74 Questions
What is the primary wrist stability provided by?
ligaments
What deformity is characterized by a radius fracture within 2.5 cm of the wrist with the distal radius displaced in a dorsal direction?
dinner fork deformity
What wrist injury often results from a fall with the wrist hyperextended?
wrist sprains
What is the therapy goal in managing Complex Regional Pain Syndrome (CRPS)?
Reduce swelling
What is the common pathophysiology of a scaphoid fracture?
Fractures in the proximal pole (proximal 1/3 of scaphoid) are more likely to result in non-union and avascular necrosis due to poor blood supply.
What is the characteristic mechanism of injury associated with a scaphoid fracture?
Wrist hyperextension with radial deviation.
What is the common name for Dupuytren’s contracture and what age group is it most prevalent in?
Also known as 'The Pope Sign', Dupuytren’s contracture primarily affects individuals aged 40 and older.
How is Dupuytren’s contracture typically treated?
Surgical intervention to excise the palmar fascia or perform a fasciectomy.
What is the characteristic feature of boutonniere deformity?
Flexion at the PIP joint and hyperextension at the DIP joint.
What treatment is recommended for DeQuervain's Tenosynovitis?
Wrist and thumb immobilization, modalities to decrease swelling and pain
What is a common symptom of DeQuervain's Tenosynovitis?
Pain and swelling at the radial styloid
What is the purpose of Finklestein's Test?
To diagnose DeQuervain's Tenosynovitis
How should resistance exercise be focused for DeQuervain's Tenosynovitis?
On contractions that do not produce symptoms
What is the recommended action if pain and swelling are reduced in DeQuervain's Tenosynovitis?
Begin active motion of wrist and thumb
What is the typical treatment for Mallet finger?
Splinting the DIP joint for 6 to 10 weeks in zero degrees extension
Describe the deformity that results in the Boutonniere deformity.
A rupture or stretch to the extensor tendon at the PIP joint, causing PIP flexion and DIP hyperextension.
What area of the hand is known as 'no man’s land' when it comes to tendon lacerations?
The area of palm from the distal palmar crease to the middle phalanx.
What is the characteristic presentation of Swan neck deformity?
PIP hyperextension and DIP flexion.
What is the progression from static splinting for tendon lacerations?
Dynamic splinting, allowing partial active extension and passive flexion.
What are the two joints that make up the wrist joint?
Radiocarpal and midcarpal joints
What carpal bones make up the distal part of the radiocarpal joint?
Scaphoid, lunate, and triquetrum
What type of joint is the radiocarpal joint?
Condyloid joint
Which ligament attaches to the radial styloid and trapezium and scaphoid, providing lateral support?
Radial collateral ligament
What is the common pathologies of the wrist that involves the entrapment of the median nerve?
Carpal Tunnel Syndrome (CTS)
What is the purpose of placing a distal cast proximal to the distal palmar crease?
Facilitate exercises
What is Complex Regional Pain Syndrome (CRPS) also known as?
RSD (reflex sympathetic dystrophy)
List three characteristics of Complex Regional Pain Syndrome (CRPS)
Pain, Hyperesthesia, Edema
Does the severity of the injury directly correlate with the severity of pain experienced in CRPS?
No
What is Smith’s fracture and how does it differ from a Colles Fracture?
A reverse Colles Fracture - the rigid fragment displaced in palmar direction instead of dorsal
Describe the common clinical symptoms associated with median nerve compression.
Numbness, tingling, pain in wrist, clumsiness in hand activities, weak grip, swelling, atrophy in thenar muscles
What special test involves pressing the backs of hands together to elicit a tingling response in median nerve compression?
Phalen’s test
Which test involves tapping the ventral wrist to stimulate a tingling response in the median nerve?
Tinel’s test
What is the treatment approach for managing median nerve compression?
Eliminate motions causing symptoms, splinting, corticosteroid injections, elbow and shoulder exercise, decompression surgery if necessary
What deformity is characterized by a radius fracture within 2.5 cm of the wrist with the distal radius displaced dorsally?
Boutonniere deformity
What is tested by the Digital Allen Test?
Radial and digital artery circulation recovery
What is the primary focus of exercise for a patient with median nerve compression?
Elbow and shoulder range of motion and strengthening
What surgical procedure involves cutting the transverse ligament to release pressure on the median nerve?
Decompression surgery
What is the common outcome of decompression surgery for median nerve compression?
Scarring
What is the major cause of median nerve compression?
