Podcast
Questions and Answers
Which of the following is a common cause of wrist and hand osteoarthritis?
Which of the following is a common cause of wrist and hand osteoarthritis?
Which of the following is a conservative treatment for wrist and hand osteoarthritis?
Which of the following is a conservative treatment for wrist and hand osteoarthritis?
Which joints are more commonly affected by osteoarthritis of the hand?
Which joints are more commonly affected by osteoarthritis of the hand?
What is the typical range of motion restriction after surgical intervention for wrist osteoarthritis?
What is the typical range of motion restriction after surgical intervention for wrist osteoarthritis?
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Which of the following is considered the treatment of choice for patients with significant carpal degeneration?
Which of the following is considered the treatment of choice for patients with significant carpal degeneration?
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Which structure does NOT contribute to the roof of the cubital tunnel?
Which structure does NOT contribute to the roof of the cubital tunnel?
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Which of the following is a characteristic sign of a distal ulnar nerve lesion?
Which of the following is a characteristic sign of a distal ulnar nerve lesion?
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The ulnar nerve originates from which cord of the brachial plexus?
The ulnar nerve originates from which cord of the brachial plexus?
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A patient presents with weakness in finger adduction and abduction, as well as sensory loss on the medial side of the hand. Which nerve is most likely involved?
A patient presents with weakness in finger adduction and abduction, as well as sensory loss on the medial side of the hand. Which nerve is most likely involved?
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Which of the following best describes the motor innervation of the flexor carpi ulnaris (FCU) by the ulnar nerve?
Which of the following best describes the motor innervation of the flexor carpi ulnaris (FCU) by the ulnar nerve?
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Which test is used to assess the distal median nerve?
Which test is used to assess the distal median nerve?
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If a patient experiences numbness and tingling in the distribution of the median nerve during testing, which of the following tests would be considered positive?
If a patient experiences numbness and tingling in the distribution of the median nerve during testing, which of the following tests would be considered positive?
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Which test involves the therapist attempting to supinate a patient's forearm while the patient is resisting the motion?
Which test involves the therapist attempting to supinate a patient's forearm while the patient is resisting the motion?
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What anatomical structure does the Scaphoid shift test primarily assess?
What anatomical structure does the Scaphoid shift test primarily assess?
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A positive result for the Finklestein's test is indicated by:
A positive result for the Finklestein's test is indicated by:
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During the Scaphoid shift test, where should the therapist place their thumb?
During the Scaphoid shift test, where should the therapist place their thumb?
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Which test involves passively pressing the palmar sides of the hands together at chest height?
Which test involves passively pressing the palmar sides of the hands together at chest height?
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In the Pronator teres syndrome test, what action is the therapist resisting while the patient is in a pronated position?
In the Pronator teres syndrome test, what action is the therapist resisting while the patient is in a pronated position?
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Which test involves ulnarly deviating and axially loading the patient's wrist, then moving it volarly and dorsally?
Which test involves ulnarly deviating and axially loading the patient's wrist, then moving it volarly and dorsally?
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What is the primary purpose of the Piano keys test?
What is the primary purpose of the Piano keys test?
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Tapping four to six times over a nerve to check for nerve impairment symptoms is the procedure for which test?
Tapping four to six times over a nerve to check for nerve impairment symptoms is the procedure for which test?
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Which of these conditions is most common in athletes and involves inflammation of the tenosynovium of the first dorsal compartment tendons?
Which of these conditions is most common in athletes and involves inflammation of the tenosynovium of the first dorsal compartment tendons?
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Which condition is characterized by a rupture of the EPL tendon at Lister's tubercle, often as a delayed complication of a distal radial fracture?
Which condition is characterized by a rupture of the EPL tendon at Lister's tubercle, often as a delayed complication of a distal radial fracture?
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What is the primary cause of 'DeQuervian's Tenosynovitis'?
What is the primary cause of 'DeQuervian's Tenosynovitis'?
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Which of the following can be used to check for a fracture, according to the content provided?
Which of the following can be used to check for a fracture, according to the content provided?
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Which of the following conditions commonly occurs in mothers who pick up their children?
Which of the following conditions commonly occurs in mothers who pick up their children?
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Which of the following is the MOST common mechanism of injury for a scaphoid fracture?
Which of the following is the MOST common mechanism of injury for a scaphoid fracture?
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A patient presents with severe pain upon passive stretching of their muscles after a fracture. What does this symptom most strongly suggest?
