Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Semester 4 PM Exam 4 > Wrist and Hand Pathology > Flashcards

Wrist and Hand Pathology Flashcards

(75 cards)

Start Studying
1
Q

Carpal tunnel syndrome - define

A

Compression of the median nerve in the carpal tunnel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What makes up the carpal tunnel

A

Transverse ligament - pisiform and hook to the trapezium and scaphoid - forms the volar portion of the tunnel
Flexor retinaculum
Carpal bones - top of the carpal tunnel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Contents of the carpal tunnel

A 
FDS
FDP
Flexor pollicis longus
Median n. 
Flexor carpi radialis (travels in the retinaculum)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Etiology of CTS

A
  1. Incongruence between size of tunnel and contents of it
  2. Dec gliding of flexor tendons - n. irritation/swelling
  3. Miscellaneous reasons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Miscellaneous causes of CTS

A 
Repetitive wrist motions
Prolonged improper wrist position
Wrist trauma (fracture)
Pregnancy
Arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Presentation with CTS

A 
Pain and paresthesias in hand (m.n distribution)
Weakness
Atrophy (ape hand)
Dropping items
Night discomfort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CTS - what will their hand look like

A

Atrophy of median nerve innervated mm - ape hand
Mainly thenar mm - except adductor pollicis (innervated by ulnar)
Their thumb will be adducted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Colles’ Fracture - define

A

Fracture of the distal radius (sometimes radius and ulna)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Colles’ Fracture - etiology

A

Usually from fall backwards landing on an extended wrist (FOOSH with extended wrist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Opposite of Colles’ fracture =

A

Smith’s fracture

Radial fracture in a wrist flexion position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Presentation of Colles’ fracture

A
  1. Stiffness and dec ROM
  2. Dec strength (prolonged immob)
  3. Pain and paresthesia
  4. Dec functional use of wrist and hand
  5. CTS, Complex regional pain syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who is more likely to end up with a Colles fracture

A

Women more than men

More common in senior adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

People with a Colles fracture might end up with what deformity

A

Dinner fork deformity - can heal improperly and leave patient with slight angulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Wrist and finger sprains - define

A

Trauma resulting in various degrees of ligamentous involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Wrist and finger sprain - etiology

A

Direct blow - “jam”

Fall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Presentation of wrist and finger sprain

A 
Pain in joint when stretch ligament
Instability or possible hypomobility 
Dec func. use of joint
Limited ROM and strength
Possible joint deformity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What else can happen if the finger/wrist sprain turns into a dislocation

A

Volar ligament plate - rupture

Collateral ligaments - rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What else needs to be ruled out with a wrist/finger sprain

A

Need to rule out a fracture, subluxation, dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

DeQuervain’s Tenosynovitis - tenosynovitis of what muscles

A

Abductor pollicis longus

Extensor pollicis brevis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Etiology of DeQuervains Tenosynovitis

A
  1. Overuse of thumb

2. Forceful thumb injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Presentation of DeQuervains Tenosynovitis

A
  1. Tenderness of swelling over 1st dorsal extensor compartment
  2. Pain with resisted thumb extension and abduction
  3. Localized edema
  4. Possible dec strength of thumb ext and abd
  5. Dec func use of thumb
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Miscellaneous things with DeQuervains Tenosynovitis - may mimic what

A

Scaphoid fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Miscellaneous things with DeQuervains Tenosynovitis - may involve what nerve

A

Radial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Dupuytren’s Contracture - etiology

