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1 Hand & Wrist Exam
Terms in this set (27)
What is the mnemonic for the carpal bones?
Where do we start on the hand using this?
Some Lovers Try Positions That They Can't Handle
- thumb side, then back to thumb side moving distally!
What other exams should be considered if there is an upper extremity problem?
1. Neck exam
2. Neuro exam
If there are any changes upon inspection, what should be noted?
- symmetry! Compare both side always
Where are nodes of Arthritis most commonly seen?
- Heberden's & Bouchard's
Where are Heberden's Nodes?
- DIP joints
Where are Bouchard's nodes?
- PIP joints
"close to Body"
What are the 3 finger joint problems?
1. Mallet Finger
2. Swan neck
What causes Mallet finger?
- a rupture of extensor tendon DIP joint
What causes Swan neck?
- Hyperextension of PIP & flexion of DIP
What causes Boutonniere?
Flexion of PIP & hyperextension of DIP
Etiology of Swann neck and Boutonniere:
RA- most common!
Laxity/ rupture of ligaments
Untreated Mallet Finger
Trigger Finger is when:
What sound can you hear & when?
-> a painless nodule forms on the flexor tendon
-> slide through sheath
-> "Pop" as tendon slips through sheath
Dupuytren's Contracture is a:
-> Thickened nodule → thickened fibrotic cord of flexor tendon → limits extension
What is a ganglion?
- Synovial fluid trapped in a cystic cavity
What is Thenar atrophy? What nerve would this indicate a problem with?
- Base of thumb has flattening eminence
- Median nerve
What bone is most likely diseased if pain in "snuff box"?
- Scaphoid fracture suspected
What is the floor of the anatomical snuffbox?
Which nerve runs through this?
What vessel runs through this?
- Scaphoid & trapezium
- Superficial branch of radial nerve
- radial artery
What is Hypothenar atrophy? What nerve issue can cause this?
- Base of pinky has wasting of eminence
- Ulnar nerve
What nerve innervates the palmer 1st 3 fingers and the 2nd and 3rd dorsal fingers?
- the median nerve
What nerve innervates the palmar and dorsal 4th and 5th fingers?
- the ulnar nerve
What nerve innervates the dorsal 1st and 2nd fingers?
- radial nerve
What muscles does the Finkelstein test (DeQuervain's tendonitis) stretch?
1. Abductor pollicis brevis
2. Extensor pollicis brevis
What does Allen's test for?
What is a normal time frame?
- to evaluate patency of radial & ulnar arteries before blood draw or line placement
< 3 - 5 seconds
What is Gamekeeper's or Skier's Thumb?
- a strain or tear in the ulnar collateral ligament
What does Froment's sign test for?
- suggests adductor pollicis weakness and/or ulnar nerve palsy
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