WEEK 10 wrist and hand

Question 1

What is carpal tunnel syndrome?

Answer 1

Compression of the median nerve in the wrist as it passes through a tunnel bordered by carpal bones and roofed by the transverse carpal ligament.

Question 2

What is the peak age of onset for carpal tunnel syndrome?

Answer 2

45-60 years

Question 3

t/f prevalence of CTS is 3 to 10 times higher in females than males

Answer 3

true

Question 4

CTS occurs when volume of carpal tunnel ____ or the volume of the contents ____ resulting in increased pressure within the tunnel

Answer 4

decrease; increase

Question 5

Where is median nerve pain, paresthesia, and/or numbness felt in carpal tunnel syndrome?

Answer 5

Volar aspect of the radial 3 digits

Question 6

advanced cases of CTS include weakness and atrophy ____ muscles and ____ muscles to the index and middle fingers, hypohidrosis

Answer 6

thenar and lumbricals

Question 7

MOI of CTS
sleeping with wrist in ___

Answer 7

full flexion

-prolonged repetitive activity with hands, vibration, pressure over volar wrist

Question 8

arthritis spurs
synovitis
tumor formation such as ganglion cyst
chronic postioning to mid to end range of wrist flexion or extension

are all factors that

Answer 8

decrease volume of tunnel

Question 9

increase fluid retention such as hypothyroidism or prego
irritaion of tendon sheath
congenital abnormalitis such as unusual proximal lumbrical origin on FDP tendon

Answer 9

increase volume of content

Question 10

can obesity, alcoholism, smoking and diabetes lead to CTS

Answer 10

yes

Question 11

pain and paresthesias felt volar aspect of which fingers and in radial aspects of which two as well as dorsum of these digits distal to DIP joint

Answer 11

index and middle and ring and thumb

Question 12

is the palm involved in CTS

Answer 12

no

Question 13

Which thumb motion is weak in carpal tunnel syndrome?

Answer 13

Opposition

Question 14

patients may complain of pain in volar forearm, anterior upper arm and even shoulder for

Answer 14

CTS

Question 15

surgery of CTS releases

Answer 15

transverse carpal ligament

Question 16

Which two tendons are involved in De Quervain’s?

Answer 16

• EPB
• APL

Question 17

What results from initial physical irritation in De Quervain’s?

Answer 17

Acute inflammation of the tendon sheath leading to chronic degenerative changes and tendinosis.

Question 18

What causes De Quervain’s?

Answer 18

Repeated wrist radial deviation and/or thumb palmar or radial abduction.

Question 19

What type of splint is used in De Quervain’s?

Answer 19

Thumb spica

Question 20

pain in radial aspect of wrist over the involved tendons, refers into the thumb and up the radial side of forearm

Answer 20

dequevarins

Question 21

aggravating factors include activites involved in ___grip and resistance to ____ deviation such as pouring milk, using hammer, lift infant

Answer 21

wide and ulnar

Question 22

Which five diseases are associated with trigger finger?

Answer 22

• Diabetes
• Rheumatoid conditions
• Gout
• Hypothyroid
• Amyloidosis

Question 23

What is trigger finger?

Answer 23

Tenosynovitis of digital flexor tendons.

Question 24

associated with repetitive, forceful gripping of hands with symetric diseases like gout which casues patho changes in tendon

Answer 24

trigger finger

Question 25

hallmark sign of trigger finger

Answer 25

catching or triggering of flexor tendons during active or passive flexion/ext of digits

Question 26

At what age is trigger finger most commonly found?

Answer 26

40-70 years in females

Question 27

found more in farmers, manual labor, musicians whose occupations involve repeated gripping

Answer 27

trigger finger

Question 28

Where does a fibrous nodule form in trigger finger?

Answer 28

Along the tendon of FDS as it passes under the A1 pulley.

Question 29

Which flexor tendon is most often affected in trigger finger?

Answer 29

FDS

Question 30

Where is pain felt in trigger finger?

Answer 30

Volar surface of the digit

Question 31

Which fingers are most often seen with trigger finger?

Answer 31

1st, 3rd, 4th

Question 32

Which joint is most often affected in trigger finger?

Answer 32

MCP