Term
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Definition
Distal Carpal row, IF and MF metacarpals |
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Term
Mobile Arches of the Hand Unit 1 |
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Definition
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Term
Mobile Arches of the Hand Unit 2 |
|
Definition
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Term
Mobile Arches of the Unit 3 |
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Definition
MF, RF, SF phalanges, RF and SF metacarpals |
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Term
Causes of Ulnar Nerve palsy creates what condition of the Mobile Arches? |
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Definition
Mobile Arches are flattened because ulnar extensors overpower the intrinsics |
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Term
What type of Joint is the Distal Radial Ulnar Joint |
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Definition
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|
Term
The main Stabilizer of the Radial Ulnar Joint |
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Definition
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Term
Resting Position of the Radial Ulnar Joint |
|
Definition
Neutral with Slight ulnar deviation |
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Term
Close-packed position of Radial Ulnar Joint |
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Definition
Forearm Supinated approx 5 deg |
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Term
Capsular Pattern of the Radial Ulnar Joint |
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Definition
Equal Restrictions of Flexion and extension |
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Term
Functions of the Radial Ulnar Joint |
|
Definition
Transmits loads from hand to forearm |
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Term
Joint Surfaces of the Radial Carpal joint |
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Definition
Convex side: Lunate, scaphoid and TFCC. Concave Side: Radius |
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Term
Resting Position of the Radial Carpal Joint |
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Definition
Neutral with slight ulnar deviation |
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Term
Close-Packed Position of the radio-carpal joint |
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Definition
extension with Radial Deviation |
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Term
Capsular Pattern of the Radio Carpal Joint |
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Definition
Equal restriction in all directions |
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|
Term
|
Definition
Fibrocartilaginous disk between medial and proximal row and ulna |
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Term
Functions of the TFCC Complex (3) |
|
Definition
1. Enhances joint congruity
2. Cushions ag compressive F
3. Separates distal ulna from direct contact with the carpals but allows gliding betwen the carpals, disk and ulna during P/S |
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|
Term
Proximal Row of Midcarpal Joints is Laterally and medially |
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Definition
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|
Term
Approximately % of wrist Flexion and 34% of wrist occur at the midcarpal joint |
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Definition
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Term
What is Resting Position for the MCP and IP ? |
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Definition
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Term
What is the Close-Pack position of the MCP? |
|
Definition
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|
Term
What is the Close Pack position of the IP? |
|
Definition
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|
Term
What is the capsular pattern of the MCP and IP? |
|
Definition
Greater Limitation of flexion than extension; restriction in all directions |
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|
Term
No motion of the MCP joints when the digits are at the MCP joints because the collateral ligament are tight |
