Study Carpal Tunnel Syndrome Flash Cards

 
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Carpal Tunnel Syndrome

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True/False

Extensor tendons are thinner than flexor tendons?
TRUE
True/False

Extensor injuries are LESS common then flexor because they are more superficial
FALSE

EXTENSOR INJURIES ARE MORE COMMON BECAUSE THEY ARE MORE SUPERFICIAL
Dupuytren's disease?
-PROGRESSIVE FIBROSIS OF PALMER APONEUROSIS
-MAINLY MEN OVER 40
-ETOH, EPILEPSY, GOUT
-PAINLESS
-PRODUCES A FIXED FLEXION CONTRACTURE OF ONE OR MORE DIGITS
Tx for a mallet finger?
SPLINT IN SLIGHT EXTENSION FOR 8 WEEKS
Innability to actively extend the DIP joint?
MALLET FINGER
Avulsion Fx?
TENDON PULLS FROM THE BONE

(DELTOID LIGAMENT PULLS PART OF MEDIAL MALLEOLUS OFF)
What is the tx goal of RA?
DECREASE PAIN
True/False

About two million Americans have RA, and most of them are women?
TRUE
What is rheumatoid arthritis?
A CHRONIC, OR LONG TERM, INFLAMMATORY FORM OF ARTHRITIS
(AUTOIMMUNE)
Clinical signs of boutonniere deformity?
-FLEXION OF PIP
-HYPER EXTENSION OF DIP
A partial tear from skier's thumb will result in immobilization for?
6 WEEKS
Signs and symptoms of skier's thumb?
-SWELLING AND TENDERNESS OVER ULNAR ASPECT
-PAIN WITH VALGUS STRESS
-PARTIAL TEAR: 6 WEEKS IMMOBILIZATION
-COMPLETE TEARS USUALLY REQUIRE SURGERY
Skier's thumb?
SPRAIN IN THE ULNAR COLLATERAL LIGAMENT OF 1ST MCP JOINT
Sprain in the ulnar collateral ligament is AKA?
SKIER'S THUMB
Tx for a Bennett's fx?
-SURGERY AND IMMOBILIZATION FOR 2-3 WEEKS
-REHAB TO REGAIN ROM AND STRENGTH
MOI of a Bennett's fx?
PUNCH OR FALL ON ABDUCTED THUMB
Location of a Bennett's fx?
BASE OF 1ST METACARPAL
Myotomes?
MUSCLES INNERVATED BY A SPECIFIC NERVE ROOT
Dermatomes?
SKIN INNERVATED BY A SPECIFIC NERVE
What tx is given to someone with ulnar nerve compression?
-SPLINT
-NSAIDS
-CHANGE GRIP
Where is parasthesia felt with ulnar nerve compression?
5TH AND ULNAR SIDE OF 4TH FINGER
Where is the Guyon's canal located?
BETWEEN THE PISIFORM AND HAMATE
What will surgeons do to relieve pressure in the carpal tunnel?
CUT THE TRANSVERSE CARPAL LIGAMENT
Volar?
ANTERIOR/PALMAR
Tx of choice for carpal tunnel?
CONSERVATIVE TX
-SPLINT
-NSAIDS
-SURGERY
Extrensic flexors?
CROSS THE WRIST JOINT (FDS, FDP)
Contraindicaitons after immobilization of a scaphoid fx?
PASSIVE STRETCHING/MOBILIZATION EXERCISES
What is probably the most clinical feature to determine a scaphoid fx?
PAIN IN THE ANATOMICAL SNUFF BOX
MOI for scaphoid fx's?
WRIST HYPEREXTENSION WITH ULNAR DEVIATION
What is unige about a scaphoid fx?
- RAY IS OFTEN NORMAL
-BONE SCAN AFTER 48 HOURS
This fx will show a loss of grip strength?
SCAPHOID FX
This fx will have minimal pain and will be tender over the anatomical snuff box?
SCAPHOID FX
MOI of a scaphoid fx?
FALL ON OUTSTREATCHED HAND
Who are colles' fx's most common in?
MIDDLE AGED AND ELDERLY WOMEN
Tx for a colles' fx?
-COLSED REDUCTION ORIF OR EXT FIXATION
-6 WEEKS ARM PLASTER
-REHAB GEARED AT REGAINING FULL ROM
This fx will have a dinner fork deformity?
COLLES' FX
When does rehabilitation begin after a colles' fx?
IMMEDIATELY, DURING IMMOBILIZATION
MOI of a colles' fx?
FALL ON AN OUTSTREATCHED ARM
Colles' fx is a fx of what bone?
DISTAL RADIUS (DORSAL DIRECTION)
What is the most common wrist fracture?
COLLE' FX
What structures are irritiated with De Quervian's Tenosynovitis?
INFLAMMATION OF THE ABDUCTOR POLLICIS LONGUS AND EXTENSOR POLLICIS BREVIS
When does the moderate protection phase begin with flexor tendon injuries?
BEGINS AT 4 WEEKS AND CAN LAST UP TO 8 WEEKS POST OP
If a dynamic splint is worn during the day, what can be worn at night?
STATIC DORSAL BLOCKING SPLINT
What is of utmost importance after hand surgery?
PATIENT EDUCATION
What is the rationale for early controlled motion after tendon repair?
-DECREASES POSTOPERATIVE EDEMA
-MAINTAINS TENDON-GLIDING
-DECREASES FORMATION OF ADHESIONS
-INCREASES SYNOVIAL FLUID DIFFUSION
-INCREASES WOUND MATURATION
-DECREASES GAP FORMATION (SPACE BETWEEN THE TENDON)
-Worn exclusively for exercise sessions
-No dynamic traction with elastic bands
-Allows full wrist flexion and limited (approx 30 degrees) wrist extention, but maintains the MCP joints in at least 60 degrees of flexion and IP joints in full extension when the straps are secured.
-
DORSAL TENDONESIS SPLINT WITH WRIST HINGE
-Allows early motion of the operated joint while the hand is in the splint
-At rest, the elastic band provides dynamic traction that holds the operated finger in flexion
-Allows active extention of the IP joints to the surface of the dorsal splint
-While the PIP and DIP extensor relax, the tension from the elastic band pulls on the finger, causing passive flexion
DORSAL BLOCKING SPLINT WITH DYNAMIC TRACTION
-Restricts wrist and MCP extention
-worn during early phases of rehabilitation
-Removed/loosened for early exercises
-Worn as a protective night splint?
STATIC DORSAL BLOCKING SPLINT
After being post op for 10 days. What motions should you limit in that time period after CTS surgery?
AVOID ACTIVE WRIST FLEXION PAST NEUTRAL AS WELL AS ACTIVE FINGER FLEXION WITH WRIST FLEXED
What are two common impairments associated with CTS?
-SENSORY LOSS
-MOTOR WEAKNESS
In non operative patients, what position is the wrist splinted in?
NEUTRAL
About 10% of the population does not possess this muscle?
PALMARIS LONGUS
Phalen's test and tinel sign are performed to test for what nerve?
MEDIAN NERVE
What are the special tests for CTS?
-PHALEN'S TEST
-TINEL SIGN
Where is parasthesia felt with CTS?
FIRST 3.5 FINGERS (RADIAL SIDE OF 4TH FINGER)
Where is pain felt in CTS?
ANTERIOR (VOLAR) WRIST
What components pass through the carpal tunnel?
-FDL
-FDS
-PALMARIS LONGUS
-MEDIAN NERVE
What nerve is affected by carpal tunnel syndrome?
MEDIAN NERVE
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