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SCS > SCS Study Guide- EWH > Flashcards

SCS Study Guide- EWH Flashcards

1
Q

where is the A1 pulley in the finger

A

A1 is at the MCP joint, responsible for trigger finger

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2
Q

what are the most improtant pulleys for prevention of bowstringing in the finger

A

A3-4

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3
Q

what innervates the thenar side of the thumb

A

all of them are median nerves, except adductor pollicus which is the ulnar nerve

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4
Q

hypothenar innervation

A

ulnar nerve

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5
Q

what innervates the lumbricals, DABS/PADS

A

DABS/PADS are ulnar
lumbricals are the median and ulnar

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6
Q

what is a bishop sign

A

ulnar nerve palsy, flexion of the 4th and 5th fingers due to hypothenar eminence wasting

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7
Q

drop wrist is a palsy of what

A

radial nerve

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8
Q

claw hand is an issue with which nerve

A

ulnar

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9
Q

ape hand happens from

A

palsy of the median nerve

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10
Q

boutonniere deformity

A

hyperextension at DIP, flexion at PIP

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11
Q

swan neck deformity

A

hyperextension at PIP, flexion at DIP

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12
Q

dupuytren contracture

A

tightening of fascia in creating claw like hand

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13
Q

FCR, PL, FDS, FPL, PQ are innervated by what

A

median nerve

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14
Q

FDP (goes to the ??) innervated by what

A

innervated by median and ulnar, and goes to DIP

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15
Q

FCU innervated by

A

ulnar nerve

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16
Q

ECRL/B
AbPL
EPB

A

innervated by the radial nerve

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17
Q

ED, EDM, ECU, EPL, EI innervated by

A

radial nerve

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18
Q

finkelsteins

A

dequervains

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19
Q

tinel

A

CTS

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20
Q

Phalen

A

CTS

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21
Q

lunotriquetral ballotment test

A

LT joint instab/dislocation

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22
Q

allen;s

A

issue with radial or ulnar arteries

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23
Q

MP grind/torsion/compression

A

possible fracture

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24
Q

bunnel littler test

A

intrinsic capular tightness. MCP flex and PIP flex, then MCP ext and PIP flex and check for restricitons

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25
Q

murphy’s sign

A

dislocated lunate: make a fist and check alignment of knuckles, if 2nd knuckle is in line, then lunate issue. should be higher

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26
Q

froment’s sign

A

adductor pollicus paralysis

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27
Q

shuck test
shear test
press test

A

lunotriquetral pathology

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28
Q

TFCC grind test

A

TFCC

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29
Q

piano key sign

A

laxity at radioulnar joint

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30
Q

Wartenberg sign

A

neuritis of superficial radial nerve

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31
Q

trigger finger causes and exam and treatment

A

causes: FDP/FDS unable to glide in teh A1 pulley
exam: painful snapping, triggers after making a fist then extending. tendon at A1 thicker
treatment: injection of corticosteroids

32
Q

jersey finger: causes, exam and treatment of

A

FDP avulsion from forced extension of the DIP during flexion (caught in jersey)
exam: pain and swelling at volar DIP, unable to flex
treatment: splint and refer

33
Q

how do you splint the wrist after a jersey finger repair

A

wrist in 30 degrees flexion, MCP at 70 flexion and PIP and DIP in full extension
first 10 days.
after 10 days: to 3 weeks, wrist in neutral and MCP at 50 flexion

34
Q

when can splint be D/c after jersey finger surgery

A

6 weeks (night splint till 8 weeks)

35
Q

when can tendon gliding and strengthening begin for jersey finger repair

A

5-10 weeks

36
Q

mallet finger cause, exam and treatment
what zone

A

cause: extensor injury to zone one.
cause: avulsion of extensor at DIP, forced flexion of finger
exam: extensor lag at the dorsal DIP
treatment: continuous splinting for DIP for 6-10 weeks with PIP free
at 6 weeks: there needs to be night splint for 3+ more weeks. then if at 6 weeks and sports, additional splinting for 6 more weeks

37
Q

if the finger drops into flexion with mallet finger splinting what happens

A

splinting clock starts over

38
Q

central slip extensor tendon injury (possible _____ deformity)
case, exam, treatment

A

boutonniere
cause: PIP forcibly flexed while extended.
exam: will be no active extension
treatment: splint for 6 weeks, but if after 6 weeks cannot extend, see MD

39
Q

collateral ligament injuries are usually ______, at the ___
cause, exam and treatment

A

jammed fingers, at the PIP
cause: forced UD/RD at IP joints
exam: pain at ligament and inc valgus/varus
Treatment: buddy tape