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Definition
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|
Term
The Trapezium is general from palmar to dorsal and from medial to lateral |
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Definition
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Term
What are the functions of Pulleys (2) |
|
Definition
1. Prevent bowstringing
2. Promote efficiency in flexion |
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|
Term
How many Transverse annular ligaments are there? |
|
Definition
|
|
Term
There are 3 Ligaments in the IP |
|
Definition
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|
Term
What Flexor tendon Zone is from A1 to to Flexor Digitorum Superficialis ? |
|
Definition
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|
Term
What are the land marks for Flexor tendon zone 1? |
|
Definition
Between insertion of flexor digitorum superficials and flexor digitorum profundus |
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Term
What are the landmarks for flexor tendon zone 3? |
|
Definition
Flexor rentinaculum to the A1 pulley |
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|
Term
What flexor tendon zone is from the Forearm to the distal wrist crease? |
|
Definition
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Term
What zone is associated with the Carpal Tunnel? |
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Definition
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Term
What is the functional position of the hand? (2) |
|
Definition
1. Extended 20 degrees
2. Ulnar Deviation 10 degrees |
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Term
What are the functional position of the (1) MP (2) PIP and (3) DIP |
|
Definition
1. flexed 45 degrees
2. flexed 30-45 degrees
3. 10-20 degrees |
|
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Term
What are the Functional position of the thumb? (3) |
|
Definition
1. 1st CMC partially abducted and Opposed
2. MP joint flexed 10 degree
3. IP joint flexed 5 degree |
|
|
Term
What are the 3 prehension grips ? |
|
Definition
1. Pinch
2. Palmar (holding a Pencil)
3. Lateral (holding a key) |
|
|
Term
What are the 3 power grips? |
|
Definition
1. Cylindrical
2. Spherical
3. Hook |
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|
Term
What is the most common compartment for compartment syndrome? |
|
Definition
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|
Term
What is the causes of compartment syndrome? (2) |
|
Definition
1. an increase in tissue pressure with in a closed osteofascial compartment which compromises blood flow to the muscles and nerves with in the compartment
2. begins when tissue pressure is greater than venous pressure and impair s blood outflow |
|
|
Term
What problems are associated with compartment syndrome? |
|
Definition
1) lack of oxygenated blood and lack of waste removal leading to pain and decresed nerve sensation
2) absence of distal pulse
3) hypoesthesia
4) extremity paresis |
|
|
Term
What are some possible etiologies of compartment syndrome? (7) |
|
Definition
1)External Compartment resriction
2) Tight splints, casts, dressings
3) Burns
4) Tight fascial closure during ORIF
5) Malfunctioning sequential pressure devices
6) Postoperative hematoma /muscle edema
7) Trauma producing hematoma/edema |
|
|
Term
What are signs and sx of compartment Syndrome? (6) |
|
Definition
1)Crescendo pain
2) Pain with passive stretch of fingers (most reliable sign)
3) Paresthesia (not Reliable)
4) diminished or absent pulse
5) pallor
6) Porkiness |
|
|
Term
What are possible treatments of compartment syndrome? (2) |
|
Definition
1) Bivalve or removal of casts, dressings, ect
2) early faciotomy if pressure remains
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|
|
Term
What are the causes of a Volkmann's Ischemic Contracture? |
|
Definition
1) Untreated compartment syndrome
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|
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Term
What are the main symptoms of Volkmann's Ischemic Contracture? (3) |
|
Definition
1)Prolonged muscle ischemia results in necrosis which leads to scarring and contracture
2) Rhabdomyolysis
3) Renal Failure |
|
|
Term
