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128 Cards in this Set
- Front
- Back
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what is the normal ROM for pronation at the distal radio-ulnar joint? |
75-80 degrees |
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what is the normal ROM for supination at the distal radio-ulnar joint? |
75-80 degrees |
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is the distal radius convex or concave? |
concave |
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what is the normal ROM for radial deviation at the distal radio-ulnar joint? |
15-20 degrees |
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what is the convexity/concavity for the distal radio-ulnar joint? |
concave on convex |
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when mobilizing the DRUJ, in which direction do you mobilize to increase pronation |
volarly |
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what is the convexity/concavity for the radio-carpal joint? |
concave on convex |
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which carpal bones are part of the radio-carpal joint? |
scaphoid, lunate, triquetrum |
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in the radio-carpal joint, is there more flexion or extension ROM available? |
flexion |
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in the radio-carpal joint, is there more radial or ulnar deviation ROM available? |
ulnar |
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which joint bears 80% of the weight in the wrist? |
radio-carpal joint |
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what carpal bones form the distal row? |
trapezium, trapezoid, capitate, hamate |
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what is the convexity/concavity of the radial half of the midcarpal joint? |
concave on convex |
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what is the convexity/concavity of the ulnar half of the midcarpal joint? |
convex on concave |
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what is the convexity/concavity of the 1st CMC joint for flexion/extension? |
concave on convex |
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what is the convexity/concavity of the 1st CMC joint for abduction/adduction? |
convex on concave |
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what is the intrinsic + position? |
90 degrees of MCP flexion |
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what is the intrinsic - position? |
fingers in full extension |
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what is the convexity/concavity of the PIP and DIP joints of the fingers? |
concave on convex |
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what are the extrinsic ligaments of the wrist? |
radiocarpal, radioscaphoid, radioscaphocapitate, radioscapholunate |
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what are the ulnocarpal ligaments? |
ulnolunate, ulnotriquetral, TFCC |
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what are the intrinsic wrist ligaments? |
scapholunate and lunotriquetral |
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which ligament in the wrist is the most commonly injured? |
scapholunate |
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what is normal wrist extension ROM? |
70-80 degrees |
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what is normal wrist flexion ROM? |
85 degrees |
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what is normal ulnar deviation ROM? |
30-35 degrees |
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what are the primary wrist movers? |
FCR, FCU, palmaris longus |
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what nerve innervates FCR? |
median nerve |
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what nerve innervates FCU? |
ulnar nerve |
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what nerve innervates palmaris longus? |
median nerve |
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what are the secondary wrist movers? |
FDS, FDP, FPL |
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what nerve innervates FDS? |
median nerve |
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what nerve innervates FDP? |
1/2 AIN, 1/2 ulnar nerve |
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what nerve innervates FPL? |
AIN |
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what are the secondary wrist extensors? |
APL, EPL, EDC, EI, EDM |
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what nerve innervates the secondary wrist extensors? |
PIN |
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What is the normal ROM for thumb flexion at the CMC joint? |
45-50 degrees |
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What is the normal ROM for thumb abduction at the CMC joint? |
60-70 degrees |
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What is the normal ROM for thumb adduction at the CMC joint? |
30 degrees |
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What is the normal ROM for thumb extension at the MCP joint? |
0 degrees |
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What is the normal ROM for thumb flexion at the MCP joint? |
90 degrees |
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What is the normal ROM for thumb abduction at the MCP joint? |
20-30 degrees |
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What is the normal ROM for flexion at the PIP joints? |
110 degrees |
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What is the normal ROM for extension at the PIP joints? |
0 degrees |
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What is the normal ROM for extension at the DIP joints? |
0 degrees |
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What is the normal ROM for flexion at the DIP joints? |
90 degrees |
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what is thickened in a Dupuytren's contracture? |
palmar aponeurosis |
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what is the convexity/concavity of the heads of the metacarpals? |
biconvex |
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what is the volar plate? |