40
Q

T or F: radiographic healing lags behind clinical presentation

A

true

41
Q

after a MC of phalange fracture, MCP joints are positioned how

A

in flexion to avoid extension contractions

42
Q

after a MC of phalange fracture, IPjoints are positioned how

A

full extension

43
Q

how long does a metacrapal fx take to heal

A

6 weeks due to good blood supply

44
Q

splinting for metacarpal fractures

A

in position of function
wrist 30-60 extension, MCP 70 flexion, IP 0-10 degree flexion

45
Q

is wrist positioned functionally for boxer fractrue

A

no, usually in ulnar gutter, 3 weeks (MCP at 80 flex, PIP straight, DIP free)

46
Q

what degree of displacement means surgery for boxers fracture

A

over 40 degrees displacement

47
Q

post ORIF for boxer, how long in a splint

A

3 weeks

48
Q

Causes and exam and imaging for boxers

A

cause: punch that doesnt land on 2nd/3rd MC
exam: malposition with fist
x-ray: lateral view

49
Q

coaches finger is a dislocation at the ____ and is usually a ___ direction dislocation

A

at the PIP, usually dorsally
TTP at volar plate and reduced and splinted in flexion and extension

50
Q

CMP dislocation cause, exam and treatment

A

cause: foce dorsally or volarly, pain and swelling, and splint to avoid full extension

51
Q

bennet fracture cause, exam and treatment

A

cause: add or sligthly flexed finger, fall. lateral x-ray, treat with open or closed reduction and casting

52
Q

gamekeeper thumb cause, exam and treat

A

cause: valgus at thumb, exam, weakened key pinch and valgus stress test and imaging would be plain x-ray and treat with 30-35 degree RD

53
Q

what is a stenner lesion

A

aponeuosis and UCL is entrapped

54
Q

structures that provide ulnar stability of the thumb

A

adductor aponeurosis, Adductor pollicus, UCL, volar plate

55
Q

UCL is splinted how

A

in arm spice cast with IP free

56
Q

how long to splint UCL if on contact situations

A

2 months

57
Q

when can you start A/PROM and gripping in UCL

A

ROM at 3-4 weeks gripping at 6 weeks

58
Q

after a thumb UCL repair, when ca you start PROM of thumb

A

6 weeks

59
Q

when to d/c splint with UCL-R/r

A

8 weeks

60
Q

UCL thumb repair RTS

A

3-4 months

61
Q

CTS cause, exam and treatment

A

cause: inflammation of tendons and synovial sheaths in the wrist with repeated flexion
exam: phalen, tinel, medial compression test, sensory changes and paresthesia
treatment: non op: wrist splint in neutral, op: release

62
Q

CT release timeline for ROM/ADL/strengthening/gripping and RTW/RTP

A

ROM at 2 weeks
ADLs 7d-14d
pinch/grip 2-4 weeks
RTP/RTW 2-4 week

63
Q

bowler’s thumb

A

digital nerve compression from bowling ball

64
Q

hamate fracture
cause exam and treatment

A

cause: contact while athlete is holding sport club/rqchuet into ulnar side of hand
wrist will be painful and weak
casting and immob for 6-8 weeks

65
Q

scaphoid fracture
cause, exam and treatment

A

hypertext and RD wrist
TTP snuffbox, tubercle tenderness, compression pain
imaging with posterolateral, oblique and ulnar flex, PA, MRI
treatment varies

66
Q

stable scaphoid fracture treatment

A

6 week sugar tong/long arm thumb splica by 6 weeks short arm thumb splica

67
Q

minimally displaced scaphoid fracture

A

percutaneous fixation with scres

68
Q

displaced scaphoid fx treatment `

A

ORIF

69
Q

RTS after scaphoid fracture

A

18 weeks

70
Q

colles fracture

A

radius, dirsal angulation of distal part

71
Q

smith fracture

A

distal radius is palmarly displace

72
Q

silver fork

A

hand dorsally displaces

73
Q

how to treat a radius fracture

A

braced 4-6 weeks

74
Q

DeQuervain’s cause, exam, treatment

A

cause: grasp with UD (tennis)
exam: pain at radial ascpect wrist, finkelstein’s pain with turning
immobilize with a radial thumb splica

75
Q

TFCC cause, exam, treatment

A

FOOSH, rotational injury, repeated axial loading
exam: ulnar wrist pain, crepitus, pain with gripping and RD, shuck/shear/grind/press test
imaging: PA/lateral oblique with sho ABDwrist brace 4-6 weeks, RTS 3 months

76
Q

RTS for TFCC issues

A

3 months

77
Q

Keinboch’s disease

A

AVN lunate, maybe fall, pain like a sprained wrist, stiff, decreased grip strength, pain with turning hand upwards,
immobilized in cast early on!

SCS (26 decks)

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