Hand and Wrist Patient Intake and Examination
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Questions and Answers

What is the primary purpose of asking the patient about their dominant hand?

  • To assess the patient's pain tolerance
  • To evaluate the patient's emotional state
  • To understand how the injury may impact the patient's daily activities (correct)
  • To determine the patient's level of hand dexterity

    • What is the purpose of the Tinel's test during the wrist exam?

  • To evaluate for carpal tunnel syndrome (correct)
  • To assess for tendon inflammation
  • To check for range of motion limitations
  • To measure grip strength

    • Which of the following is NOT a range of motion that can be assessed during the wrist exam?

  • Radial and ulnar deviation
  • Flexion and extension
  • Circumduction
  • Pronation and supination (correct)

    • What is the purpose of the Fovea sign during the wrist exam?

    <p>To assess for a triangular fibrocartilage complex (TFCC) injury</p> Signup and view all the answers

    Which of the following is NOT a key piece of information the clinician should ask the patient about during the history taking for a injury?

    <p>Patient's medications</p> Signup and view all the answers

    What anatomical structures would the clinician palpate during the wrist exam?

    <p>The radius and ulna bones, distal radioulnar joints, and carpal bones</p> Signup and view all the answers

    What is the primary purpose of the Finkelstein's test during the wrist exam?

    <p>To assess for pain with passive ulnar deviation of the wrist</p> Signup and view all the answers

    What is the primary purpose of the Phalen's test during the wrist exam?

    <p>To assess for numbness and tingling in the median nerve distribution</p> Signup and view all the answers

    Which type of wrist pain is associated with de Quervain's tenosynovitis and carpal-metacarpal osteoarthritis?

    <p>Radial-sided wrist pain</p> Signup and view all the answers

    What is a common presentation of De Quervain’s Tenosynovitis?

    <p>Radial wrist pain worsened with lifting</p> Signup and view all the answers

    What is a positive special test associated with TFCC Tear?

    <p>Fovea sign</p> Signup and view all the answers

    Which diagnostic test is considered the best for diagnosing TFCC Tear?

    <p>MRI Arthrogram</p> Signup and view all the answers

    What is a common cause of tendonitis of the ulnar wrist extensors?

    <p>Repetitive overuse</p> Signup and view all the answers

    What type of pain is typically associated with Radiocarpal Osteoarthritis?

    <p>Morning stiffness with joint swelling</p> Signup and view all the answers

    What is the primary treatment for de Quervain's tenosynovitis?

    <p>Ice, thumb spica splints, rest, physical therapy, and steroid injections</p> Signup and view all the answers

    What is a common presentation of tendonitis of the ulnar wrist extensors?

    <p>Ulnar-sided wrist pain, clicking, popping, and decreased range of motion</p> Signup and view all the answers

    What is the gold standard for diagnosing median nerve compression?

    <p>EMG confirmation</p> Signup and view all the answers

    What is the primary treatment for a forearm fracture in both arms?

    <p>Open reduction with internal fixation</p> Signup and view all the answers

    What is the key difference between a Monteggia fracture and a Galeazzi fracture?

    <p>Monteggia involves a fracture of the ulna shaft with a proximal radius dislocation, while Galeazzi involves a fracture of the radial shaft with a distal ulna dislocation.</p> Signup and view all the answers

    What is the acronym used to remember the key difference between Monteggia and Galeazzi fractures?

    <p>MUGR</p> Signup and view all the answers

    What is the most common mechanism of injury for a mallet finger?

    <p>Jamming the tip of the finger</p> Signup and view all the answers

    In trigger finger, what prevents the tendon from sliding under a pulley?

    <p>Nodule of inflammation</p> Signup and view all the answers

    Which type of infection primarily causes paronychia?

    <p>Bacterial infection</p> Signup and view all the answers

    What percentage of nail involvement in a subungual hematoma requires nail removal and suturing?

    <p>More than 50%</p> Signup and view all the answers

    What is the most common metacarpal fracture known as?

    <p>Boxer's fracture</p> Signup and view all the answers

    Which finger is most commonly affected in Jersey finger injuries?

    <p>Ring finger</p> Signup and view all the answers

    What is the first-line treatment for septic tenosynovitis?

    <p>Incision and drainage with IV antibiotics</p> Signup and view all the answers

    What is the most common cause of trigger finger in children?

    <p>Congenital condition</p> Signup and view all the answers

    Which wrist injury requires surgical repair?

