe pain- burning
Allodynia or hyperalgesia
Abnormal blood flow, motor function (stiffness) or sweating
Trophies changes (colour, temp, edema, shiny tight skin, abnormal hair and nail growth)

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7
Q

CRPS- clinical course

A

Stage 1- acute/reversible stage (immediate)
Stage 2- dystrophic or vasoconstriction (ischemic) stage (3-6 mnths)
Stage 3 Atrophic stage (6 mnth-1yr +)

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8
Q

CRPS- interventions

A

Education
Mobility
Encourage ADLs
Compressive loading
Distraction
Desensitization
Edema control
Modalities
Mirror therapy
Aerobic activity

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9
Q

Immobilizations- warning signs

A

Increased pain- CRPS
Cast tightness- CRPS
Ct looseness
Changes in surrounding skin colour/ sensation
Increased swelling- CRPS

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10
Q

DOs and DONTS of immobilization

A

DOs
- maintain jts above and below
Skin integrity
Capillary refill
Reducing swelling
Education on warning signs
Remove tight jewelry

DONTS
Stick things inside the cast (ie to scratch)
Get the cast wet

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11
Q

Scaphoid #

A

Most commonly fractures carpal bone
Complications- avascular necrosis, nonunion of fracture, and arthritis
Young males are common (high risk activities)
Radial side pain, tenderness on anatomical snuff box, pain with longitudinal thumb compression

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12
Q

Scaphoid # interventions

A

Mobilization
Strengthening

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13
Q

De Quervains Tenosynovitis

A

Painful inflammation of the sheath surrounding tendons of the 1st dorsal compartment (abductor pollicis longus and extensor pollicis brevis)

Caused by overuse (repetitive thumb or wrist mvmts) or blunt trauma

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14
Q

De Qua- special tests

A

Finkelstein test

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15
Q

De quavers interventions

A

Activity mod
Cryotherapy
Splinting
Graduation stretching and strengthening (as tolerated)

Medical (NSAIDs, corticosteroid injections- super helpful, surgical release-rare)

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16
Q

TFCC tear

A

A tear in the ligament out and cartilaginous structures of the TFCC
- radius will bear more load than it should

Clicking- a hallmark sign

17
Q

TFCC - special test

A

TFCC load test (Sharpey’s test)
Press test

18
Q

TFCC interventions

A

Activity mod
Bracing (widget)
Cryotherapy
Progressive strengthening and mobility exercises when able to tolerate

Medical- NSAIDs, corticosteroid injection, surgery

19
Q

Peripheral neuropathy- nerves and inervations

A

Radial- BEST (Brachioradialis, extensors, supinators, triceps and anconeus)
Median- 2LOAF (lumbrical 1/2, opponens pollicis brevis, flexor pollicis brevis)
Ulnar- (Lumbrical 3[4, hypothenar muscles, interosseim, adductor pollocis

20
Q

PAD DAB

A

Palmar adducts
Dorsal abducts

21
Q

Hand deformities due to nerve lesions

A

Median- ape hand, hand of benediction
Ulnar- claw hand
Radial- wrist drop

22
Q

Carpal tunnel

A

Flexor reinaculum and carpal creates a tunnel containing:
- median nerve
- 9 total tendons

23
Q

Carpal tunnel- etiology

A

Insidious
Repetitive hand mvmts
Vibrations
Associated conditions (RA, COlles, lunate subluxation, hypothyroidism, pregnancy, DM, obesity)

24
Q

Carpal tunnel- S&S

A

Median nerve parenthesis- palmar 1, 2, 3, half of 4
Nocturnal pain
Relief with flicking
Weakness and clumsiness in hand (decreased grip strength)

25
Q

Carpal tunnel special test

A

Tinels
Phalens
Reverse phalens
Carpal compression
Resisted APB
ULTT median nerve bias
Nerve conduction velocity test

26
Q

Carpal tunnel interventions

A

Activity modifications
Splinting in neural
Nerve mobs

Medical- NSAID, corticosteroid, carpal release surgery

27
Q

Double crush syndrome

A

Nerve compression at more than 1 site along nerve
Proximal compression or pathology of a nerve is suggested to increase vulnerability of a nerve at a distal point

28
Q

Ulnar tunnel syndrome

A

Compression of ulnar nerve at Guyons canal syndrome
Caused from trauma, chronic pressure, space occupying lesions, extended use of crutches, higher risk amongst cyclist, baseball catchers, karate players and use of jack hammers

29
Q

Ulnar tunnel S&S

A

Parenthesia and pain in ulnar nerve distribution of hand (5th and half of 4th)
Decreased muscle strength
Atrophy of muscle innervated by ulnar

30
Q

Ulnar special test

A

Froment’s sign
Guy on canal compression test
Tinels test over Guyons canal
ULTT ulnar nerve bias
Nerve conduction velocity test

31
Q

Ulnar tunnel interventions

A

Activity mods
Bracing- cockup splint
Ergo and padding equipment and tools
Frequent changes of hand positions
Nerve mods

Med- NSAIDS, corticosteroid injections, release surgery

32
Q

Gameskeeper/ skiers thumb

A

Sprain of ulnar collateral lig of the thumb (MCP joint)
Valgus force on MCP joint
Commonly seen in games keeper, skiers, and volleyball players

Pain at base of thumb and with stretch
Worse with mvmt
Decrease pinch and gri

33
Q

Gameskeeper test

A

Thumb UCL laxity or instability test

34
Q

Gameskeeper interventions

A

Activity mod
Split MCP in slight flexion
Gentle ROM as tolerated
Strengthening (putty)

35
Q

CMC OA

A

Most common OA of the hand
Repetitive mvmts and joint injury
Classic S&S of OA

36
Q

CMC OA special test

A

Grind test

37
Q

CMC OA- interventions

A

Activity mod
Splinting
Larger grip handles
AROM within tolerable limits
Strengthening

38
Q

Finger deformities

A

Dupuytrens contracture
- fixed flexion deformity
- skin aherent to the fascia

Trigger
- thickening of the flexor tendon sheath (Notta’s nodule)
- results in the tendon sticking, catching, or locking when attempting to flex the affected finger
- often associated with RA

Mallet finger
- flexion of DIP at rest (splint and will be better in 6-8 wks) due to extensor tendon rupture

Bouchard node (PIP)
- OA

Heberden node (DIP)
- OA

Swan neck deformity
- RA

Boutonniere
- RA

Ulnar drift
- RA

Canadian Exam (56 decks)

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