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Ortho 1 > Wrist and Hand > Flashcards

Wrist and Hand Flashcards

(63 cards)

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1
Q

What is carpal tunnel syndrome?

A

Entrapment of the MEDIAL NERVE at the wrist

mc compression neuropathy in the Upper extremity

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2
Q

What can happen if someone has carpal tunnel syndrome

A

Pain, burning, tingling along median nerve, so thumb, index, long fingers

frequently drop things

night pain and numbness

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3
Q

What do you prominently see on exam for carpal tunnel

A

Thenar atrophy, thumb opposition weakness

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4
Q

What two tests can you do for carpel tunnel syndrome

A

Whalen’s test: Wrist flexion at 45

Tinel’s sign: tapping over the median nerve at wrist

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5
Q

How do you test for carpal tunnel syndrome

A

EMG/NCV

x-rays to rule out arthritis

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6
Q

Treatment for carpal tunnel syndrome?

A

Splinting

steroid injection

ergonomic modification

surgery

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7
Q

What happens with carpal tunnel during pregnancy

A

It can occur in pregnancy, but resolves after birth

treat with splint only

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8
Q

What is Dupuytren’s Contracture

A

Thickening fibrosis of the palmar fascia

You’ll see that prominent chord on the palmar side

Also called viking disease because it usually affects people of Northern European descent

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9
Q

Who gets Dupuytrens’ Contracture

A

Genetically

men who are over 50

ETOH, smoking, diabetes, repetitive trauma

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10
Q

Signs and symptoms of Dupuytrens Contracture

A

Nodular or cordlike thickening near distal palmar crease

non tender

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11
Q

What fingers are commonly involved in Dupuytrens contracture

A

little and ring fingers MC involved

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12
Q

What is limited and normal in Dupuytren;s contracture

A

Extension limited

flexion normal

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13
Q

How do you treat Dupuytrens

A

Splints to slow progression, NOT CURATIVE

Can try injection of steroid or collagenase

SURGERY if severe and interferes with function

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14
Q

What is Duquervains Tenosynovitis

A

Irritation and swelling of the tendons on the thumb side of the wrist

inflammation thickens the tendon sheath and constricts the tendon as it glides in the sheath

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15
Q

What tendons are affected on in De Quervains

A

Abductor pollicis longs and Extensor policies brevis

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16
Q

Symptoms and exams for DeQuervains?

A

Pain and swelling over radial styloid with movement or making a fist

Finklesteins tests positive

tender to palpation

crepitation

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17
Q

Diagnosis for De Quervains?

