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Regional Orthopedics > Wrist/Hand Slides > Flashcards

Wrist/Hand Slides Flashcards

(56 cards)

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1
Q

What are the expected ROM for the wrist?

A

ext 70*
flex 80*
radial deviation 20*
ulnar deviation 30*

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2
Q

1st metacarpal mainly articulates with…

A

trapezium

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3
Q

2nd metacarpal mainly articulates with…

A

trapezoid, also trapezium/capitate a bit

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4
Q

3rd metacarpal mainly articulates with…

A

capitate

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5
Q

4th metacarpal mainly articulates with…

A

hamate, also capitate

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6
Q

5th metacarpal mainly articulates with…

A

hamate (4th MC)

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7
Q

Which 2 fingers are more mobile than the other 2?

A

1st & 5th

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8
Q

What is the volar plate?

A

multilayered condensation of fibrocartilagenous tissue originating from the proximal phalanx and inserts onto the middle phalanx

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9
Q

What passes through the carpal tunnel?

A

4 FDP tendons
4 FDS tendons
1 FPL tendon
median nerve

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10
Q

The median nerve travels between which two muscles in the forearm?

A

FDS and FDP

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11
Q

Once the median nerve reaches the carpal tunnel, the ____ goes anterior to the flexor retinaculum to innervate the palm.

A

palmar cutaneous branch

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12
Q

The radial nerve is a continuation of the ____ cord, composed of nerve roots __ to ___. It emerges from between the ___ and ___ heads of the triceps, continuing through the spiral groove of the humerus.

A

posterior cord

C5-T1

long and medial

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13
Q

The ulnar nerve originates from the ___ cord, composed of nerve roots __ to __.

It follows along the __ wall of the axilla beneath the ___ muscle

A

medial

C8-T1

posterior wall

beneath pec minor

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14
Q

The ulnar nerve travels between which two muscles in the forearm?

A

FCU and FDP

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15
Q

Ganglion cysts tend to develop where?

A

areas of high friction, especially along tendons of the hand/wrist

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16
Q

Risk factors for ganglion cysts include…

A

being female
age 20-40
OA or RA
wrist injury hx

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17
Q

What ROM clue would you have when a dorsal ganglion is still developing?

A

pain on pROM ext of wrist

or sense of pressure within the joint

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18
Q

It’s important to ddx Dequervain’s from…

How would you do so?

A

OA of trapezium/1st MCP

joint play will be painful and restricted

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19
Q

What is flexor tenosynovitis?

A

nodule on flexor tendon becomes entrapped behind thickened tendon sheath, usually at MCP joint, causing finger to become stuck in a flexed position

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20
Q

Digital tenovaginitis stenosans is also called…

A

trigger finger or flexor tenosynovitis

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21
Q

A Galeazzi fracture of the radius is accompanied by a dislocation of the ___, while a Monteggia fracture of the ulna results in a dislocated ___

A

ulna

radius

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22
Q

With FOOSH injuries, the lunate is commonly dislocated in what direction?

A

palmarly

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23
Q

Colles Fractures were named for WHO?

Study These Flashcards
A

Abraham Colles, who first described the condition in 1814

24
Q

The most common fracture in older people is the…

Study These Flashcards
A

Colles fracture (of the distal radius)

25
"Boxer's fractures" =
metacarpals, M/C 4th or 5th
26
Which carpal bone is the most commonly fractured? What % does it account for?
scaphoid, 85%
27
The more proximal the scaphoid fracture, the more likely ___ is - which occurs in what percentage of proximal scaphoid fractures?
avascular necrosis 99%
28
Displaced scaphoid fractures have a non-union rate of approx...
60%
29
Differentiate type 1 vs. type 2 TFCC injuries.
type 1: direct trauma | type 2: repetitive overuse
30
General degeneration of the TFC begins at age __, but most people over age __ have some degeneration
30 50
31
Type 1 TFCC injuries are often d/t...
FOOSH or oversupination/pronation when using tools like a drill
32
What is: a progressive disease of genetic origin resulting in contracture of palmar fascia and fixed flexion deformity of the MCP and PIP joints?
dupuytren's contracture
33
True or false: Bouchard's nodes are distal, Heberden's are proximal
false, it's the reverse
34
What are the MC deformities in RA?
ulnar drift palmar subluxation of MCP joints Swan Neck & Boutonniere deformities also Bouchard's & Heberden's nodes
35
What is: rupture of central band of extensor hood leading to flexion of PIP and extension of DIP?
Swan neck deformity
36
What is: laxity of PIP joint with bowstringing of lateral bands of the extensor hood leading to hyperextension of PIP and flexion of DIP?
boutonniere deformity
37
What causes the zigzag deformity of the thumb commonly seen in arthritis?
mm imbalance and ligament laxity with adductor pollicis tension
38
What is Sweater/Jersey finger?
the inability to flex the affected DIP joint due to rupture of the FDP tendon common in football/rugby players
39
Which is more common: extensor or flexor tendon ruptures?
extensor d/t superficial location and thinness
40
What is mallet finger?
flexion deformity at the DIP d/t extensor tendon avulsion from distal phalanx
41
CTS usually sees paresthesia to which fingers?
1-3, sometimes 4
42
The following are all symptoms of? clumsiness with fine motor skills of the hand pain/paresthesia awakens patient at night usually insidious
CTS
43
What testing would you use for carpal tunnel syndrome?
thenar mm weakness Phalen's Tinel's Carpal compression
44
How would you ddx between CTS and C6-7 nerve root involvement?
C6-7 involvement: use of hand will NOT increase symptoms no nocturnal pain
45
Loss of thumb function affects what percentage of total hand function?
40-50%
46
Where is the surgical 'no man's land' of the hand?
between the distal palmar crease and mid portion of the middle phalanx
47
Ape hand deformity is characterized by ____ and is d/t ___ nerve palsy
thenar eminence atrophy median nerve
48
Bishop's hand is characterized by ___ and is d/t ____ nerve palsy
hypothenar eminence wasting, flexion of fingers 4&5 ulnar nerve
49
Pulp to pulp pinch would be a functional assessment for the __ nerve. Tip to tip would be a functional assessment for the ___ nerve.
ulnar median
50
If pt c/o pain on wrist flexion, lesion is probably in the...
midcarpal joints
51
Flexion sees more movement at the ___ joints and extension sees more movement at the ___ joints
flexion: greater at intercarpal extension: greater at radiocarpal
52
Wrist flex/ext AND radial/ulnar deviation primarily happen through which carpal?
capitate
53
True or false: scaphoid moves more in relation to the radius than to lunate or triquetrum
true
54
What is the volar plate/its function?
limiting hyperextension | tough fibrocartilage on the palmar side of the fingers
55
Which branch of the median nerve goes anterior to the flexor retinaculum?
palmar cutaneous branch
56
The EPL tendon passes around what bony landmark?
Lister's tubercle

Regional Orthopedics (6 decks)

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