fibrocartilaginous plate or disc that attaches to the volar surface of the proximal aspect of the PIP and the distal aspect of the metacarpal |
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what do you injure when you "stove" your finger? |
volar plate |
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what are the extrinsic hand muscles? |
palmaris longus, FPL, APL, EPL, EPB, EI, FDS, FDP, EDC, EDM |
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are flexor or extensor tendon injuries more common? |
flexor tendon injuries because we grab onto things |
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what is a zone 1 flexor tendon injury? |
DIP |
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what is a zone 2 flexor tendon injury? |
middle phalanx-distal palmar crease |
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what is a zone 3 flexor tendon injury? |
over the carpal tunnel |
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what is a zone 4 flexor tendon injury? |
around the wrist |
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what is a zone 5 flexor tendon injury? |
forearm |
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what are the intrinsic muscles of the hand? |
APB, FPB, opponens pollicis, adductor pollicis, abductor digiti minimi brevis, flexor digiti minimi brevis, opponens digiti minimi |
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how many PADs are there? |
3 |
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how many DABs are there? |
4 |
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what are the 3 bands of the extensor expansion mechanism? |
2 lateral bands and 1 central band |
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where does the central band of the extensor expansion insert? |
base of the middle phalanx |
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where do the lateral bands of the extensor expansion insert? |
come together and insert into the distal phalanx |
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what is the purpose of the oblique retinacular ligament? |
to secure the bands to the lateral surfaces of the digit |
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what is the purpose of the transverse retinacular ligament? |
connects lateral band from one side of the digit to the lateral and on the other side of the digit |
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what causes mallet finger and what does it do? |
loss of active DIP extension because the terminal band has been avulsed |
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what causes swan neck deformity and what does it do? |
oblique retinacular ligament is destroyed, causes dorsal displacement of the lateral bands, which causes hyperextension of the PIPs and flexion at the DIPs |
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what causes boutonniere deformity and what does it do? |
loss of the central tendon and transverse retinacular ligament, causes the lateral bands to slide volarly and results in flexion of the PIPs and DIPs in hyperextension |
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what condition occurs in the wrist with a high radial nerve lesion? |
drop wrist (cannot extend at all) |
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what occurs in the wrist/hand with a median nerve lesion? |
Ape/Simian hand (thenar eminence starts to atrophy) |
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what occurs in the wrist/hand with an ulnar nerve lesion just proximal to the wrist? |
claw hand |
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what special test can you use to check the blood supply to that hand? |
Allen's test |
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when should you begin strengthening exercises post-fracture? |
12 weeks |
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what tendons make up the radial border of the snuffbox? |
EPB & APL |
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what is the position for Finkelstein's test? |
thumb flexion, grab thumb, and ulnar deviation |
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what is Finkelstein's test testing for? |
DeQuervain's tenosynovitis |
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what is Watson's test looking for? |
scapholunate ligament instability |
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Tenderness when palpating the lunate may be an indicator of what? |
Kienbock's disease (avascular necrosis of the lunate) |
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what is the piano key test looking for? |
DRUJ instability |
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how do you perform the piano key test? |
key grip the distal ulna and move it dorsally and volarly in different positions of pronation and supination |
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where is the triangular fibrocartilage complex located? |
distal to the DRUJ, between the ulna and the triquetrum |
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how do you perform the TFCC load test? |
ulnarly deviate the wrist, then move it dorsally and volarly |
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what does the TFCC test look for? |
TFCC tear or ulnocarpal abutment |
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what does Phalen's test look for? |
median nerve entrapment (Carpal tunnel) |
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how do you perform Phalen's test? |
passive wrist flexion for 15-60sec |
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how many weeks post-op can you begin PREs with someone who had a Dupuytren's contracture? |
4-6 weeks |
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what is the most superficial structure in the carpal tunnel? |
median nerve |
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what structure is directly outside the carpal tunnel? |
palmaris longus |
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how long should you immobilize a distal radius fracture? |
6-8 weeks |
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what is the most common FOOSH injury? |
