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 (C)</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 (C)</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 (A)</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 (D)</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 (D)</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 (A)</p> Signup and view all the answers

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

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

What is a positive special test associated with TFCC Tear?

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

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

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

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

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

What type of pain is typically associated with Radiocarpal Osteoarthritis?

<p>Morning stiffness with joint swelling (B)</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 (D)</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 (B)</p> Signup and view all the answers

What is the gold standard for diagnosing median nerve compression?

<p>EMG confirmation (C)</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 (D)</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. (A)</p> Signup and view all the answers

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

<p>MUGR (B)</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 (B)</p> Signup and view all the answers

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

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

Which type of infection primarily causes paronychia?

<p>Bacterial infection (C)</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% (B)</p> Signup and view all the answers

What is the most common metacarpal fracture known as?

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

Which finger is most commonly affected in Jersey finger injuries?

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

What is the first-line treatment for septic tenosynovitis?

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

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

<p>Congenital condition (C)</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 (A)</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 (A)</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 (B)</p> Signup and view all the answers

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

<p>50% (C)</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 (A)</p> Signup and view all the answers

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

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

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

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

What test is used to diagnose carpometacarpal osteoarthritis?

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

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

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

What radiographic finding is associated with carpometacarpal osteoarthritis?

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

What is the key feature finding for a scaphoid fracture?

<p>Pain in the snuff box (C)</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 (B)</p> Signup and view all the answers

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

<p>Osteonecrosis (A)</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 (B)</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 (C)</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 (D)</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 (A)</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 (D)</p> Signup and view all the answers

What is the typical treatment for a Smith fracture?

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

What is the primary treatment for a septic tenosynovitis?

<p>Incision and drainage with IV antibiotics (D)</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 (B)</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 (B)</p> Signup and view all the answers

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

<p>A nodule of inflammation (C)</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 (B)</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 (B)</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 (B)</p> Signup and view all the answers

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

<p>Congenital (B)</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 (D)</p> Signup and view all the answers

What is a positive special test associated with TFCC Tear?

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

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