MSK_Wrist-Hand_ALL

Home > Preview

The flashcards below were created by user Tanuisha on FreezingBlue Flashcards.


  1. ROM - Wrist
    • Flexion - 80
    • Extension - 70
    • Radial deviation - 20
    • Ulnar deviation - 30
  2. ROM - 2-5 MCP - flexion; hyperextension
    • Flexion - 90
    • Hyperextension - 45
  3. ROM - 2-5 PIP - flexion; hyperextension
    • Flexion - 100
    • Hyperextension - 45
  4. ROM - 2-5 DIP - flexion; hyperextension
    • Flexion - 90
    • Hyperextension - 10ish
  5. ROM - thumb - MCP flexion; IP flexion
    • MCP flexion - 50
    • IP flexion - 80
  6. Radiocarpal joint articulates what w/what?
    • Convex scaphoid & lunate articulate w/concave radius
    • Ulna is convex at its distal end relative to triquetrum
  7. Wrist flexion/extension is predominantly at what joint?
    • Flexion - mid carpal jt
    • Extension - Radiocarpal jt
  8. What range of wrist is needed for optimal use of hand?
    Wrist extension of 20°-30°
  9. Distal aspect of proximal row is ______ at lunate/capitate & triquetrum/hamate articu­lations
    Concave
  10. Scaphoid is _______ anterior/posterior & ______ medial/lateral relative to trape­zium/trapezoid
    • Convex
    • Concave
  11. Capitate is ____, & articu­lates w/concavities of what carpal bones?
    • Convex
    • Scaphoid - inferiorly
    • Hamate - medially
    • Trapezoid - laterally
  12. Radiocarpal joint - Resting position
    Neutral w/slight ulnar deviation
  13. Distal radioulnar jt - Closed-packed position for 2
    • Extension
    • Radial deviation
  14. Proximal carpals lateral to medial
    • Scaphoid
    • Lunate
    • Triquetrium
    • Pisiform
    • Image Upload
  15. Distal carpals from lateral to medial
    • Trapezium
    • Trapezoid
    • Capitate
    • Hamate
    • Image Upload
  16. Which bone is most frequently fractured carpal bone? Why?
    • Scaphoid
    • Poor blood supply - frequently develops avascular necrosis during healing
  17. Anterior dislocation of lunate - can compress what nn against flexor retinaculum?
    Median
  18. Volar plate is present on what aspect of MCP, PIP, DIP joints? Does what?
    • Palmar
    • INC articular surface during extension & protect joint volarly
  19. Collateral ligament - which fibers tighten w/flexion/extension
    • Flexion - all fibers
    • Extension - Volar fibers
  20. Transverse ligament - present at what jts? Provide reinforcement to capsule how?
    • MCP
    • Anterior
  21. 1st CMC - concave/convex
    • flex/ext
    • ABD/ADD
    • Flex/Ext = Concave moving on convex
    • ABD/ADD = Convex moving on concave
  22. Which muscle holds the wrist in extension?
    Extensor carpi radialis brevis
  23. MMs - functional power vs fine control
    • Functional power - Extrinsic muscles
    • Fine control - Intrinsics
  24. W/RA pts what splint is used & describe?
    • Intrinsic plus splint
    • Image Upload
    • Flex @ MPs/ Ext @ PIP/DIP
  25. Carpal Tunnel Syndrome - S/S + if splinting is needed what position?
    • Sensory changes aggravated by prolonged use of hand - Worst at night
    • Onset - Insidious; 40-60
    • Weakness in pinch
    • Seen w/RA, DM, pregnancy
    • Long-term compression causes atrophy/weakness of thenar mms & lateral 2 lumbricals
    • Splinting - Wrist in neutral - wrist flat/fingers relaxed & slightly curved
  26. De Quervain's tenosynovitis - 7
    • Pain at anatomical snuffbox
    • Tenderness to palpation over radial styloid
    • Swelling
    • Weak thumb ABD
    • DEC grip & pinch strength
    • Tendons affected - EPB, ABD pollicis longus 
    • Complication of swelling during pregnancy
  27. Image UploadWhat deformity is pictured?
    • Dupuyten’s Contracture
    • Painless fibrosis of palmar aponeurosis - Palmar nodule or contracture
    • Diabetic - contracture of 3rd, 4th digits
    • Non-diabetic - contracture of 4th, 5th MCP & PIP
    • Inability to extend digits
  28. Image UploadWhat deformity is pictured?
    • Buttonier’s deformity
    • Rupture of central tendinous slip of extensor hood
    • Extension of MCP/DIP w/flexion of PIP
    • RA pts
  29. Image UploadWhat deformity is pictured?
    • Swan neck deformity
    • Contracture of intrinsic muscles w/dorsal subluxation of lateral extensor tendons
    • Flex MCP & DIP/Hyperextension PIP
    • Onset - trauma; RA
    • PT - Splinted in slight flexion
  30. Image UploadWhat deformity is pictured? 2 names; what lig is torn; pain INC w? what type of instability? PT
    • “Gamekeeper’s thumb” + “Skier’s thumb” 
    • Injury of ulnar collateral ligament of thumb MCP 
    • Pain INC w/PINCH GRASP
    • Results in medial instability of thumb
    • PT - immobilization for 6 wks
  31. Image UploadWhat deformity is pictured? another name; mechanism of injury; how is radius displaced? complications; PT
    • Colles' fracture - “Dinner fork” deformity
    • Extension fx of radius - Fall on an outstretched hand
    • Distal fragment of radius dislocated in dorsal (posterior) direction
    • Complications - DEC grip strength, carpal tunnel syndrome, CPRS
    • PT - immobilized for 5-8 weeks
  32. Image UploadWhat deformity is pictured? another name; mechanism of injury; how is radius displaced? complications; PT
    • Smith’s fracture - "Garden spade" deformity
    • Flexion fx of radius - falling onto FLEXED wrist 
    • Distal fragment of radius dislocated in VOLAR direction
    • PT - immobilized for 5-8 weeks
  33. Scaphoid fracture - mechanism of injury; immobilization for how long?
    • FOOSH (fall onto outstretched hand) in younger person
    • PT - immobilized for 4-8 weeks
  34. Image UploadWhat deformity is pictured? describe; PT initial vs later
    • Boxer's fracture
    • Fx of neck of 5th metacarpal
    • Sustained during a fight, or from punching a wall
    • PT initial - 2-4 weeks in cast
    • PT later - Strengthening initiated when flexibility is restored
  35. Image UploadWhat deformity is pictured?
    • Mallet finger
    • Rupture or avulsion of extensor tendon at its insertion into distal phalanx of digit
    • Deformity - Flexion of DIP joint
    • Trauma - forcing distal phalanx into a flexed position
  36. Kienbock's Disease - S/S - 5
    • Blood supply to lunate is interrupted
    • Onset - trauma
    • Wrist pain
    • Pain INC by wrist flexion/extension
    • Lunate tender to palpation
    • Progressive limitation of wrist motion
  37. Image UploadName test; what is tested? describe; (+)
    • Finkelstein's test
    • de Quervain's disease - 1st dorsal compartment tenosynovitis
    • MMs - ABD pollicis longus &/or extensor pollicis brevis
    • Pt makes fist w/thumb inside
    • PT passively moves fist into ulnar deviation
    • (+) Pain in wrist
  38. Image UploadName test; what is tested? describe; (+)
    • Bunnel-Littler Test
    • Differentiates between tightness @ MCP jts - capsule or intrinsic mms
    • MCP in slight extension & PIP joint is flexed
    • MCP in flexion & PIP joint is flexed
    • (+) Capsule tightness = If flexion @ PIP is limited in both cases
    • (+) Intrinsic mm tightness = If flexion @ PIP is limited more w/MCP flexion
  39. Name test; What is tested? describe; (+)
    • Image Upload
    • Tight retinacular test
    • Differentiates bet tightness @ PIP jt - capsule or retinacular ligaments
    • PIP stabilized in neutral --> DIP is flexed
    • PIP is flexed & DIP is flexed
    • (+) Capsule tightness = flexion limited in both cases
    • (+) Ligament tightness = more DIP flexion w/PIP flexion
  40. Image UploadName test; what is tested? describe; (+)
    • Phalen's test
    • Identifies carpal tunnel compression of median nn
    • Pt maximally flexes both wrists holding them against each other for 1 minute
    • (+) tingling and/or paresthesia into hand following median nn distribution
  41. Image UploadName test; what is tested? describe; (+)
    • Allen 's test
    • Identifies vascular compromise
    • Find radial & ulnar arteries at wrist
    • Pt open/closes fingers quickly several times & then make a closed fist
    • PT occludes artery & have patient open hand
    • Release compression on artery & observe for vascular filling
    • (+) Will present by abnormal filling of blood within hand during test
    • Under normal circumstances, there is a change in color from white to normal appearance on palm of hand
  42. Image UploadName test; what is tested? describe; (+)
    • Watson’s tests
    • Scaphoid-lunate instability
    • Palpate at bottom of thumb
    • Ulnar deviation
  43. Image UploadName test; what is tested? describe; (+)
    • Murphy test
    • Dislocation of lunate
    • Pt makes fist
    • (+) 3rd MCP is level
  44. Convex/Concave - what glide to INC radiocarplal
    • Flexion
    • Extension
    • Radial deviation
    • Ulnar deviation