A

Result of a disease of the palmar fascia resulting in thickening and contracture of the fascia
Adheres to tendons, bidns them down and shortens them
Cause is UNKNOWN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Dupuytren's Contracture - Presentation
1. usually effects 4th and 5th digits 2. Finger flexion contracture (AROM and PROM limitations) 3. Presence of adhesions and dec palmar tissue mobility 4. May result in non functional hand
26
Miscellaneous with Dupuytren's contracture - What if left untreated - Bilateral or unilateral - Where else does it occur
1. Progressive if left untreated 2. Can be bilateral or reoccur 3. May occur in plantar fascia
27
Thumb Ulnar Collateral Ligament Sprain - AKA
Gamekeepers Thumb
28
Gamekeepers thumb - define
Injury to the ulnar collateral ligament of the thumb MCP
29
Gamekeepers thumb - etiology
1. Forceful radial deviation of thumb MCP 2. Falling on outstretched thumb 3. End result of repetitive strain of UCL
30
Presentation of Gamekeepers thumb
1. Swelling around thumb MCP 2. Painful and dec ROM 3. Dec thumb strength 4. Dec func use of thumb 5. Possible thumb instability
31
Miscellaneous with Gamekeepers thumb - Tear can be __ or __ Integrity of lig. - what is indicative of rupture
Tear can be partial or complete rupture of UCL | More than 30 joint laxity is indicative of a rupture
32
RA - etiology
Disease process causing synovial inflammation and tissue proliferation
33
RA - presentation
1. Pain, limitation, swelling and warmth in joint bilaterally 2. Usually present in wrist, MCP, and PIP 3. Tendon sheath inflammation causing mm imbalance in length and strength agonist and antagonist relationship 4. Fatigue 5. Joint capsule weakening, bone erosion, tendon ruptures, subluxations
34
Subluxations that may occur with RA
1. Ulnar subluxation of carpals - radial deviation | 2. Radial subluxation of prox phalanx - ulnar drift of fingers
35
What deformities may you see with RA
1. Swan neck deformity - PIP hyperextension and DIP flexion Volar lig. rupture 2. Boutonniere - PIP flexion and DIP ext - typically an ext tendon slip
36
Miscellaneous - RA - may develop ___
CTS from lack of motion
37
OA - etiology
Overuse of joints | Poor biomechanics
38
OA - presentation
1. Swelling and pain in joints 2. Reduced ROM 3. Possible strength deficits 4. Possible joint deformity and loss of joint integrity
39
OA is commonly noted at which joints
1st CMC joint and the DIPs
40
Compression of Guyon's tunnel - define
Ulnar nerve compression resulting in irritation and swelling of ulnar nerve
41
Etiology of compression at guyon's tunnel
1. Sustained pressure on hypothenar eminence 2. Repetitive gripping 3. Trauma (fall)
42
Presentation - compression at guyon's tunnel
1. Pain and paresthesias along ulnar border of palm, 4th and 5th digits 2. Weakness and possible atrophy of hypothenar, interossei, medial lumbricals 3. Dec ROM and strength
43
What might be seen in someone with compression at guyon's tunnel
Ulnar claw
44
Differentials with compression at guyon's tunnel
If present with ulnar claw, could be D contracture | Differentiate with ROM and palpation
45
Wrist drop is associated with what nerve
Radial nerve palsy knocking out extensors
46
Claw hand/Intrinsic Minus Hand associated with
Ulnar and Median n. compromise
47
Ape hand is associated with
Median nerve - pulling thumb into adduction
48
Bishop's deformity is associated with
Knocking out of lumbricals and thenar eminence
49
Scaphoid fracture - etiology
Trauma - direct blow to region Forceful thumb stretch Fall
50
Presentation - Scaphoid fracture
1. Localized swelling 2. Dec and painful thumb ROM 3. Dec func use of thumb/hand
51
Indications for arthroplasty
1. Severe joint instability and deterioration of joint surfaces 2. Dec loss of ROM at joint 3. Chronic subluxing and dislocating joint 4. Severe joint pain
52
Raynaud's Syndrome - what is it
Vasospasm of the small cutaneous and subcutanous arteries and arterioles Idiopathic in nature
53
Raynaud's syndrome - description
Produces phasic changes in skin color possible perception of coolness Pallor (VC), Cyanosis, Rubor (VD) Precipitated by cold or emotion
54
Volkmann's Ischemic Contracture - what is it
Contracture, fibrosis and atrophy of muscles resulting from dec blood supply
55
Volkmans ischemic contracture - usually due to what
obstruction of blood supply to forearm mm typically due to cast being too tight In as little as 6 hrs mm will begin to necrose - fibrose and result in flexor mm contracture
56
Presentation with Volkmans ischemic contracture
1. Wrist and finger flexor contracture 2. Diminished radial pulse 3. Circulatory and neuro sx
57
Intervention for Volkmans Ischemic Contracture
1. Medical emergency 2. ROM, muscle re-ed 3. Edema and inflammation relief
58
Etiology of Volkmans Ischemic Contracture
Erbs palsy or other brachial plexus injury Compression from not fitting splint properly Lymphedema Significant trauma
59
Ganglion cysts - description
``` Soft, movable cyst (benign) Repetitive motion may exacerbate Typically not painful Can be surgically removed or aspirated Usually no PT ```
60
Complex regional pain syndrome - Cause
Sympathetic dysfunction of unknown origin - most of the time is a precipitating factor that leads to it
61
What is complex regional pain syndrome
Hypo-vascularity to a portion of the body due to abnormal sympathetic activity which results in changes to neuromusculoskeletal system
62
Precipitating factors with complex regional pain syndrome
1. Direct trauma to peripheral nerve 2. Edema from prolonged immobilization 3. Psychological predisposition 4. Low pain tolerance
63
Phases with complex regional pain syndrome - name them
Acute Dystrophic Atrophic
64
Acute phase of complex regional pain syndrome - time
1 to 3 months | You want to catch it early in this phase
65
Dystrophic phase of complex regional pain syndrome - time frame
3 to 9 months | Skin and mm are deteriorating
66
Atrophic phase of complex regional pain syndrome - time frame
Can be permanent - can be dry, flaky skin, loss of hair
67
Presentation of complex regional pain syndrome
1. Hyperalgesia (loss of motion very quickly) 2. Capsular restrictions 3. Hyperhydrosis 4. Atrophy 5. Trophic changes 6. Osteoporosis 7. Edema
68
Interventions for complex regional pain syndrome
1. ROM - maintain 2. Desensitization 3. Splinting 4. Modalities 5. Joint loading 6. Stellate ganglion block 7. Emotional management
69
What is a bennetts fracture
metacarpal fracture
70
Triangular fibrocartilatge complex injury
Ulnar disc and carpals Allow for closed chain rotary components (gymnast) Can become damaged or town
71
Trigger finger
Irritation in one of the flexor tendons | If not addressed can lead to rupture
72
FOOSH =
fall on outstretched hand injury
73
FOOSH - Does not signify
a specific injury or location of injury - just describes the mechanism
74
FOOSH - pertinent to
Shoulder, elbow, forearm, wrist, and hand
75
Wrist extensor compartments - what are they held in place by
Held in place by extensor retinaculum

Semester 4 PM Exam 4 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions