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19 Cards in this Set

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anatomic snuff box
comprised of extensor pollicis longus and extensor pollicis brevis
-“contains” scaphoid bone
When examining the DIP's and PIP's look for
- Hebernon’s or Brouchard’s
Phalen’s Test
completely flex each wrist and hold the dorsal surface of each hand together in front of the patient for approximately 60 seconds. Reproduction of pain and or tingling along the median nerve distribution represents a positive Phalen’s sign. A positive Phalen’s sign is indicative of carpal tunnel syndrome.
Tinel's Test
percussing over the anterior surface of the patient’s distal wrist and the proximal hand over the median nerve at the carpel tunnel. Reproduction of pain and or tingling along the median nerve distribution which could include part of the hand, digits one, two, three and half of four represents a positive Tinel’s sign. A positive Tinel’s is indicative of carpal tunnel syndrome
Carpal tunnel syndrome
- pain and numbness
- weakened grip strength
- pain along distribution of median nerve
- eliminate source of syndrome (repetitive action)
- splinting wrist can help
- NSAIDS, steriod, surgical release
Ganglion Cyst
- collection of synovial fluid within a joint or tendon sheath
- tender, pain with movement, edema
- often on dorsal and volar wrist, flexor surface of MCP joint
- cyst aspiration, steroid injection, surgical excision (not common)
Dupuytren's Contracture
- dz of palmar fasica w/ progressive contracture that leads to deformity
- genetic, DM, epilepsy, liver disease are causes
- usually painless, often in fourth digit
- surgical tx w/ a true contraction, stretching before
colles's fx
- most common fx of wrist
- fall on outstretched hand
- fx of distal radius
- x-ray
- apply longitudinal traction, and other stuff too
- cast
Smith's fx
- reverse colle's fx
- articular fragment can be present
- x-ray
-
Scaphoid fx
- carpal bone is prone to fx.
- blood to scaphoid enters distal portion
- must fix to avoid avascular necrosis
- FOOSH
- Tenderness and swelling in ANATOMICAL SNUFFBOX
- Xray, bone scan
- FX MAY NOT BE VISIBLE FOR 2-4 WEEKS
- must do repeat xray
Bennetts Fx
- fx dislocation that occurs at the carpometacarpal joint of the thumb
- usually from punching
- usually dislocated proximally
- must reduce open with internal fixation if displacement greater than 3mm
Boxer's fx
- punch
- 5th metacarpal
- look for fight bite
- x ray
- surgery cast
Trigger finger
Stenosign tenosynovitis
- tenosynovitis develops in flexor sheaths of fingers and thumb
- can become nodular
- will hear painful snap on extension
- may lock in flexion over time
- steriod injection
- surgery
Mallet finger
- avulsion of insertion of extensor tendon @ base of distal phalanx
- active extension is lost
- tenderness and swelling over posterior surface of the DIP
- if no fx - immobilize in slight hyperextension
- if fx and unstable - surgery
Boutonniere deformity
- laceration over the joint that involves central slip
- rheumatoid arthritis
- can manifest acutely w/ trauma
- usually progressive arthritis
- splint
- surgery
Central Plate injuries
- central slip inserts at the base of middle phalanx and is main PIP extensor
- Hx- laceration, forced flexion with PIP i extension
Volar plate injuries
- hyperextension injury, may involve piece of bone avulsed off middle phalanx
- volar plate normally prevents hyperextension
- damaged in subluxation an dislocations
PIP dislocations
- most common ligamentous injury of the hand
- axial load and hyperextension
- tx- digital nerve block and reduction
Gamekeepers thumb (skiier's thumb)
- forced abduction injury
- rupture of the ulnar collateral ligament with radieal deviation of the MP joint