    <p>Flexor tendon rupture due to forceful extension of the DIP joint</p> Signup and view all the answers

    What is the main treatment approach for Metacarpal Fracture with more than 40% angulation?

    <p>Surgical reduction and pinning of the pinkie finger</p> Signup and view all the answers

    What is the primary treatment for a felon, an abscess of the finger pad?

    <p>Incision and drainage with antibiotics</p> Signup and view all the answers

    What percentage of nail involvement in a subungual hematoma requires nail removal and suturing?

    <p>50%</p> Signup and view all the answers

    What is the characteristic presentation of a boutonneiere deformity?

    <p>Flexion of the PIP and hyperextension of the DIP</p> Signup and view all the answers

    What is the most common cause of paronychia, a digital infection?

    <p>Localized staph cellulitis</p> Signup and view all the answers

    Which fingers are most commonly affected by Dupuytren's contracture?

    <p>Ring and small finger</p> Signup and view all the answers

    What test is used to diagnose carpometacarpal osteoarthritis?

    <p>Grind test</p> Signup and view all the answers

    What is the treatment of choice for a skier's or gamekeeper's thumb injury without displacement or mild laxity?

    <p>Thumb spica cast for 6 weeks</p> Signup and view all the answers

    What condition is characterized by an avulsion fracture where the ligament pulls off a piece of the bone?

    <p>Skier's or gamekeeper's thumb</p> Signup and view all the answers

    If a contracture of the thumb is more than what degree, surgery is indicated?

    <p>30 degrees</p> Signup and view all the answers

    What radiographic finding is associated with carpometacarpal osteoarthritis?

    <p>Osteophytes and joint narrowing</p> Signup and view all the answers

    What is the key feature finding for a scaphoid fracture?

    <p>Pain in the snuff box</p> Signup and view all the answers

    Why does casting for a torus fracture in children differ from adults?

    <p>Children have more flexible bones</p> Signup and view all the answers

    What can happen if a scaphoid fracture is not properly healed with immobilization?

    <p>Osteonecrosis</p> Signup and view all the answers

    Why do younger children with torus fractures require a longer cast?

    <p>Short arm casts would fall off younger children</p> Signup and view all the answers

    What is the first-line treatment for both types of fractures of the distal radius discussed?

    <p>Immobilization with splints</p> Signup and view all the answers

    Which type of wrist fracture is caused by a fall on an outstretched hand with the wrist extended?

    <p>Colles fracture</p> Signup and view all the answers

    What is the typical treatment for a Colles fracture with less than 15 degrees of angulation?

    <p>Short arm cast for 6 weeks</p> Signup and view all the answers

    What is the key difference between a Colles fracture and a Smith fracture?

    <p>The wrist is extended in a Colles fracture, but flexed in a Smith fracture</p> Signup and view all the answers

    What is the typical treatment for a Smith fracture?

    <p>Short arm cast for 6 weeks</p> Signup and view all the answers

    What is the relative frequency of Colles fractures compared to Smith fractures?

    <p>Colles fractures are much more common than Smith fractures</p> Signup and view all the answers

    What is the primary treatment for a septic tenosynovitis?

    <p>Incision and drainage with IV antibiotics</p> Signup and view all the answers

    Which condition is characterized by an avulsion fracture where the ligament pulls off a piece of the bone?

    <p>Gamekeeper's thumb</p> Signup and view all the answers

    What is the primary purpose of the Finkelstein's test during the wrist exam?

    <p>To assess for de Quervain's tenosynovitis</p> Signup and view all the answers

    In trigger finger, what prevents the tendon from sliding under a pulley?

    <p>A nodule of inflammation</p> Signup and view all the answers

    What is the treatment of choice for a skier's or gamekeeper's thumb injury without displacement or mild laxity?

    <p>Splinting and immobilization</p> Signup and view all the answers

    What is the primary purpose of asking the patient about their dominant hand during the wrist exam?

    <p>To evaluate for potential nerve compression syndromes</p> Signup and view all the answers

    What is the primary treatment for a felon, an abscess of the finger pad?

    <p>Incision and drainage with antibiotics</p> Signup and view all the answers

    What is the most common cause of trigger finger in children?

    <p>Congenital</p> Signup and view all the answers

    What is the main treatment approach for Metacarpal Fracture with more than $40%$ angulation?

    <p>Reduction and percutaneous pinning</p> Signup and view all the answers

    What is a positive special test associated with TFCC Tear?

    <p>Press test</p> Signup and view all the answers

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