What are signs for Chronic Forearm Compartment Syndrome? |
|
Definition
1) Bilateral Sypmtoms
2) Pain may be reproduced at specific workload or time interval
3) Swollen and tender compartments shortly after activity
4) Symptoms tend to resolve after an hour of ceasing activity |
|
|
Term
What is anatomical problem causing carpal tunnel syndrome? |
|
Definition
Ischemic compression of median n. with in the carpal tunnel |
|
|
Term
What are signs and symptoms of carpal tunnel syndrome? (5) |
|
Definition
1) Spontaneous onset
2) Gradually increasing pain at night
3) Pain radiating to forearm, elbow and shoulder
4) Numbness/tingle along median n. distribution
4) Sense of weakness of hand
5) Thenar atrophy
|
|
|
Term
What are treatments of Carpal Tunnel Syndrome? (7) |
|
Definition
1) Eliminate Cause
2) NSAIDS
3) Injections
4) Splinting
5) Stretching
6) Neural Glides
7) Surgical Release |
|
|
Term
Cause of ulnar tunnel syndrome? (2) |
|
Definition
1)Entrapment at Guyon's canal
2) resulting from pressure of tumor, ganglia, constricting bands of muscle or thrombosis of ulnar artery
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|
|
Term
What are signs and features of ulnar tunnel syndrome? (2) |
|
Definition
1) pain or numbness along ulnar border
2) Claw Hand |
|
|
Term
Who has a high incidence of ulnar tunnel syndrome? |
|
Definition
|
|
Term
What test can be used for ulnar tunnel syndrome? (2) |
|
Definition
|
|
Term
What are treatments for Ulnar Tunnel Syndrome? |
|
Definition
1) Splinting
2) avoidance
3) Neural Glides
4) surgical |
|
|
Term
What is the Mechanism of Injury for a TFCC lesion? (2) |
|
Definition
1) Fall on out stretched hand (supinated)
2) chronic or repetitive rotational loading |
|
|
Term
What is the main complaint of a pt with a TFCC lesion? |
|
Definition
Medial wrist pain just distal to ulna, with an increase at end range pronation/supination and forceful gripping
|
|
|
Term
What are signs of TFCC lesions? (4) |
|
Definition
1) Painful Clicking
2) Tenderness localized to dorsal anatomical depression
3) Painful crepitus in posterior mobilization of carpal condyle against head of ulna in ulnar deviation
4) Pain in passive supination combined with ulnar deviation |
|
|
Term
What are treatments of TFCC lesions? (2) |
|
Definition
1) Conservative
2) Surgical |
|
|
Term
What is game keepers Thumb? |
|
Definition
Instability of the thumb due to injury of the UCL |
|
|
Term
What are the causes of game Keepers thumb? (2) |
|
Definition
1) valgus force on an abducted thumb
2) RA can cause ligament laxity |
|
|
Term
Who is susceptible to gamekeepers thumb? |
|
Definition
Snow Skiers. Caused by the Ski pole |
|
|
Term
What are signs of gamekeepers thumb? |
|
Definition
1)pain and swelling in the ulnar aspect of the thumb
2) Laxity on the valgus stress test
3) Decreased ROM |
|
|
Term
What is the treatment for Gamekeepers thumb? |
|
Definition
1) Grade 1 and 2 are non surgical
2) Grade 3 are surgical |
|
|
Term
What is the most Common joint disease? |
|
Definition
|
|
Term
Where is primary OA commonly found? |
|
Definition
1st CMC and scaphotrapeziotrapezoid joint |
|
|
Term
In what population does primary OA affect? |
|
Definition
|
|
Term
Where is the Heberden's node found? |
|
Definition
|
|
Term
What node is usually found in the PIP |
|
Definition
|
|
Term
What are the Characteristics of RA? (5) |
|
Definition
1) Pain
2) stiffness
3) Joint damage
4) Instability
5) deformity |
|
|
Term
What are common hand deformities caused by RA? |
|
Definition
1) Ulnar Drift
2) Boutonnier Deformity
3) Swan Neck |
|
|
Term
What are treatments for RA? (5) |
|
Definition
1) Control Inflamation
2) Exercise to maintain strength
3) Joint protection
4) Splinting
5) Pain Management |
|
|
Term
What is Dupreytren's Contracture? |
|
Definition
Palmer disease, causing contractures leading to flexion deformities of hand and fingers |
|
|
Term
Dupreytren's Contracture usually affect side of hand. |
|
Definition
|
|
Term
What is the most common treatment of Dupreytren's? |
|
Definition
|
|
Term
What are associated risk factors for Dupreytren's Contracture? (4) |
|
Definition
1) race
2) Sex (males 7-15x higher incidence)
3) Alcohol consumption
4) Smoking |
|
|
Term
Where can a ganglion ST lesion be found? (2) |
|
Definition
1) Adjacent to a joint or tendon sheath.
