CHAPTER 15: wrist and forearm

Paronychia

A fungal/bacterial infection in the folds of the skin surrounding a finger or toenail

Intersection Syndrome

A tendonitis or friction tendonitis in the first and second dorsal compartments of the wrist

When the proximal phalanx is overstretched, injury to the ___________ on the palmar surface of the joint should be suspected? A. Volar Plate B. Radial Collateral Ligament C. DIP joint D. Ulnar Collateral Ligament E. Profundus tendon

A. Volar Plate

Poor blood supply to the anatomical snuffbox increases the risk of ___________ to this area. A. aseptic necrosis B. ulnar palsy C. Smith fractures D. lunate dislocations E. neurological deficits

A. aseptic necrosis

de Quervain's Tenosynovitis

An inflammatory stenosing tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons

Kinebock's Disease

Avascular necrosis of the lunate often seen in young athletes, thought to be caused by repetitive trauma or an unrecognized lunate

Specialized Connective Tissue That forms protective patthways through tendons, nerves, and blood vessels pass is called A. Carpal Tunnel B. Retinacula C. Stenosing Tunnels D. Tendinous Tunnels E. Tunneloses

B. Retinacula

Ganglion Cysts

Benign tumor mass commonly seen on the dorsal aspect of the wrist

To ensure the most complete healing of a dislocated PIP joint, the finger should be splinted in about 30 degrees of flexion with active motion starting after A. 1 to 3 days B. 4 to 7 days C. 10 to 14 days D. 15 to 35 days E. 14 to 21 days

C. 10 to 14 days

A softball catcher is complaining of swelling over the hypothenar eninence and numbness into the small finger. What structures might be injured? A. Musculocutaneous Nerve B. Carpal Tunnel C. Ulnar Nerve D. Radial Nerve E. Median Nerve

C. Ulnar Nerve

Bowler's Thumb

Compression of the digital nerve on the medial aspect of the thumb leading to paresthesia in the thumb

Carpal Tunnel Syndrome

Compression of the median nerve as it passes through the carpal tunnel leading to pain and tingling in the hand

Trigger Finger

Condition whereby the finger flexors contract but are unable to re-extend due to a nodule within the tendon sheath or the sheath being too constricted to allow free motion

Possible complications of the forearm fracture are muscle spasms, swelling or arterial damage that inhibits blood flow to the wrist or hand. This complication is known as A. Colles' fracture B. Trigger finger C. Bowler's Syndrome D. Volkmann's Contracture E. Compartment Syndrome

D. Volkmann's Contracture

_____________ strength is often limited during carpal tunnel syndrome. A. grip B. pinch C. wrist extension D. grip and pinch E. wrist extension and grip

D. grip and pinch

Tapping sign over the transverse ligament tests for A. Arterial impingememnt B. Tenosynovitis of flexor tendons C. de Quervain's Disease D. Ganglion Cyst E. Carpal Tunnel Syndrome

E. Carpal Tunnel Syndrome

Gloves used in cycling, rowing, and weight lifting are used to: A. decrease direct compression forces B. decrease friction to the dorsal surface C. decrease tensile forces D. cushion the dorsum of the hand E. add padding to the palmar surface

E. add padding to the palmar surface

In what position should the wrist be held if maximum grip strength us desired? A. Radial deviation and slight hyperextension B. Ulnar deviation and slight hyperextension C. Radial deviation and flexion D. Ulnar deviation and flexion E. Ulnar deviation and extension

E. ulnar deviation and extension

True or False? A mallet finger is usually splinted in full flexion for 6-8 weeks.

False

True or False? Tearing the radial ligament of the thumb is often a result when the MP joint is forcefully abducted away from the hand.

False

True or False? Tensile loading on the proximal palm during a fall on an outstretched hand is the leading cause of wrist sprains.

False

True or False? The closed pack position of the proximal interphalangeal joint and the distal interphalangeal joint is full flexion.

False

Coach's Finger

Fixed flexion deformity of the finger resulting from dislocation of the PIP joint

Colles' Fracture

Fracture of distal metaphysic of the radius, with displacement of the distal fragment dorsally

Boxer's Fracture

Fracture of the fifth metacarpal resulting in a flexion deformity due to rotation of the head of the metacarpal over the neck

Bennett's Fracture

Fracture-dislocation to the proximal end of the first metacarpal at the carpal-metacarpal joint

Subungual Hematoma

Hematoma beneath a finger or toenail

Boutonniere Deformity

Rupture of the central slip of the extensor tendon at the middle phalanx, resulting in no active extensor mechanism at the PIP joint

Mallet Finger

Rupture of the extesnsor tendon from the distal phalanx due to forceful flexion of the phalanx

Jersey Finger

Rupture of the flexor digitorum profundus tendon from the distal phalanx due to rapid extension of the finger while it is actively flexed

Cyclist's Palsy

Seen when bikers lean on the handlebar for an extended period of time resulting in paresthesia in the ulnar nerve distribution

Describe: Carpal Tunnel Compression Test

Tests for: carpal tunnel syndrome The examiner pushes the carpals together to check for any pain or numbness

Describe: Phalen's Test

Tests for: median or ulnar nerve compression Place the back of the hands together at maximum flexion and hold for 1 minute

Describe: Froment's Sign

Tests for: paralysis in the adductor pollicis Hold a piece of paper between the thumb and the pointer finger while the examiner tries to pull it away; avoid flexing the thumb while holding the paper

Describe: Finkelstein's Test

Tests for: tenosynovitis Grip the thumb within the hands; with arms straight out to the side, move hands into ulnar deviation

Describe: Valgus Stress Test of the Thumb

Tests the ligamentous structures of the thumb Push thumb laterally on the MCP and IP joint

Aseptic Necrosis

The death or decay of tissue due to a poor blood supply in the area

True or False? Hammer exercises are used to strengthen radial and ulnar deviation.

True

True or False? Individuals who sustain multiple severe traumas to the palmar aspect of the hand are at risk of developing trigger finger.

True

True or False? Most wrist motion occurs at the radiocarpal joint.

True

True or False? The Allen's test is used to determine function of the radial and ulnar arteries.

True

True or False? The baseball grip is an example of a precision grip.

True

True or False? The hand is a very superficial structure and, as a resile of this, contusions must always be assessed for possible fractures.

True