Repetitive motion of the wrist
Match the following ligaments with their attachment sites:
Radial collateral ligament = Attaches to radial styloid and trapezium and scaphoid Ulnar collateral ligament = Attaches to ulnar styloid and pisiform and triquetrum Palmar radiocarpal ligament = Attaches to anterior ulna and radius and to the anterior surface of the proximal carpals Dorsal radiocarpal ligament = From posterior surface of the distal radius to posterior scaphoid, lunate, and triquetrum
Match the following wrist joint characteristics with their descriptions:
Radiocarpal joint = Made of distal radius and radioulnar disk proximally, and scaphoid, lunate, and triquetrum distally Midcarpal joint = Between the two rows of carpal bones, contributing to wrist motion Synovial joint = Condyloid type allowing biaxial movement Plane joint = Non-axial joint allowing plane motion
Match the following common wrist pathologies with their characteristics:
Carpal Tunnel Syndrome = Affects 4% of the entire US workforce due to entrapment of the median nerve within the carpal tunnel DeQuervain's Tenosynovitis = Characterized by pain and swelling at the base of the thumb Scaphoid Fracture = Associated with a characteristic mechanism of injury Dupuytren's Contracture = Commonly known as 'Viking disease'
Match the following deformities with their descriptions:
Boutonniere Deformity = Results from a rupture of the central slip of the extensor mechanism at the PIP joint with flexion at PIP and hyperextension at DIP Swan Neck Deformity = Characterized by hyperextension at PIP and flexion at DIP due to imbalance in intrinsic muscles Smith's Fracture Deformity = Distal radius displaced in a volar direction Colles Fracture Deformity = Distal radius displaced dorsally
Match the following terms with their explanations:
CRPS (Complex Regional Pain Syndrome) = Also known as reflex sympathetic dystrophy (RSD) or causalgia Smith's Fracture = Fracture within 2.5 cm of the wrist with distal radius displaced in a volar direction Scaphoid Fracture Pathophysiology = Associated with poor vascularity leading to high risk of non-union Dupuytren's Contracture Treatment = Surgical procedure involving fasciectomy or collagenase injection
Match the following descriptions with the correct condition: 1) Distal and midportion of the scaphoid have good blood supply, proximal pole has poor blood supply; 2) Most common carpal bone fracture due to wrist hyperextension with radial deviation
Scaphoid fracture = Scaphoid fracture Dupuytren's contracture = Dupuytren's contracture CRPS = Complex Regional Pain Syndrome Smith's fracture = Smith's fracture
Match the following clinical features with the correct condition: 1) Contracture of longitudinal bands of palmar aponeurosis; 2) Contracture primarily seen in 4th and 5th digits
Scaphoid fracture = Scaphoid fracture Dupuytren's contracture = Dupuytren's contracture CRPS = Complex Regional Pain Syndrome Smith's fracture = Smith's fracture
Match the following treatments with the correct condition: 1) Surgical intervention to excise palmar fascia or perform a fasciectomy; 2) Extended healing time up to 24 weeks
Scaphoid fracture = Scaphoid fracture Dupuytren's contracture = Dupuytren's contracture CRPS = Complex Regional Pain Syndrome Smith's fracture = Smith's fracture
Match the following mechanisms of injury with the correct condition: 1) Wrist hyperextension with radial deviation; 2) Fall resulting in wrist being hyperextended
Scaphoid fracture = Scaphoid fracture Dupuytren's contracture = Dupuytren's contracture CRPS = Complex Regional Pain Syndrome Smith's fracture = Smith's fracture
Match the following pathologies with the correct condition: 1) Involves entrapment of median nerve; 2) Commonly known as 'The Pope Sign'
Scaphoid fracture = Scaphoid fracture Dupuytren's contracture = Dupuytren's contracture CRPS = Complex Regional Pain Syndrome Smith's fracture = Smith's fracture
Match the following complications with the corresponding wrist pathology:
Non-union = Scaphoid fracture Tendon adhesions = Colles fracture Instability = Dupuytren's contracture Volkmann’s ischemic contracture = Complex Regional Pain Syndrome (CRPS)
Match the following deformities with the corresponding wrist injury:
Boutonniere deformity = Colles fracture Swan neck deformity = Scaphoid fracture Dinner Fork Deformity = Smith's fracture Dupuytren's contracture = Complex Regional Pain Syndrome (CRPS)
Match the following common outcomes with the corresponding wrist pathology:
Mal-union = Dupuytren's contracture Median nerve compression = Scaphoid fracture CRPS = Complex Regional Pain Syndrome (CRPS) Flexor tendons affected = Smith's fracture
