Hand Conditions and Signs Quiz
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Questions and Answers

What condition is indicated by Froment’s sign?

  • Carpal tunnel syndrome
  • Dupuytren contractures
  • Scaphoid fracture
  • Ulnar neuropathy (correct)

Which sign is indicative of cubital tunnel syndrome?

  • Froment’s sign
  • Wartenberg’s sign (correct)
  • Tinel's sign
  • Finkelstein test

What is a primary risk factor for Dupuytren contractures?

  • Excessive weight lifting
  • Running
  • Trauma (correct)
  • Excessively playing video games

Which underlying condition is commonly associated with chronic carpal tunnel syndrome?

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

What is the typical mechanism of injury for a scaphoid fracture?

<p>Falling onto an outstretched hand (A)</p> Signup and view all the answers

Which clinical feature is commonly associated with an anterior cruciate ligament (ACL) injury?

<p>Immediate hemarthrosis (A)</p> Signup and view all the answers

What includes a common presentation of a Baker's cyst?

<p>Synovial cyst in the popliteal fossa (D)</p> Signup and view all the answers

Which statement regarding medial collateral ligament (MCL) injury is accurate?

<p>Valgus stress causes widening of the medial joint space. (C)</p> Signup and view all the answers

In the context of knee dislocation, what does the term 'closed reduction' refer to?

<p>A maneuver performed to realign the joint externally (D)</p> Signup and view all the answers

What does 'genu valgum' refer to in knee alignment?

<p>Medial misalignment resulting in knocked-knee deformity (C)</p> Signup and view all the answers

Which injury is indicated by the presentation of the 'unhappy triad'?

<p>ACL tear, MCL tear, and medial meniscus tear (B)</p> Signup and view all the answers

What is a typical feature of Osgood-Schlatter disease?

<p>Anterior knee pain worsened by activity (C)</p> Signup and view all the answers

What does an abnormal ankle brachial index (ABI) indicate?

<p>Presence of peripheral artery disease (PAD) (D)</p> Signup and view all the answers

What is the primary function of the infraspinatus muscle?

<p>External rotation of the shoulder (D)</p> Signup and view all the answers

Which test is associated with a suspected injury to the teres minor?

<ul> <li>Hornblower’s sign (B)</li> </ul> Signup and view all the answers

What does a positive Lachman test indicate?

<p>Anterior cruciate ligament (ACL) injury (C)</p> Signup and view all the answers

The Bulge Sign test is used to assess which condition in the knee?

<p>Effusion in the suprapatellar bursa (A)</p> Signup and view all the answers

In which test is the knee held in maximal flexion while applying varus stress?

<p>McMurray Test (D)</p> Signup and view all the answers

What does a positive Varus Stress Test indicate?

<p>Lateral collateral ligament (LCL) injury (A)</p> Signup and view all the answers

Which knee structure is primarily assessed with the Posterior Drawer Test?

<p>Posterior cruciate ligament (PCL) (B)</p> Signup and view all the answers

What is the clinical presentation of osteochondritis dissecans?

<p>Localized necrosis of subchondral bone (D)</p> Signup and view all the answers

Which of the following tests is specifically for assessing the MCL?

<p>Valgus Stress Test (B)</p> Signup and view all the answers

What is the function of the subscapularis muscle in the shoulder?

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

What is the primary physical exam maneuver used to test for medial epicondylitis?

<p>Supinate the arm and extend the wrist and elbow (A)</p> Signup and view all the answers

Which of the following is a clinical feature of olecranon bursitis?

<p>Erythema and localized swelling around the elbow (A)</p> Signup and view all the answers

What is the etiology of a radial head subluxation known as Nursemaid’s Elbow?

<p>Axial traction of the pronated and extended forearm (A)</p> Signup and view all the answers

Which clinical feature is indicative of a radial head fracture?

<p>Radial head tenderness and hemarthrosis (D)</p> Signup and view all the answers

How is lateral epicondylitis (Tennis Elbow) tested during a physical examination?

<p>Extending the wrist and fingers against resistance while pronating (A)</p> Signup and view all the answers

What type of inflammation characterizes olecranon bursitis?

<p>Non-septic caused by repeated trauma (C)</p> Signup and view all the answers

Which management technique is appropriate for treating radial head subluxation?

<p>Supination-flexion maneuver (C)</p> Signup and view all the answers

What symptom might a patient with distal biceps tendon rupture present with?

