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Flashcards in hand and wrist Deck (121)
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1

At the wrist, the ______ gives off a superficial palmar branch which completes the superficial palmar arterial arch.

At the wrist, the RADIAL ARTERY gives off a superficial palmar branch which completes the superficial palmar arterial arch.

2

the ULNAR ARTERY enters the hand anterior to the _____ just lateral to the pisiform

The ULNAR ARTERY enters the hand anterior to the flexor retinaculum, just lateral to the pisiform bone. It gives off the deep palmar branch and continues onto the palm as the superficial palmar arterial arch.

3

ulnar nerve passes between

passing between hook of hamate

4

radial nerve superficial branch travels above

Superficial branch above radial styloid

5

median nerve travels through the

Median nerve: through carpal tunnel

6

Superficial radial nerve supplies

Superficial radial nerve supplies skin on the lateral side of the dorsum of the hand, and a small portion of the thenar eminence

7

the recurrent branch of the median n. supplies

the recurrent branch of the median n. supplies the muscles of the thenar eminence

8

cutaneous branch of the median nerve is responsible for

b. cutaneous branches to the skin on the palmar surfaces of the of the first 3½ digits

9

The ulnar nerve enters the palm of the hand through the ___-

1. The ulnar nerve enters the palm of the hand through the ulnar canal

10

Prior to entering the ulnar canal, ulnar n gives off:

a palmar cutaneous branch
(ulnar aspect of the palm)


A dorsal cutaneous branch

(the ulnar aspect of the dorsum of the hand)

11

what is the most frequent injury of the hand and commonly fractured


what is the most common finger

Lacerations most frequent injury

Distal phalanx most commonly fractured

Little finger most common in US

12

how do you document hand injury

i. Dominant hand
ii. Occupation
iii. Tetanus status
iv. Traumatized or non traumatized documentation


always think in terms of anatomy (ulnar or radial aspect of the hand)

volar or dorsal (flexor or extensor)

13

this nerve is responsible fo

the ulnar nerve innervates all the intrinsic muscles of the hand not innervated by the median nerve.

14

how to document trauma

1. Ascertain hx of trauma
2. Time elapsed since injury (golden window = 6 hours)
3. Environment of injury
4. Mechanism of injury

15

how to document non-trauma

v. Nontraumatized
1. When did sx begin
2. What functional impairment
3. What activities worsen sx

16

what are the NEVER rules with excessive bleeding

i. Elevation
ii. Apply a sterile wet-compression dressing.

NEVER LEAVE BP CUFF FOR MROE THAN 30

never ligate a hand vessel without directly visualizing the bleeding vessel and all surrounding structures

17

dorsum of first web space.

radial

18

how do you test strength of R/U/M nerve

1. Radial: extension at wrist and MP joint

2. Ulnar: forcible spread of fingers

3. Median: flexion of wrist and PIP of thumb and index against resistance

19

5th finger sensory what N

ulnar

20

flexor aspect of index and middle

medial

21

document ROM in

degrees

22

this PE finding is common with tendon injury

Patients unable to flex one finger together with the others often found to have associated tendon injury.


pain with flexion is indicative of a partial tear

23

testing flexor digitorum profundus and Flexor Pollicis Longus

hold down all other fingers in extension and have pt just test finger needed

24

Test by holding all other fingers in extension and have the pt flex the finger to be tested

Flexor Digitorum Superficialis

25

how to test extension

: hand palm-down on a table and extend the fingers off the table one at a time.

26

If you suspect an extensor tendon laceration but cannot visualize in the wound,

try putting the hand in the position it was in when the injury occurred.

27

whenever there is glass involved

get an xray

XRAYS sensitive for glass > 2mm

ULS is also sensitive for glass
Sensitive 95-100% < 1-4mm

28

best imaging for organic FB

uls

29

Consideration for the management of FB

anbx

might need OR removal

30

why are hands a scary place for infx?

infections extend QUICKLY across the fascial planes of the hand without resistance.

many structures and a lil meat