Match the following therapy goals with the corresponding wrist condition:
Reduce swelling, maintain motion = Scaphoid fracture Non-painful exercises to maintain motion = Complex Regional Pain Syndrome (CRPS) Rigid cast and reduction if needed = Colles fracture Tape reinforcement for weak ligaments = Dupuytren's contracture
Match the following characteristics with the corresponding wrist pathology:
Most common wrist fracture = Colles fracture Known as 'no man’s land' in tendon lacerations = Scaphoid fracture Entails cutting transverse ligament for release of median nerve pressure = Dupuytren's contracture Requires gentle active ROM exercises post-removal of splint = Complex Regional Pain Syndrome (CRPS)
Match the special test with the wrist pathology it is associated with:
Phalen's Test = Carpal tunnel syndrome (CTS) Tinel's Test = Carpal tunnel syndrome (CTS) Digital Allen Test = Scaphoid fracture Finklestein's Test = DeQuervain's Tenosynovitis
Match the treatment approach with the wrist pathology it is primarily used for:
Eliminate motions that create symptoms, splinting, corticosteroid injection, exercise = Complex Regional Pain Syndrome (CRPS) Transverse ligament release surgery = Carpal tunnel syndrome (CTS) Exercise of affected limb, elbow and shoulder ROM, strengthening, splinting = Dupuytren's contracture Distal cast proximal to distal palmar crease, pain management = Scaphoid fracture
Match the deformity with the wrist pathology it is associated with:
Swan neck deformity = Dupuytren's contracture Boutonniere deformity = Complex Regional Pain Syndrome (CRPS) Dinner Fork Deformity = Scaphoid fracture Smith's fracture deformity = Smith's fracture
Match the common clinical symptoms with the wrist pathology they are associated with:
Numbness, tingling, pain in wrist, weak grip = Complex Regional Pain Syndrome (CRPS) Weak grip, swelling in hand and forearm, atrophy in thenar muscles = Dupuytren's contracture Clumsiness in hand activities, weak grip in pinch and thumb action = Scaphoid fracture Pain in wrist but can be muscular, symptoms worse at night = Carpal tunnel syndrome (CTS)
Match the ligament or joint stability with the wrist pathology it is related to:
Transverse ligament release surgery effect on stability = Carpal tunnel syndrome (CTS) Radial styloid and trapezium/scaphoid ligament attachment = Complex Regional Pain Syndrome (CRPS) Primary wrist stability provider = Scaphoid fracture Distal part of radiocarpal joint carpal bones = Dupuytren's contracture
Match the following wrist pathologies with their characteristics:
Scaphoid fracture = Pain in anatomical snuffbox, high risk of avascular necrosis Complex Regional Pain Syndrome (CRPS) = Pain, hyperesthesia, edema, discoloration, loss of motion and function Smith's fracture = Reverse Colles fracture, rigid fragment displaced palmarly Dupuytren's contracture = Progressive fibrosis of palmar fascia, finger contractures
Match the following descriptions with the appropriate wrist pathology:
Presents with pain in anatomical snuffbox and high risk of avascular necrosis = Scaphoid fracture Characterized by progressive fibrosis of palmar fascia leading to finger contractures = Dupuytren's contracture Involves pain, hyperesthesia, edema, discoloration, and loss of motion and function = Complex Regional Pain Syndrome (CRPS) A reverse Colles fracture where the rigid fragment displaces palmarly = Smith's fracture
Match the following wrist pathologies with their associated complications:
Scaphoid fracture = High risk of avascular necrosis if not treated promptly Complex Regional Pain Syndrome (CRPS) = Vasomotor response to chronic stimulus, can follow various injuries Smith's fracture = Displacement of rigid fragment in palmar direction instead of dorsal Dupuytren's contracture = Progressive fibrosis leading to finger contractures
Match the following wrist pathologies with their common clinical symptoms:
Scaphoid fracture = Pain in anatomical snuffbox region Complex Regional Pain Syndrome (CRPS) = Pain, hyperesthesia, edema, discoloration Smith's fracture = Displacement of fragment palmarly instead of dorsally Dupuytren's contracture = Palmar fascial fibrosis leading to finger contractures
Match the descriptions with the correct wrist pathology:
Involves high risk of avascular necrosis if not promptly treated = Scaphoid fracture Characterized by pain, hyperesthesia, edema, and discoloration = Complex Regional Pain Syndrome (CRPS) Shows displacement of rigid fragment in palmar direction instead of dorsal = Smith's fracture Leads to progressive fibrosis of palmar fascia and finger contractures = Dupuytren's contracture