    • Flexion = dorsal
    • Extension = volar
    • Radial deviation = ulnar glide
    • Ulnar deviation =radial glide
  45. W/all - Convex on concave
  46. CMC of thumb - INC flexion/extension what glide?
    • Flexion - Ulnar
    • Extension - radial

    w/flex/ext - concave on convex
  47. CMC of thumb - INC ABD/ADD what glide?
    • ABD = Dorsal
    • ADD = Volar

    w/ABD/ADD - convex on concave
  48. MCP/IP - INC flexion/ext what glide?
    • Flexion = Volar
    • Extension = Dorsal

    Convex on concave
  49. To INC wrist flexion - radius on what carpal bones & in what direction? - 4
    • Radius volar on scaphoid/lunate
    • Trapezium-trapezoid volar on scaphoid
    • Lunate volar on capitate
    • Triquetrium voler on hamate
  50. Finger tendon repair - PT starts when? why? what type?
    • Within a few days after surgery
    • To preserve tendon gliding - PROM & AAROM (promote collagen remodeling & allow free tendon gliding)
  51. Damage to posterior interosseous nn - impairment
    Wrist extension - primarily controlled by posterior interosseous nn (branch of radial nn)

Card Set Information

Author:
Tanuisha
ID:
324456
Filename:
MSK_Wrist-Hand_ALL
Updated:
2017-01-23 17:07:33
Tags:
MSK Wrist Hand ALL
Folders:
MSK
Description:
MSK_Wrist-Hand_ALL
Show Answers:

Home > Flashcards > Print Preview