2) on dorsum of wrist in radiocarpal region |
|
|
Term
What are the symptoms of a Ganglion? |
|
Definition
Pain and feeling of weakness |
|
|
Term
What causes Posterior Interosseous Nerve Compression? |
|
Definition
Dorsal Ganglions arising from the scapholunate ligament places pressure on the nerve. |
|
|
Term
What is Dequervain's Disease? |
|
Definition
Stenosing tenosynovitis of abductor policisis longus and extensor policisis brevis |
|
|
Term
What are symptoms of Dequervain's Disease? (4) |
|
Definition
1) Pain over APL/EPB with ulnar deviation and flexion and adduction of the thumb
2) crepitation and triggering
3) Palpable thickening of extensor sheath
4) Positive Finkelstein's test |
|
|
Term
What are treatments foe dequervain's disease? (3) |
|
Definition
1) NSAIDS/ Steroid Injection
2) Immobilization for 3 weeks
3) Surgical Release
|
|
|
Term
|
Definition
Painful Snapping of fingers or thumbs due to disproportion between flexor tendon and tendon sheath |
|
|
Term
Where does trigger finger occur? (2) |
|
Definition
1) metacarpal head
2) A1 pulley |
|
|
Term
What are the treatments for trigger finger? (4) |
|
Definition
1) Injection
2) MP flexion block splint for involved digit
3) Surgical release |
|
|
Term
What is the common mechanism of injury for flexor tendon injury? |
|
Definition
|
|
Term
% of Flexor tendon injuries occur in ______ __. |
|
Definition
|
|
Term
What can failure of repair of a partial flexor tendon injury cause? (2) |
|
Definition
1) triggering
2) delayed rupture |
|
|
Term
|
Definition
|
|
Term
What is the Mechanism of injury for mallet finger? |
|
Definition
|
|
Term
What is the MOI of Jersey finger? |
|
Definition
Forceful extension leading to Flexor digitorum profundus rupture |
|
|
Term
What finger is most involved in Jersey finger? |
|
Definition
|
|
Term
What is a symptom of jersey finger? |
|
Definition
unable to perform flexion at affected DIP |
|
|
Term
What is the treatment for jersey finger? |
|
Definition
Surgery within 10 day of rupture |
|
|
Term
What is the MOI for volar plate injuries? |
|
Definition
Landing on outstretched hand with the wrist extended, forces finger into hyper extension |
|
|
Term
What are the signs and symptoms of volar plate injuries? (5) |
|
Definition
1) pain
2) Swelling
3) volar bruising under the IP
4) LOM
5) Weakness |
|
|
Term
What are the treatments for Volar plate injuries? (3) |
|
Definition
1) Price
2) Splinting
3) Surgery if avulsed |
|
|
Term
What are common causes of infections of the hand? (6) |
|
Definition
1) human bites
2) Anima Bites
3) IV drug use
4) Myobacterial
5) viruses
6) pyogenic granuloma |
|
|
Term
What are types of hand infections? (4) |
|
Definition
1) Superficial spreading
2) Subcutaneous abcess
3) synovial sheath
4) Fascial space |
|
|
Term
What is Kienbock's disease? |
|
Definition
Aseptic necrosis of the lunate |
|
|
Term
What are symptoms of Kienbock's disease? |
|
Definition
1) Pain on central dorsal aspect of wrist esp after activity
2) stiffness
3) LOM
4) decreased strength |
|
|
Term
What joint is most commonly associated with intercarpal instability? |
|
Definition
|
|
Term
What is the MOI of Intercarpal Instability? |
|
Definition
|
|
Term
What are the problems associated with Intercarpal Instability? |
|
Definition
1) weakness with grasping
2) Chronic wrist pain |
|
|
Term
What is a common nondissociative problem associated with Intercarpal Instability? |
|
Definition
Dynamic Wrist Instability |
|
|
Term
What is the most common wrist injury? |
|
Definition
|
|
Term
What is the MOI of Distal Radial fracture |
|
Definition
|
|
Term
Younger pt tend to sustain radial fracture, older pt tend to radial fracture |
|
Definition
1) intrarticular
2) extraarticular |
|
|
Term
What is a Colle's Fracture |
|
Definition
Complete fracture of the distal radius with dorsal displacement of distal fragment |
|
|
Term
What is the MOI of Colle's Fracture |