A patient presents with severe pain upon passive stretching of their muscles after a fracture. What does this symptom most strongly suggest?
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Which of the following fractures is characterized by a fracture of the distal radius with dorsal displacement?
Which of the following fractures is characterized by a fracture of the distal radius with dorsal displacement?
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What specific anatomical finding is most indicative of a scaphoid fracture upon physical examination?
What specific anatomical finding is most indicative of a scaphoid fracture upon physical examination?
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A 'Boxer's fracture' typically involves which specific bone?
A 'Boxer's fracture' typically involves which specific bone?
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Which of the following fractures involves an intra-articular fracture of the first metacarpal combined with dislocation and subluxation?
Which of the following fractures involves an intra-articular fracture of the first metacarpal combined with dislocation and subluxation?
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Immobilization is immediately necessary for which type of fracture because of the risk to a major nerve and artery?
Immobilization is immediately necessary for which type of fracture because of the risk to a major nerve and artery?
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According to the information given, which of the following can be a sign of a potential neurological injury after a fracture?
According to the information given, which of the following can be a sign of a potential neurological injury after a fracture?
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Which type of fracture involves an oblique break of the radial styloid process?
Which type of fracture involves an oblique break of the radial styloid process?
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Which injury is characterized by a fracture of the radius's distal to the middle-third, associated with DRUJ dislocation?
Which injury is characterized by a fracture of the radius's distal to the middle-third, associated with DRUJ dislocation?
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A fracture at the distal end of the radius often due to a fall onto a flexed wrist is known as a:
A fracture at the distal end of the radius often due to a fall onto a flexed wrist is known as a:
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What is the most common carpal bone to fracture?
What is the most common carpal bone to fracture?
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What position is a splint typically applied for 3-6 weeks for a triquetrum fracture?
What position is a splint typically applied for 3-6 weeks for a triquetrum fracture?
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What is the recommended initial stage of physical therapy after fracture?
What is the recommended initial stage of physical therapy after fracture?
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Which muscles' tendons may endure compression in the carpal tunnel?
Which muscles' tendons may endure compression in the carpal tunnel?
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What are the extensor expansion deformities that may occur as a result of lateral band injury?
What are the extensor expansion deformities that may occur as a result of lateral band injury?
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Study Notes
Wrist/Hand Exam
- History: Includes precipitating incident, activity, date of onset, location, intensity and duration of symptoms, activities that aggravate or relieve symptoms, and previous treatment. Also includes reports of dropping objects or shaking hands improving symptoms, previous treatment results, and impact of symptoms on daily life activities and work.
Observation
- Swelling: Assess for the presence of swelling, nodules, and masses; observe for erythema, abrasions, and incisions
- AROM and PROM: Measure active and passive range of motion bilaterally.
- Muscle atrophy: Observe for muscle atrophy, especially in the thenar eminence, which may be indicative of prolonged carpal tunnel syndrome.
- Note pain, location, timing, and comparison with other side.
Palpation
- Bony and soft tissue: Palpate all carpal bones, particularly the scaphoid (often injured). Examine for tenderness, crepitus, clicks, and clunks of instabilities, and compare to the other side. Assess the anatomical snuffbox and correlate with mechanism of injury.
- Topographical Examination: Systematically analyze five zones in the wrist and hand as described by Lichtman (radial dorsal zone, central dorsal zone, ulnar dorsal zone 1 and 2, and ulnar dorsal zone 3).
Special Tests
- CMC Grind Test: Axial compression with thumb rotation to assess for pain, and correlate with palpation.
- DeQuervain’s Test (Finklesteins Test): Test for inflammation in 1st dorsal compartment (EPB and APL).
- Phalen's Test: Therapist passively forces dorsal sides of both hands together for 60 seconds to test for median nerve compression.
- Pronator Teres Syndrome Test: Tests for median nerve compression by the pronator teres. The patient's forearm is positioned in pronation and the therapist attempts to supinate the forearm while extending the elbow.
- Tinel's Test: Tap the nerve to assess for reproduction of symptoms indicative of nerve compression.
- Piano Keys Test: Tests for DRUJ instability. Stabilize distal radius and attempt passive ulnar translation of the ulna.
- Scaphoid Shift Test (Watson's Test): Evaluate scapholunate ligament instability.
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Description
Test your knowledge on wrist and hand osteoarthritis with this quiz. Explore common causes, treatments, and anatomical considerations related to this condition. Understand the key aspects of diagnosis and nerve involvement in osteoarthritis.