<p>Visible deformity of the biceps muscle (B)</p> Signup and view all the answers

What does an increased laxity result from during the Anterior Drawer Test indicate?

<p>Injury to the anterior talofibular ligament (A)</p> Signup and view all the answers

Which condition is characterized by sharp heel pain that worsens after prolonged inactivity?

<p>Plantar fasciitis (A)</p> Signup and view all the answers

What does the abbreviation ACL stand for?

<p>Anterior cruciate ligament (D)</p> Signup and view all the answers

What is a common risk factor for Achilles tendon rupture?

<p>Fluoroquinolone use (A)</p> Signup and view all the answers

Which joint is referred to by the abbreviation PIP?

<p>Proximal interphalangeal joint (C)</p> Signup and view all the answers

What does the term PROM represent in a medical context?

<p>Passive range of motion (A)</p> Signup and view all the answers

What physical exam finding is indicative of a calcaneofibular ligament injury during the Inversion Stress Test?

<p>Increased laxity when inverting the foot (C)</p> Signup and view all the answers

The abbreviation MT head refers to which part of the anatomy?

<p>Metatarsal head (A)</p> Signup and view all the answers

Which of the following is not a characteristic feature of Charcot neuropathy?

<p>Symptoms exclusively in the upper limbs (D)</p> Signup and view all the answers

Which structure does the abbreviation IT band refer to?

<p>Iliotibial band (C)</p> Signup and view all the answers

What is a primary cause of acquired pes planus?

<p>Tibialis posterior tendon dysfunction (B)</p> Signup and view all the answers

What characteristic feature is associated with 'low' ankle sprains?

<p>Tenderness along the anterior talofibular ligament (A)</p> Signup and view all the answers

What does the abbreviation DJD stand for in medical terminology?

<p>Degenerative joint disease (C)</p> Signup and view all the answers

During the Thompson Squeeze Test, what does absent foot plantarflexion indicate?

<p>Achilles tendon rupture (A)</p> Signup and view all the answers

The abbreviation RA is commonly used to denote which condition?

<p>Rheumatoid arthritis (D)</p> Signup and view all the answers

Which of the following findings is least likely to be associated with plantar fasciitis?

<p>Bruising on the plantar surface (D)</p> Signup and view all the answers

What does the abbreviation ROM represent in a clinical setting?

<p>Range of motion (B)</p> Signup and view all the answers

Which ligament is most commonly injured in a low ankle sprain?

<p>Anterior talofibular ligament (B)</p> Signup and view all the answers

Flashcards

Carpal Tunnel Syndrome

Peripheral neuropathy caused by median nerve compression by the transverse carpal ligament.

Dupuytren's Contracture

A fibroproliferative disorder of the palmar fascia, most commonly affecting the 4th and 5th fingers.

Scaphoid Fracture

Most common carpal bone fracture, often caused by a fall onto the outstretched hand (FOOSH).

De Quervain's Disease

Repetitive thumb movements causing inflammation of tendons.

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Guyon Canal Syndrome

Ulnar nerve compression, often associated with cycling or hamate fracture.

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Golfer's Elbow

Pain at the medial epicondyle, caused by inflammation of the tendons that flex the wrist and fingers.

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Tennis Elbow

Pain at the lateral epicondyle, caused by inflammation of the tendons that extend the wrist and fingers.

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Olecranon Bursitis

Inflammation of the fluid-filled sac located over the bony tip of the elbow (olecranon process).

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Nursemaid's Elbow

Partial dislocation of the radial head, commonly seen in children. Usually caused by pulling on the child's arm.

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Radial Head Fracture

Break in the radial head, often caused by falling onto an outstretched hand.

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Distal Biceps Tendon Rupture

Tear of the biceps tendon near the elbow joint.

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Enthesopathy of the Elbow

Inflammation or degeneration of the tendons where they attach to the bone (entheseal) around the elbow.

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What are the key movements to test for medial epicondylitis?

Supinate the arm, extend the wrist and elbow, and then apply resistance to wrist flexion. Pain at the medial epicondyle suggests medial epicondylitis.

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Anterior Drawer Test

Evaluates the integrity of the ACL by assessing the amount of forward translation of the tibia on the femur. Knee is flexed at 90 degrees, foot fixed, and the tibia is pulled forward.

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Posterior Drawer Test

Assesses the PCL by evaluating the posterior displacement of the tibia on the femur. Knee flexed at 90 degrees, foot fixed, and the tibia is pushed backward.

