M2-C1-L23 And L24 --> Hand

Front 1

Epicondylitis:

- etiology
- general symptoms

Back 1

Tendon degeneration (tendonosis) just distal to the epicondyle

Pain with contraction and ultimately pain at rest

Front 2

T/F - Epicondylitis is associated with inflammation.

Back 2

False

Front 3

Epicondylitis PE:

- location of pain
- exacerbated by what actions x2
- numbness
- reflex
- sensations

Back 3

Just distal to epicondyles
- lateral or medial

If lateral, extension of WRIST
If medial, flexion of WRIST

No numbness

Normal reflex

Normal sensations

Front 4

Treatment of epicondylitis

Back 4

1. Avoidance
2. Splint of WRIST (not elbow)
3. Surgery
4. NSAIDs
5. Steroids

Front 5

Radial Tunnel Syndrome:

- etiology

Back 5

Compression of Posterior Interosseus Nerve (PIN) as it enters the supinator/Arcade of Frohse.

Front 6

What disease is Radial Tunnel Syndrome often misdiagnosed as?

Back 6

Lateral Epicondylitis

Front 7

Radial Tunnel Syndrome:

- symptoms x3

Back 7

Pain 4 - 5 cm distal to lateral epicondyle
(worse with extension or resisted extension of wrist)

Piano key sign

Weakness to finger and thumb extensors

Front 8

What is Piano key sign?

Back 8

Resisted extension of the middle finger will reproduce pain.

Front 9

On exam, Radial tunnel syndrome would manifest tenderness to palpation where?

Back 9

Sulcus between ED and ECRB

Front 10

What is the treatment for Radial Tunnel Syndrome?

Back 10

1. Splint FOREARM

2. Maybe surgery

Front 11

What type of steroids would apply in Radial tunnel syndrome?

Back 11

NONE!

Don't you fucking give steroids for Radial Tunnel Syndrome

Front 12

Cubital Tunnel Syndrome:

- AKA
- etiology

Back 12

Ulnar nerve compression at the elbow

Compression of ulnar nerve at the elbow as it transverses under the Osborne's ligament

Front 13

Cubital Tunnel Syndrome:

- Symptoms x4
- Symptoms at Late Phase

Back 13

Medial Elbow pain

Numbness to ulnar (medial) two fingers

Frequently awaken at night with numbness

Persisten elbow flexion reproduce the symptoms.

LATE: Persistent numbness, weakness, and eventual atrophy

Front 14

A physical exam for Cubital Tunnel Syndrome would manifest what? x3

Back 14

1. Positive Tinel's over ulnar n.

2. Positive elbow flexion test

3. Absence of tenderness over medial epicondyle
(this is not epicondylitis)

Front 15

Treatment for Cubital Tunnel Syndrome. x4

Back 15

Avoidance

Night Splint

NSAIDs

Surgical decompression AND transposition of nerve anteriorly

Front 16

What is the most common location for degenerative arthritis in the whole body?

Back 16

Thumb

Front 17

Thumb arthritis affects what two joints specifically?

Back 17

CMC

TMC

Front 18

Thumb arthritis:

- Symptoms x3

Back 18

Pain to base of thumb

Pain to distal radial wrist

Pain to thenar

Front 19

Thumb arthritis would manifest what on the physical exam

Back 19

Positive Grind test

Positive Pinch test

Front 20

What are the NON surgical options for Thumb arthritis? x3

Back 20

Avoidance

Splint

NSAIDs

Steroids (inject into TMC)

Front 21

What are the surgical alternatives for thumb arthritis? x3

Back 21

Fusion (for younger, active pts)

LRTI

Prosthetic replacement

Front 22

What is the diagnostic tool for thumb arthritis?

Back 22

X-ray

Front 23

Scaphoid bone:

- Composition
- Vasculature

Back 23

80% cartilage

Tenuous Retrograde Vascular

Front 24

Most common wrist fracture?

Back 24

Scaphoid fx

Front 25

HPI on a scaphoid fracture would reveal what?

Back 25

Hx of forceful wrist extension

Pain to radial wrist

Tenderness to Snuff box and Distal pole.

Front 26

Treatment for Scaphoid fracture.

Back 26

Thumb spica splint

Return 2 weeks later for recheck and a reX-ray

Front 27

Mallet finger:

- etiology

Back 27

Loss of integrity of distal extensor tendon

Front 28

Mallet finger:

- HPI would reveal what? x4

Back 28

Hx of "jamming" or laceration of finger

Pain with resisted extension

Tenderness to DIP dorsum

Flexion deformity at DIP

Front 29

Treatment for Mallet finger?

Back 29

Splint DIP in extension

Front 30

Boutonniere Deformity:

- etiology

Back 30

Rupture of central slip at PIP

Front 31

Boutonniere Deformity:

- HPI would reveal what? x3

Back 31

Hx of "jamming" or laceration injury

GRADUAL formation of deformity

Elman's Test positive

Front 32

What is Elman's test?

Back 32

Hold finger over table, flexed at PIP over edge.

While securing middle phalanx, ask patient to extend finger.