|
Definition
|
|
Term
What type of deformity is associated with Colle's Fracture? |
|
Definition
|
|
Term
What is a Smith Fracture? |
|
Definition
Complete fracture of distal radius with palmar displacement of distal fragment |
|
|
Term
What is the MOI for a Smith Fracture? |
|
Definition
Fall on the back of flexed hand |
|
|
Term
What is the treatment for a Smith fracture? |
|
Definition
1) closed reduction
2) casting in supination for 3 wks |
|
|
Term
What is a Chauffer's Fracture? |
|
Definition
Strong radiocarpal ligament avulse radial styloid from metaphysis of radius. |
|
|
Term
What is the MOI of a Chauffer's Fracture |
|
Definition
Tension forces sustained during ulnar deviation and supination |
|
|
Term
What is the MOI of a Scaphoid fracture? |
|
Definition
FOOSH with wrist pronated |
|
|
Term
What does the pt usually complain of with a scaphoid fracture? (2) |
|
Definition
1) Dorsal Wrist Pain
2) tenderness over anatomical snuff box |
|
|
Term
What is a clinical test for Scaphoid Fracture? |
|
Definition
axial compression of thumb |
|
|
Term
What is a Bennett's Fracture? |
|
Definition
Intraarticular Fracture of the base of the 1st metacarpal with involvement of the CMC joint |
|
|
Term
What is the MOI of a Bennett's Fracture |
|
Definition
Axial loading of partially flexed thumb |
|
|
Term
What are symptoms of a Bennett's Fracture? (3) |
|
Definition
1) extreme pain at base of thumb
2) tenderness
3) swelling |
|
|
Term
What are the treatments of a Bennett's Fracture? (3) |
|
Definition
1) Closed Reduction
2) Thumb Spica
3) internal fixation |
|
|
Term
What are the indications of Proximal Row Carpectomy? (5) |
|
Definition
1) Advance scapholunate dissociation
2) Extension instability
3) Nonunion of scaphoid with carpal instability
4) Failed silicone lunate implant arthroplasty
5) Keinbock's Disease |
|
|
Term
What are the symptoms of Complex Regional Pain Syndrome Type 1? |
|
Definition
1) Pain triggered by noxious event , not limited to a single peripheral nerve
2) edema
3) stiffness
4) skin temperature change
5) sweating |
|
|
Term
What are the symptoms of Complex Regional Pain Syndrome Type 2? (5)
|
|
Definition
1) Pain syndrome that involves direct partial or complete injury to a nerve or its major branches
2) Edema
3) Stiffness
4) Skin temperature change
5) sweating |
|
|
Term
What are the symptoms of Complex Regional Pain syndrome type 1 at stage 1? (5) |
|
Definition
1) Limb is flushed
2) warm and dry
3) Stimulation of sweat glands is reduced
4) Edema
5) increased nail and hair growth |
|
|
Term
What is the starting symptom of Complex Regional Pain Syndrome Type 1 Stage 1? |
|
Definition
Acute inflammatory Phase ( 10 day to 3 mos) |
|
|
Term
Describe the pain associated with CRPS 1 Stage 1. (4) |
|
Definition
1) Diffuse
2) throbbing
3) Burning
4) Aching |
|
|
Term
What symptoms are associated with the end of CRPS 1 Stage 1? |
|
Definition
1) limb turns cold
2) Sweaty
3) cyanotic from vasoconstriction caused by paradoxical sympathetic stimulation |
|
|
Term
How long does CRPS 1 stage 2 last for? |
|
Definition
|
|
Term
How is the limb temperature affected in CRPS 1 Stage 2 ? |
|
Definition
|
|
Term
What are the signs of the integumentary system with CRPS 1 stage 2? (4) |
|
Definition
1) pale
2)Mottled
3) edematous
4) sweaty |
|
|
Term
what type of pain is associated with CRPS 1 stage 2? (3) |
|
Definition
1) Continuous
2) Burning
3) throbbing |
|
|
Term
In CRPS 1 Stage 2 why is limb movement limited? (2) |
|
Definition
1) Muscle Wasting
2) Joint Stiffness |
|
|
Term
CRPS 1 Stage 3 is characterized by damage to muscle and . |
|
Definition
1) Irreversible
2) joints |
|
|
Term
CRPS 1 Stage 3 causes the bones to become and joints become and . |
|
Definition
1) atrophy
2) weak
3) Stiff |
|
|
Term
How is the skin affected by CRPS 1 stage 3? (4) |
|
Definition
1) cool
2) glossy
3) pale
4) cyanotic |
|
|