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52 Cards in this Set

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  • Back
What is the most common cause of flexor tendon injuries?
What is the most common cause of extensor tendon injuries?
laceration and blunt trauma such as a mallet finger
How can you tell if a flexor tendon injury is deep or superficial?
PIP joint is superficial, DIP joint is deep
Explain why extensor tendons are the ones most commonly injured
extensor tendons have a superficial nature on the dorsum of the hand.
What gets injured more often; flexor or extensor tendons?
Discuss what should be examined with a flexor or extensor injury
PE: devascularization, skin status, posture of fingers, deformities, bleeding, grip strength, compare bilaterally, nerve testing, tendon testing, x-rays and consult.
Discuss the management of flexor and extensor injuries
treat anything with neurovascular compromise ASAP. Control px and swelling. NPO if surgery. Consult prn. immobilize
Define the term Mallet finger, MOI, tx and consequences of not treating
Zone 1 extensor tendon injury of distal phalanx and DIP. MOI: sharp or blunt trauma. Most common injury in athletes. tx: splint DIP in extension or hyper extension. If 25% refer. Consequences: necrosis
What are the 2 most common types of injuries with PIP dislocations
lateral involving the radial collateral ligament and dorsal involving the volar plate.
What is the treatment for PIP injuries
splint at 30* flexion for 3 weeks. However, if not reduceable, may need surgery.
What should you do prior to reducing any fracture?
Get an x-ray! 2 views; AP and always get a lateral
List 2 terms referring to a ruptured thumb metacarpal-phalangeal ligament and discuss how they are evaluated and treated
Gamekeepers or skier's thumb. Check for weakness of pincer function and point tenderness at volar-ulnar aspect of thumb MCP joint. Surgery recommended.
What kind of injuries are a gamekeeper's or skier's thumb?
ulnar collateral ligament injuries
How are distal phalynx fractures classified? MOI? Tx?
tuft (nailbed) shaft or intraarticular MOI: crush or shearing Tx: tx as a soft tissue injury
Mallet finger
What kind of injury is this?
Discuss MOI of distal phalanx injuries, and Tx
MOI: crush or shearing which may involve nailbed lacerations. Tx: protective splinting
Discuss Tx of proximal and middle phalange injurues
Stable: buddy tape. Unstable: closed reduction, splint from elbow to DIP with wrist at 20* extension and MP joint in 90* flexion or surgery
What is a boxer's fracture? MOI? Tx?
fracture of the 5th metacarpal NECK. MOI: direct impact force. Tx: closed reduction and splint/cast with wrist dorsiflexion of 20* and MCP @90*'s
Describe a paronychia, MOI, Tx
infection of lateral nail fold or perionychium. MOI: biting, manicures or hangnails. Tx: warm soaks, abx, I&D
Describe a felon, pathogen, and Tx
infection of the pulp of tip of finger. presents red, swollen, painful. staph, I&D on lateral aspect of finger.
List the 4 cardinal signs of flexor tenosynovitis
slight flexion, swelling, tenderness over flexor tendon sheath, pain on passive extension
What is the most common ligamentous injury to the wrist
scapholunate ligament injuries
What is the MOI for scapholunate ligament injuries? Tx?
fall on outstretched extremity. Tx: Don says orthopedic referral / surgery. Book says gutter splint or short arm volar posterior mold
What 3 radiographic signs help to diagnose scapholunate ligament injuries
1. Terry Thomas sign: widening of joint space mor than 3mm 2. Grip-compression or motion study 3. Dorsal intercalated segment instability (DISI)
Describe the PE, MOI, Tx and complications for scaphoid fractures
PE: px in snuffbox. Most occur in middle 1/3 of scaphoid. MOI: fall on outstretched. Tx: splint dorsiflexion, radial deviation. Unstable long arm spica and refer. Consequences: avascular necrosis
What is a colles fracture? MOI? PE? Tx?
fx of distal radius with displacement / angulation. MOI: fall outstretched. PE: dinner-fork deformity, palmar paresthesias, tension on median nerve. Tx: reduce splint, unstable surgery
What is a Smith's fracture
reverse colles fx. produces a garden-spade deformity but angulation is volar rather than dorsal!
What is a type I supracondylar fracture?
What is a type II supracondylar fracture?
displaced nad have cortical contact.
What is a type III supracondylar fracture?
subdivided into posterolateral and posteromedial fx's based on displacement and have no cortical contact.
What age is more at risk for supracondylar fractures?
children from a fall off swings or jungle gyms
Name the 2 kinds of supracondylar fractures and Tx
Extension (most common) and Flexion. Tx: Don says refer! Book says non-displaced splint long arm cast 4-6 wks, displaced surgery
What important signs should you look for on plain films with a supracondylar fracture
fat pad sign in undisplaced fx
Describe MOI, PE and Tx for radial head fractures
MOI: fall on outstretched. PE: radiocapitellar line; radial head should always face capitellum. XR show abnormal fat pad. Tx: nondisplaced splint. displaced surgery
What is the most common kind of elbow fracture
radial head fracture
Describe MOI, PE, and Tx of proximal biceps rupture
MOI: repetitive microtrauma and overuse. PE: snap heard, swelling, tender, crpitus over bicipital groove, arm "ball" Tx: sling, ice, analgesics, referral
Describe MOI, Tx for radius and ulna fractures
MOI: high impact MVC. Tx: nondisplaced rare! tx with plaster immobilization. Refer quickly
Identify the 2 major nerves that can be injured in a forearm fracture
Radial and ulnar
How would you evaluate the radial nerve for potential injury from ulnar/radial fracture
have pt extend both the wrist and fingers against resistance. Sensation is tested over the dorsum of the thumb index web space
How would you evaluate the ulnar nerve for potential injury from ulnar/radial fracture
ability to abduct index finger against resistance and 2-point discrimination over the tip of the little finger
Describe MOI, PE, Tx and typcial patient for a proximal humerus fracture
PT: elderly female with osteoporosis MOI: fall on outstretched PE: px, swelling, ecchymosis Tx: sling, analgesics
Discuss the MOI and treatment of humeral shaft fractures
bimodal age distribution in 30's & 70's. MOI: direct blow resulting in transverse fx. Torsion forces results in oblique fx sometimes with comminution. Tx: coaption splint, sling
What is the most common MOI of clavicular injury for any patient?
Blow to shoulder
What is the most common part of clavical to sustain a fracture? Tx?
80% middle 1/3 of clavicle. Immobilize with sling, dispaced with figure 8. Severely displaced shoulder spica or open reduction.
Describe MOI, PE and associated injuries with scapular fractures
MOI: high energy, MVC's. PE: tenderness over scapula, flattened appearance. Associated: lung, shoulder, humeral head, girdle, rib, abd, spine
Identify the MOI, PE, and Tx for an AC joint injury
MOI: trauma with arm adducted. PE: tenderness, deformity. Tx: rest, ice, analgesics, immobilization
What is a more common injury - anterior or posterior shoulder dislocation?
What is MOI, PE and complications of anterior shoulder dislocations
MOI: abduction and external rotation. PE: px, squared off. Complications: recurrent dislocations
What is the MOI for posterior shoulder dislocations
Adduction and internally rotated, flat and posterior aspect appears full, coracoid process prominent
What nerve is at risk for injury with anterior shoulder dislocations
axillary nerve
What nerve is at risk with a lateral elbow injury