A

Xray to rule out bony pathology

check for calcium deposit in tendon

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18
Q

What other diagnostic do you do for De QUervains

A

Blood draw to check blood uric acid levels for gout

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19
Q

How do you treat De Quervains

A

Immobilize wrist and thumb

2 week course of NSAID

Injection

Surgery

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20
Q

What is a Ganglion cyst

A

Cystic structure that arises from SYNVOIAL SHEATH or joint cavityS

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21
Q

What are symptoms and exam of Ganglion cyst

A

Painful or painless

pain with flex and extension of wrist

CAN change in size

TRANSILLUMINUATE

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22
Q

Dx and Tx

A

You can do an x-ray to check surrounding areas

If you ASPIRATE it has a higher chance to come back

If you surgical excise it, it will have a lower rate of exicision

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23
Q

Rheumatoid Arthritis

A

Systemic affecting synovial tissue

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24
Q

What does Rheumatoid arthritis of the hand affect

A

MCP joints (the joints closest to the palm) and wrist

ULNAR drift of the fingers

HYPEREXTENSION OF THE PIP, FLEXION OF DIP

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25
What is a common phathoneumonic term for rheumatic arthritis of the hand
Swan neck deformity where Hyperextension of the PIP Flexion of the DIP
26
What is Osteoarthritis
Loss of articular cartilage
27
What is affected in Osteoarthritis of the finger
DIP AND PIP are most involved BONE NODULES AT DIP = Heberdens BONE NODULES AT PIP = Bouchard's Nodes Booty Hole PIP DIP
28
What are Dx for Arthritis of the hand
Xray for lateral, ap, oblique Blood test to check for CRP, ESR, RH factor
29
Treatment for hand rheumatoid arthritis
Systemic treatment with ENABREL, REMICADE NSAIDs, splinting, injections NO CURE
30
Treatment for hand osteoarthritis
NSAIDS, Splinting, surgery
31
Ulnar Collateral Ligament tear, what is it
It's called Skier's Hand, Gamekeeper's Thumb FORCED RADIAL DEVIATION
32
Symptoms and exams of ulnar collateral ligament tear
Swelling, discoloartion pain, instability ulnar aspect of the MCP joint of the thumb.
33
How to diagnose gamekeeper's thumb
xray, ap, lateral, oblique IF GREATER THAN 30 DEGREE OF ANGULATION THEN IT'S A COMPLETE TEAR
34
How do you treat ulnar collateral ligament tear
Incomplete then splint Complete then surgery
35
Bennet's Fracture in a nutshell?
oblique fracture of the base of thumb metacarpal that enters the joint BASICALLY THE THUMB MAIN JOINT ON PALM symptoms are pain and swelling treat with surgery
36
What is the most common fractured carpal bone
Scapohoid
37
What is Scaphoid Fracture
The snuffbox fracture where blood supply enters the bone and can cause avascular necrosis pain with snuffbox and pain with gripping
38
Treatment for scaphoid fracture
If X-rays are negative then thumb spica splint for 1-2 weeks If x-rays positive then thumb spica splint for 6 weeks if widening or resorption then surgery
39
What is Keinbock Disease
Osteonecrosis of the lunate
40
What are signs/dx/and treatment for Keinbock Disease
Pain, stiffness, swelling XRAY ON XRAY, INCREASE DENSITY OF LUNATE Tx Immobilize and NSAIDS
41
What is trigger finger?
Inflammatory process of the flexor tendon or pulley pulleys keep the tendons from bowstringing NODULES DEVELOPS AND GET STUCK ON PALMAR SIDE OF SHEATH,. LOCKING THE FINGER IN FLEXION
42
What can be affected in trigger finger
Thumb, ring, long fingers involved Kids most commonly in trigger thumb
43
Signs and symptoms of trigger finger
Complains of catching, nodule palpable in the palm at distal palmar crease FINGER IS STUCK FLEXED
44
Tx for trigger finger?
Splinting, casting Injection Surgery
45
What is the most common extensor tendon injury
Mallet finger
46
What is mallet finger
Rupture of the extensor tendon at the base of the distal phalynx
47
Signs and symptoms of mallet finger
Unable to EXTEND DIP joint tender swollen
48
How to diagnose mallet finger
Avulsion of dorsal side of distal phalanx
49
How do you treat mallet finger
Splint to keep DIP joint in extension Splint must be on full time
50
What is Boutonneire Deformity
Tear of the central portion of extensor ligament at PIP joint
51
How do you treat Boutonniere Deformity
Splint PIP joint in extension 6 weeks for young 3 weeks for elderly
52
What is boxer's fracture
Fracture of the FIFTH METACARPAL NECK usually from hitting someone or a wall You won't see the knuckle by the pinky
53
What are signs and symptoms of boxer's fracture
Pain, swelling, ecchymosis check for shortening, knuckle depression, and rotation
54
What is the Dx and Tx for boxer's fracture
Xray ap,lat,oblique ULNAR GUTTER CAST Surgery if displaced greater than 40 DEGREES
55
What is the most common distal radius fracture
Colles Fracture aka dinner fork deformity
56
How does Colles Fracture happen
Falling onto extended wrist showing pain, swelling, deformity
57
What is smith fracture?
Reverse colles distal fragment is tilted downward
58
Treatment of Colles Fracture
Reduction cast surgery
59
how does smith fracture happen
falling onto flexed wrist
60
How do you treat Smith fracture
Reduction Cast Surgery
61
Talk about Dogs and Cats animal bites
Dogs are majority of bites but less infectious Cats are less bites but higher risk of infectionW
62
What bacteria is associated with cat and dog bites
Pasturella species
63
How do you treat Animal bites
Irrigation and debridement Prophylaxis with augmentin tetanus prophylaxis rabies prophylaxis admit all infected and bites and deep bites

Ortho 1 (3 decks)

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