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Lachman Test

A more sensitive test for ACL injury, performed with the knee in 20-30 degrees flexion, stabilizing the femur, and pulling the tibia anteriorly.

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Valgus Stress Test

Examines the MCL by applying a valgus force (away from midline) to the knee while it is extended or flexed at 20-30 degrees. Widening of the medial joint space indicates a possible MCL injury.

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Varus Stress Test

Tests the LCL by applying a varus force (toward midline) to the knee while it is extended or flexed at 20-30 degrees. Widening of the lateral joint space suggests an LCL injury.

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McMurray Test

Evaluates for a meniscal tear by listening for a click or popping sound during knee extension. Knee is flexed, tibia rotated, and then extended with a valgus or varus force.

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Bulge Sign

Indicates an effusion (fluid buildup) in the suprapatellar bursa, a sac located above the kneecap. Apply pressure over the bursa and look for a bulge.

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Osteochondritis Dissecans

A condition where a piece of cartilage and bone detaches from the surface of a joint. It's common in the knee and occurs due to repetitive trauma or stress.

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What is the “Unhappy Triad” knee injury?

An injury involving the ACL, MCL, and medial meniscus. It often occurs from a lateral force applied to the planted leg.

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What is the common mechanism of injury for an ACL tear?

Hyperextension, a sudden pivot force, or a direct impact on the knee can tear the ACL. ACL injuries often occur in athletes during sports like soccer and basketball.

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Loose Intra-articular Cartilage Fragments

Small pieces of cartilage that break off inside a joint, leading to pain and mechanical symptoms like locking or catching.

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Knee Dislocation Management

Treatment for a knee dislocation depends on the direction of the dislocation: closed reduction for anterior or posterior dislocations and open reduction for posterolateral dislocations.

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Ankle Brachial Index (ABI)

A ratio comparing the blood pressure in your ankle to the blood pressure in your arm. It helps diagnose peripheral artery disease (PAD).

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Medial Collateral Ligament (MCL) Injury Exam

A widening of the medial joint space and pain when the knee is forced inward (valgus stress) suggests an MCL injury.

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Anterior Cruciate Ligament (ACL) Injury Signs

An ACL tear often happens during a non-contact pivoting injury and causes immediate swelling (hemarthrosis).

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Osgood-Schlatter Disease

A painful condition affecting active adolescents where the patellar tendon pulls on the tibial tubercle causing inflammation.

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Genu Valgum

A misalignment of the knee where the legs are turned inwards (knock-knee deformity).

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Baker's Cyst

A fluid-filled swelling located behind the knee (popliteal fossa), often caused by knee joint problems.

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AC joint

The joint where the acromion process of the scapula meets the clavicle.

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ACL

The anterior cruciate ligament, a strong ligament that connects the femur (thigh bone) to the tibia (shin bone) and prevents the tibia from sliding forward.

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What are the movements to test for OA?

Active and passive range of motion of the affected joint, palpation for tenderness and crepitus (grating sound), and assessing for joint effusion.

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What is the IT band?

A thick band of connective tissue that runs down the outside of the thigh, connecting the hip to the shin bone.

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What is the MT head?

The ball-shaped end of a metatarsal bone, located in the foot.

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What is the function of the TCL?

The transverse carpal ligament, a thick band of tissue that covers the carpal bones and helps to hold the tendons in place.

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What is the TFCC?

The triangular fibrocartilage complex, a structure in the wrist that helps to stabilize the wrist and provide shock absorption between the ulna and carpal bones.

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What is the SLAP tear?

A tear in the labrum (cartilage) of the shoulder joint, specifically the superior labrum from anterior to posterior.

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Deltoid Ligament

A strong ligament on the medial side of the ankle that helps stabilize the joint. It consists of four main parts: the tibionavicular, tibiocalcaneal, anterior tibiotalar, and posterior tibiotalar ligaments.

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Inversion Stress Test

A physical exam maneuver used to assess the integrity of the calcaneofibular ligament (CFL) in the ankle. It involves stabilizing the tibia, dorsiflexing the foot, and inverting the foot. Increased laxity suggests a CFL injury.

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Thompson Squeeze Test

A physical exam maneuver used to identify an Achilles tendon rupture. While the patient is prone, the examiner squeezes the calf muscle. Absent foot plantarflexion indicates a ruptured tendon because the calf muscle is not able to pull on the tendon.