Match the following common wrist pathologies with their characteristics:
DeQuervain's Tenosynovitis = Affects tendons of abductor pollicis longus and extensor pollicis brevis Scaphoid Fracture = Commonly results from a fall with wrist hyperextension Dupuytren's Contracture = Common outcome of decompression surgery is a limited range of motion CRPS (Complex Regional Pain Syndrome) = Managed with the therapy goal of reducing pain and improving function
Match the following deformities with their descriptions:
Boutonniere Deformity = Characterized by PIP joint flexion and DIP joint hyperextension Swan Neck Deformity = Characterized by PIP joint hyperextension and DIP joint flexion Dinner Fork Deformity = Common wrist fracture known as Colles fracture No Man's Land = Area of hand vulnerable to tendon lacerations due to poor blood supply
Match the following special tests with their purposes:
Finklestein's Test = Used to diagnose DeQuervain's Tenosynovitis Digital Allen Test = Tests for collateral circulation in the hand Tap Test = Involves tapping the ventral wrist to detect median nerve compression Distal Palmar Crease Test = Assesses tendon function post-splinting for lacerations
Match the following treatments with their corresponding pathologies:
Wrist and Thumb Immobilization = Recommended for DeQuervain's Tenosynovitis Transverse Ligament Release Surgery = Treatment for median nerve compression Modalities to Decrease Swelling and Pain = Beneficial for scaphoid fractures Therapeutic Massage to Reduce Scarring = Useful for Dupuytren's contracture
Match the following ligaments with their attachment sites:
Radioscaphocapitate Ligament = Attaches to radial styloid and scaphoid, providing lateral support Transverse Carpal Ligament = Attaches to trapezium and scaphoid, providing carpal tunnel support Dorsal Radiocarpal Ligament = Attaches to dorsal wrist, providing stability during wrist extension Palmar Ulnocarpal Ligament = Attaches to ulnar side, supporting wrist flexion
Match the following wrist pathologies with their characteristic features:
Scaphoid fracture = Commonly associated with a fall on an outstretched hand Complex Regional Pain Syndrome (CRPS) = Characterized by severe pain, swelling, and changes in skin color and temperature Smith's fracture = Distinct from Colles' fracture by the direction of distal radius displacement Dupuytren's contracture = Commonly known as 'Viking disease' and prevalent in older age groups
Match the following wrist pathologies with their typical treatment approach:
Scaphoid fracture = Often requires immobilization in a cast or surgery with internal fixation Complex Regional Pain Syndrome (CRPS) = Management involves a multidisciplinary approach including physical therapy, medications, and nerve blocks Smith's fracture = May require closed reduction and casting followed by physical therapy Dupuytren's contracture = Treatment options include needle aponeurotomy, collagenase injections, or surgical fasciectomy
Match the following wrist pathologies with their common clinical symptoms:
Scaphoid fracture = Tenderness in the anatomical snuffbox area with pain on axial loading of the thumb Complex Regional Pain Syndrome (CRPS) = Excessive pain, edema, changes in skin temperature, and abnormal hair/nail growth Smith's fracture = Pain, swelling, and limited range of motion at the wrist Dupuytren's contracture = Formation of nodules and thick cords in the palm leading to finger contractures
Match the following wrist pathologies with their recommended actions:
Scaphoid fracture = Prompt immobilization to prevent nonunion and avascular necrosis Complex Regional Pain Syndrome (CRPS) = Early diagnosis and aggressive treatment to prevent progression to irreversible changes Smith's fracture = Evaluation for associated injuries and monitoring for signs of compartment syndrome Dupuytren's contracture = Regular monitoring for disease progression and consideration of intervention based on severity
Match the following wrist pathologies with their characteristic presentations:
Scaphoid fracture = Painful snuffbox tenderness with decreased range of motion at the wrist Complex Regional Pain Syndrome (CRPS) = Severe pain disproportionate to the inciting event along with autonomic dysfunction Smith's fracture = Sudden onset of wrist pain and visible deformity on physical examination Dupuytren's contracture = 'Pitting' or 'dents' on the skin surface along with flexion contractures of fingers
Test your knowledge on Complex Regional Pain Syndrome (CRPS), its characteristics, causes, and treatment. Learn about the importance of distal cast placement and exercises in managing CRPS.
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