DDX A1 Final Review Tutor notes pt 2 (better)

Mary has a pins and needles sensation in her hands that wakes her up at night, what are possible ddxs?

tunnel of guyon syndrome

cheiralgia parasthetica

carpal tunnel syndrome

pronator teres syndrome

carpal tunnel syndrome

What are possible causes of carpal tunnel syndrome?

palmar lipomas

pronator muscle hypertrophy rheumatoid arthritis

carpal subluxation

Carpal subluxation

rheumatoid arthritis

palmar lipomas

The gold standard to confirm carpal tunnel syndrome is

X-RAY

NCV

MRI

CLA

NCV (Nerve conduction velocity test)

Entrapment of what nerve may be caused by excessive use of a screwdriver?

ulnar nerve

musculocutaneous nerve

median nerve

radial nerve

musculocutaneous nerve

Which test can help determine if pain is coming from the AC joint vs the GH joint?

Painful arc

Speed's test

Codman's drop arm

Yergason's test

Painful arc

Management of little leaguer's shoulder include

Casting the shoulder

Rest for a minimum of 3 months

Refer to physical therapist for rehab post rest

Taping up the shoulder and letting them play

Rest for a minimum of 3 months

Refer to physical therapist for rehab post rest

Match the MOI to the possible ddx of the wrist & hand.

A. Epiphyseal torus

B. fracture in children

C. Carpal irritation

D. Carpal dislocation

E. Navicular fracture

1. Fall on dosiflexed hand

2. Axial Compression

1. E, A, D

2. C, B

Barbara is 36 years old and has swollen PIP joints bilaterally, they are warm to touch and tender. She also complains about fatigue. Her doctor has ordered a few blood tests. What is the most likely DDX?

Avulsion Fracture

Volar Plate Injury

Osteoarthritis

Rheumatoid Arthritis

Rheumatoid Arthritis (RA)

Nursemaid's elbow has the highest incidence in children aged

under 1 year old

4-6

1-4

6-10

1-4

Non-traumatic causes of shoulder pain include:

Impingement

Avulsion fracture

Dislocation

Fracture

Impingement

Sudden traction of the forearm can cause what types of elbow injuries

Radial head subluxation

Ulna fracture

Supracondylar fracture in children Nursemaid's elbow

Radial head subluxation

Nursemaid's elbow

The median nerve is responsible for what types of grips?

Three-fingered pinch

Key pinch

Tip pinch

Hook pinch

Three-fingered pinch

Tip pinch

Key pinch

What are common comorbidities to carpal tunnel syndrome?

Pregnancy

Diabetes

Colorectal cancer

Hypothyroidism

Pregnancy

Diabetes

Hypothyroidism

What are the 3 types of labrum tears?

(fill in)

SLAP Tear (Superior Labrum anterior posterior)

Bankart Tear -

Bennet Lesions -(Posterior Labrum Tear)

What is the most commonly fractured carpal bone?

Trapezius

Pisiform

Scaphoid

Hamate

Scaphoid

Match the carrying angles to their names

A. -15

B. 30

C. -5

1. Excessive Cubitus Valgus

2. Cubitus Varus

3. Gun stock deformity

A. 3

B. 1

C. 2

If I have a impaired thumb, index, and middle finger flexion as well as a positive tinel's sign over the pronator teres, what nerve is being affected?

Radial nerve (superficial branch)

Median Nerve

Ulnar Nerve

Radial Nerve (posterior interosseous)

Median Nerve

Medial epicondylitis affects the

Common Flexor tendon

Common Extensor tendon

Common flexor tendon

T/F A FOOSH injury can cause a radial head fracture

True

With Nursemaid's elbow what bone is pulled out of the socket?

Ulna

Radius

Radius

Mary is a stay at home mom who hurt her hand while wringing out her laundry. She has aching pain at the wrist and thumb base. What is the best ddx?

Intersection syndrome

DeQuervain's tenosynovitis

Triangular fibrocartilage injury

Cheiralgia parasthetica

DeQuervain's tenosynovitis

T/F Surgery is a definite cure for carpal tunnel syndrome.

False

T/F Neuros will be within normal limits on examination for someone with olecranon bursitis.

True

T/F The ulnar nerve is important for power grips.

True

How can someone manage their carpal tunnel syndrome?

Wrist splint at night or during activity

Cast

Get wrist adjusted to create space in tunnel

Amputate

Get wrist adjusted to create space in tunnel

Wrist splint at night or during activity

T/F You need to take an x-ray to rule out carpal tunnel syndrome

False, rules out pathologies

Nick is a chiropractor and he has felt this painful click with ulnar to radial deviation of the wrist. What is the most likely ddx?

Triquetrohamate subluxation Scapholunate subluxation

Triquetrolunate subluxation

Scapholunate subluxation

Boutonnière Deformity

"Button hole" deformity, rupture or splitting of the extensor tendon at the middle phalanx leading to hyperextension of MCP & DIP & hyper-flexion of PIP joint. May be seen in RA & following severe sprains/fractures of the finger.

Claw Hand Deformity

Flexion contracture of all 5 digits due to combined ulnar & median nerve palsy results in finger flexion contracture; may involve cords of brachial plexus or above.

Jersey Finger

Rupture of a flexor digitorum profundus tendon. Patient unable to bend the proximal finger & distal phalanges of injured finger when making a fist.

Mallet Finger

Rupture of extensor tendon from its insertion on distal phalanx (unable to extend distal phalanx). Patient unable to extend the fingertip of injured finger.

Seal Fin Deformity

Ulnar deviation of fingers (RA often seen in combination with deformity). Haygarth's nodes & Bouchard's nodes also may be present

What are 3 visceral referrals to the shoulder? (fill in)

Heart

Gallbladder

Lungs

Diaphragm

Lateral epicondylitis is also known as

Tennis elbow

Proximal humeral epiphysitis is also known as

Little League Shoulder

T/F X-rays can show an active dislocation of the shoulder.

True

Paul cannot fully adduct his fingers or flex his wrist, ring finger, and pinky. What does he most likely have?

Anterior Interosseous Nerve Syndrome

Tunnel of Guyon Syndrome

Capral Tunnel Syndrome

Pronator Teres Syndrome

Tunnel of Guyon Syndrome