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Ankle Sprain

A common ankle injury involving a stretch or tear of one or more ligaments. 'Low ankle sprains' affect ligaments on the lateral side of the ankle. 'High ankle sprains' involve ligaments at the top of the ankle joint.

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Plantar Fasciitis

A common condition caused by inflammation of the plantar fascia, a thick band of tissue on the bottom of the foot. It typically causes heel pain that is worse in the morning or after periods of inactivity.

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Charcot Neuropathy

A serious complication of nerve damage, usually caused by diabetes. It can lead to joint damage and deformity because of repeated microtrauma, resulting from loss of sensation and proprioception in the affected joint.

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Acquired Pes Planus

Flatfoot caused by dysfunction of the tibialis posterior tendon, a muscle that helps support the arch. Weakness in this tendon can cause the arch to flatten.

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Varus/Valgus Deformities

Deformities of the foot that occur when the ankle joint is shifted inwards (varus) or outwards (valgus). These deformities can cause problems with walking and pain.

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Enthesopathy of the Ankle

Inflammation or degeneration of the tendons at the point where they attach to the bone (entheseal) around the ankle joint. This can cause pain, stiffness, and tenderness.

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Study Notes

Musculoskeletal (MSK) Course Primer

  • This primer covers various musculoskeletal topics including the spine, hand/wrist, elbow, shoulder, knee, hip, ankle/foot, bone biology & bone tumors, additional videos, and abbreviations.
  • The course directors are Dr. Kamalpreet Buttar, MD and Dr. Farzana Nuruzzaman, MD.
  • The primer was created by Jack Scheutzow and Kevin Kashanchi.

Learning Objectives for Spine

  • Know the basic components of the physical examination of the cervical and lumbar spine.
  • Understand the implications of Spurling's Test, Lhermitte Sign, and Straight Leg Raise.
  • Identify and understand the clinical presentation, physical exam findings, and basic management of common spinal disorders, including thoracic kyphosis, vertebral fractures (pathologic), disc herniation, lumbar disc (L4-L5), cervical disc (posterolateral annulus fibrosus), Paget's disease (Osteitis deformans), spondylolisthesis (risk factors), ankylosis/spondyloarthropathies, cervical nerve radiculopathy, and enthesopathy of the spine.

Basic Anatomy of the Spine

  • Diagrams depict the anterior, left lateral, and posterior views of the spine, highlighting vertebrae (cervical, thoracic, lumbar, sacrum, coccyx), processes (spinous, transverse, articular), and associated structures.

  • Anatomical details of various vertebral parts include body, vertebral foramen, superior vertebral notch, inferior vertebral notch, superior articular facet, inferior articular facet, etc. are illustrated.

Muscles of the Spine and Back

  • Detailed diagrams illustrate the muscles of the posterior aspect of the body.
  • Muscle names are listed with diagrams.

Normal Physical Exam Components of the Cervical Spine & Lumbar Spine

  • Examine gait, alignment, posture, and skin.
  • Palpate muscles, bony structures, and soft tissues.
  • Assess range of motion for flexion/extension, lateral flexion, and rotation.
  • Perform Spurling's maneuver and Lhermitte's sign for specific assessments.

Normal Physical Exam Components of the Wrist

  • Examine gross deformity, swelling, wasting, skin changes, and nerve sensation.
  • Palpate carpal bones, soft tissues and joints.
  • Evaluate range of motion (flexion, extension, radial/ulnar deviation, pronation, supination).
  • Perform specific maneuvers such as Finkelstein's test, Watson's test, Phalen's test, and Froment's test.

Normal Physical Exam Components of the Elbow

  • Inspect for gross deformity, swelling, wasting, and skin changes.
  • Perform palpation of bony and soft tissue structures
  • Evaluate range of motion (flexion/extension, pronation/supination).
  • Perform specific tests like medial and lateral epicondylitis tests.

Additional Information

  • Comprehensive information about various musculoskeletal conditions, including specific tests and diagnostic criteria, is provided for each body region and the related diseases in subheadings.
  • There are links to videos for upper/lower extremities and spine and back.
  • A complete list of abbreviations used in the primer is included.

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2023 MSK Primer PDF

Description

Test your knowledge on various hand conditions and their associated signs. This quiz covers important clinical signs like Froment's sign, as well as conditions such as Dupuytren's contractures and carpal tunnel syndrome. Sharpen your understanding of hand injuries and treatments.

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