Y2B2B Cs- Hand/wrist/elbow Ss

Front 1

what is carpal tunnel?

Back 1

entrapment of the median nerve at the wrist

Front 2

what causes carpal tunnel?

Back 2

any condition that reduces the size or space of the carpal tunnel can cause compression of the median nerve

ie:Tenosynovitis of flexor tendons

Front 3

what are the sxs of Carpal tunnel syndrome?

Back 3

vague aching that radiates to thenar area. Paresthesias or numbness in the median distribution (thumb, index finger, long finger, and radial 1/2 of the ring finger) and sxs are often worse at night.

Front 4

what will you see on physical exam of a pt w/ carpal tunnel syndrome?

Back 4

possible thenar weakness and/or atrophy. Tinel sign.

Front 5

what is the most useful clinical test for carpal tunnel syndrome?

Back 5

phalen maneuver

Front 6

what is the most useful confirmatory test for carpal tunnel syndrome?

Back 6

electrophysiologic testing

Front 7

what is the tx for carpal tunnel syndrome?

Back 7

splinting the wrist in a neutral position, NSAIDs, ergonomic modifications, and surgery for failed nonsurgical txs

Front 8

what can dequervian tenosynovitis cause?

Back 8

pain, swelling and locking of the tendon as the pt moves the thumb.

Front 9

what test reproduces the pain that is evident in dequervian tenosynovitis?

Back 9

Finkelstein test

Front 10

what is the tx for dequervian tenosynovitis?

Back 10

thumb spica splint (to immobilize both the wrist and thumb) and NSAIDs. If everything else fails give a steroid injection and if that fails, then surgical tx.

Front 11

what is dupuytren disease?

Back 11

nodular thickening and contraction of the palmar fascia

Front 12

what would a physical exam reveal of a pt with dupuytren disease?

Back 12

palmar skin nodule, abnormal cords or bands; finger is held in contracted position

Front 13

how do you tx dupuytren disease?

Back 13

surgery

Front 14

what is felon? what is the most common cause?

Back 14

infections of the fingertip in the ulp or palmar tip of the finger. Staph Aureus

Front 15

what is paronychia? what is the most common cause?

Back 15

infection of the soft tissues directly surrounding the fingernail. Staph aureus.

Front 16

what are the sxs of felons? tx?

Back 16

sxs: severe pain and swelling in the pad of the fingertip
tx: incision and drainage

Front 17

what are the sxs of paronychia?

Back 17

swelling of the tissues around the fingertip.

Front 18

what does swelling proximal to the distal flexion crease in paronychia suggest?

Back 18

a deeper, more complex process such as infection in the flexor tendon sheath.

Front 19

how do you tx paronychia? what about late-stage paronychia?

Back 19

warm, moist soaks, oral antibiotics.
late stage paronychia: when a purulent collection is noted, drainage should be performed.

Front 20

what is herpetic whitlow characterized by? what must you distinguish this from?

Back 20

formation of vesicles filled w/ clear fluid.
important to distinguish from a felon.

Front 21

T/F

Incision of a whitlow is contraindicated

Back 21

true

Front 22

T/F

Partial lacerations of the flexor tendon may have full ROM, but they have more pain than expected.

Back 22

true

Front 23

when should you consider surgical exploration for flexor tendon injuries?

Back 23

if diagnosis is unclear

Front 24

how do you tx flexor tendon injuries?

Back 24

ensure correct diagnosis
surgical repair

Front 25

what signs of tenosynovitis would you see on a physical?

Back 25

signs of a well establish infection: 1) fusiform swelling of the finger
2) significant tenderness along the course of the tendon sheath
3) marked increase in pain on passive extension
4) a flexed position of the finger at rest

Front 26

how do you tx tenosynovitis?

Back 26

must be rapid and aggressive:

IV antibiotics and/or surgical drainage

Front 27

T/F

Ganglia of the wrist and hand are malignant

Back 27

FALSE

Benign

Front 28

what bacteria is associated with human bites?

Back 28

eikenella corrodens

Front 29

how do you tx human bites?

Back 29

cleanse, irrigate thoroughly, x-ray, DO NOT SUTURE CLOSED (wound needs to drain), antibiotics, recheck w/n 24 hrs, infections and wounds involving joint, tendon or bone should be sent to specialist.

Front 30

what are the sxs of trigger finger?

Back 30

pain and catching when flexing the finger
may feel "out of joint"
may become locked (usually temporary)

Front 31

how do you tx trigger finger?

Back 31

NSAIDs, steroid injection, surgical release.

Front 32

what will you find on a physical of a pt w/ lateral epicondylitis?

Back 32

pain over common extensor origin 1 cm distal to lateral epicondyle. Pain when lifting with the palm down.

Front 33

where does medial epicondylitis occur?

Back 33

in the flexor pronator muscles just distal to the medial epicondyle.

Front 34

what would you see on physical exam of a pt w/ medial epicondylitis?

Back 34

pain is exacerbated by pronating the forearm and flexing the wrist against resistance. These pt will have pain when lifting with the palm up.

Front 35

how do you tx epicondylitis (both medial and lateral)?

Back 35

avoid activities that cause sxs
NSAIDs

Front 36

what is the main sx of olecranon bursitis?

Back 36

swelling

Front 37

what would you find on physical exam on a pt with olecranon bursitis?

Back 37

redness and heat are not uncommon and could indicate infection

Front 38

what diagnostic measure for olecranon bursitis is both diagnostic and therapeutic? what do you do if it is due to trauma?

Back 38

aspiration

trauma: obtain xray to r/o fracture

Front 39

how do you tx olecranon bursitis?

Back 39

activity modification
NSAIDs
drainage
elbow pad during activities
compression bandage

Front 40

how do you tx septic olecranon bursitis?

Back 40

antibiotics
drainage
compression
surgical drainage and irrigation if pt doesn't respond to oral antibiotics or if a serious infection