Normally, the distal phalanx remains floppy.

A positive would show a hyperextension of the distal phalanx.

Front 33

Tx of Boutonniere Deformity?

Back 33

Splint in extension.

Make sure affected joint has normal PASSIVE ROM

Front 34

In treating Boutonniere Deformity, what must you be sure of?

Back 34

That the affected joint for normal PASSIVE ROM

Front 35

Carpal Tunnel Syndrome:

- etiology

Back 35

Compression of median nerve as it passes through the inexpansible carpal tunnel

AND

associated Tenosynovium

Front 36

Define tenosynovium

Back 36

Inflammation of tendon and its enveloping sheath

Front 37

HPI of carpal tunnel syndrome would indicate what? x6

Back 37

Associated with DM and hyperthyroidism

Pain to radial 3.5 digits

Exacerbated by activity

Numbness to radial 3.5 digits

Increased pain + numbness 2 - 3 hours after going to bed

Shoulder pain (70%)

Front 38

What would a physical exam indicate for Carpal Tunnel syndrome? x4

Back 38

Thenar (fasciculations, weakness, and atrophy)

Tinel's test (positive)

Digital Compression Test (positive)

Phalen's Test (positive)

Front 39

What is Phalen's test?

Back 39

Max wrist flexion (reverse pray) for 60 seconds will indicate pain, numbness, and tingling at median innervated digits for someone with carpal tunnel syndrome?

Front 40

What is the treatment for carpal tunnel syndrome? x5

Back 40

Avoidance
Splint
Surgery

NSAIDs
Steroids

Front 41

DeQuervain Tenosynovitis:

- etiology

Back 41

Inflammation of the tenosynovium at the 1st dorsal compartment (Abductor Pollicis Longus / Extensor Pollicis Longus)

Front 42

DeQuervain Tenosynovitis:

- Hx/symptoms
- Radiation
- Exacerbation

Back 42

Pain a the radial styloid

radiating proximally and distally

by activity, but later occurs all the time

Front 43

DeQuervain Tenosynovitis:

- Exam reveals what? x3

Back 43

Pain with thumb extension

Tenderness to 1st dorsal compartment

Finkelstein test Positive

Front 44

What is the Finkelstein test?

Back 44

Make fist with thumb on the inside. Tilt thumb towards ulnar.

Pain means positive.

Front 45

Treatments for DeQuervain Tenosynovitis.

Back 45

Avoidance
Splint
(Thumb spica with wrist immobilized)

Surgery

NSAIDs
Steroids

Front 46

Ganglia:

- etiology
- Hx

Back 46

Ganglion cysts (with thick fluid)

Spontaneous lump
(+/- pain)
(can pretty much appear anywhere)

Front 47

Treatment of ganglia

Back 47

Benign Neglect (PRIMARY)

Aspiration/Injection
(Recurrence high)

Excision
(Recurrence high, unless stalk also removed in which case the recurrence would be lower)

Front 48

Trigger finger:

- AKA

Back 48

Stenosing Tenosynovitis

Front 49

Trigger finger:

- etiology

Back 49

Repetitive, forceful grasping causes INFLAMMATION to:

- Flexor tendons
- Tendon sheaths
- Associated Tenosynovium

Front 50

Trigger finger:

- history x2

Back 50

Progressive pain along line of tendon in the palm

Progressive locking

Front 51

Trigger Finger:

- Exam x4

Back 51

1. Tender flexor tendon @ A1 pulley

2. Triggering with pressure over A1 pulley

3. Pain with resisted flexion of FDS tendon

4. Palpable nodule in flexor tendon

Front 52

Trigger Finger:

- Treatment

Back 52

Avoidance (sorbothane bicycle glove)

Splint

Surgery (release A1 pulley)

NSAIDs

Steroids

Front 53

Match the following with the disease:

- Piano sign

Back 53

Radial Tunnel Syndrome

Front 54

Match the following with the disease:

- Tinel's sign
- Elbow Flexion test

Back 54

Cubital Tunnel Syndrome

Front 55

Match the following with the disease:

- Grind Test
- Pinch Test

Back 55

Thumb arthritis

Front 56

Match the following with the disease:

- Elman's Test

Back 56

Boutonniere's Deformity

Front 57

Match the following with the disease:

- Thenar (fasciculation, weakness, and atrophy)
- Tinel's sign
- Digital Compression Test
- Phalen's Test

Back 57

Carpal Tunnel Syndrome

Front 58

Match the following with the disease:

- Finkelstein Test

Back 58

DeQuervain Tenosynovitis

Front 59

Match the following with the disease:

- Wrist splint

Back 59

Epicondylitis

Front 60

Match the following with the disease:

- Forearm splint

Back 60

Radial Tunnel Syndrome

Front 61

Match the following with the disease:

- Night splint

Back 61

Cubital Tunnel Syndrome

Front 62

Match the following with the disease:

- Splint finger in extension x2

Back 62

Mallet finger

Boutonniere's deformity
(make sure full, passive ROM)

Front 63

Match the following with the disease:

- Thumb spica + immobilize wrist

Back 63

DeQuervain Tenosynovitis