Colle's fracture (dorsal displacement of the distal radius) |
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what are the contents of the carpal tunnel? |
all finger flexors, flexor carpi radialis, median nerve |
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to which zone do the most flexor tendon injuries occur? |
zone 2 |
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when can you start AROM/PROM with someone with DeQuervain's syndrome? |
1 week |
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how long are people with metacarpal fractures immobilized in the intrinsic plus position? |
3-6 weeks |
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how soon should you being ROM in someone who just had surgery for a Dupuytren's contracture? |
2-3 days post op |
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what are the borders of the carpal tunnel? |
proximal: scaphoid and pisiform, distal: trapezium and hook of hamate, hood: flexor retinaculum |
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in what population are Colle's fractures most common? |
elderly because of OA |
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what is a Smith fracture? |
volar displacement of the radius (opposite of Colle's fracture) |
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do you apply resistance in a joint with RA? |
no |
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Are Herberden's nodes in OA at the PIP or DIP? |
DIP |
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Are Bouchard's nodes in OA at the PIP or DIP? |
PIP |
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is conservative or surgical treatment more common for mallet finger? |
conservative treatment |
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which carpal is the second most commonly fractured? |
triquetrum |
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what is the most frequently injured carpal bone? |
scaphoid |
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where is the blood supply to the scaphoid located? |
distal to proximal |
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where do fractures usually occur in the scaphoid? |
at the waist or proximal pole (no blood supply here - take a long time to heal) |
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what characterizes complex regional pain syndrome? |
disproportionate pain level |
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what are the two types of complex regional pain syndrome? |
type I: RSD - nerve without injury type II: causalgia - with nerve injury |
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what are signs and symptoms of complex regional pain syndrome? |
[ain, trophic changes, autonomic instability, sensory abnormalities, bony changes |
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what does Bunnell's test look for? |
intrinsic tightness |
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what occurs in the wrist/hand with an ulnar nerve lesion at the elbow? |
ulnar paradox (less clawing than a more distal lesion) |
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what are the most common symptoms of thoracic outlet syndrome? |
neurological - parathesias along C8-T1 distribution |
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what are the differential diagnoses for thoracic outlet syndrome? |
cervical disc lesions, cubital tunnel syndrome, lung tumors, RSD |
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how do you test for thoracic outlet syndrome using ROOS/EAST? |
goalpost arms, make fists for 3 min (+ test is if people bring their arms down bc they are fatigued) |
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how do you test for thoracic outlet syndrome using Adson's maneuver? |
extend and laterally rotate arm, bring head towards the arm to compress the interscalene triangle and hold for 1-2min (check for reproduction of symptoms) |
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how do you test for thoracic outlet syndrome using costoclavicular test? |
aka military brace test, shoulder blades back, chest out, pull shoulder blades, then check radial pulse |
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how do you test for thoracic outlet syndrome using Wright's maneuver? |
arm up by the head and elevate, check radial pulse |
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what does the suprascapular nerve innervate? |
supraspinatus and infraspinatus |
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what can a suprascapular nerve entrapment be confused for? |
rotator cuff tear |
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what are the two possibilities of suprascapular nerve entrapment? |
traction injury or compression injury |
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what is the main symptom of suprascapular nerve entrapment? |
poorly localized to the posterior/lateral aspect of the shoulder |
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what is the main symptom of axillary nerve entrapment? |
poorly localized pain increased with abduction/external rotation, pins & needles lateral shoulder and upper posterior arm |
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what are the borders of the quadrangular space? |
lateral - neck of the humerus, medial - long head triceps, top - teres minor, bottom - teres major |
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what nerve entrapment is quadrilateral space syndrome? |
axillary |
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where do you experience a limitation in long thoracic nerve palsy? |
abduction, and elevation above horizontal |
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what occurs with trapezius paralysis? |
shoulder drooping, severe limitations with shoulder elevation, asymmetry of neck line, prognosis dependent upon etiology |
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in which nerve stretch are the wrist/thumb/fingers extended? |
median nerve stretch |
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in which nerve stretch are the wrist/thumb/fingers flexed? |
radial nerve stretch |
