Ch. 20 Wrist and Hand

Ch. 20 Wrist and Hand Ch. 20 Wrist and Hand - Start

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Ch. 20 Wrist and Hand




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Presentations text content in Ch. 20 Wrist and Hand

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Ch. 20 Wrist and Hand

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Anatomy

27 bones in the hand and wrist

NervesMedialUlnarRadialFlexor and extensor tendon for each finger

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Anatomy

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Carpals

ScaphoidLunateTriquetralPisiformTrapeziumTrapezoidCapitateHamate

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Carpals

Scaphoid-SallyLunate-LikesTriquetral-ToPisiform-Party

Trapezium-TrooperTrapezoid-TaylorCapitate-CanHamate-Hit

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Muscles

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Muscles

FlexorsFlexor Carpi RadialisFlexor Carpi UlnarisPalmaris LongusExtensorsExtensor Carpi RadialisExtensor Carpi UlnarisSupinatorPronator Teres and Pronator Quadratus

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Dislocations

Displacement of any bone from normal positionSubluxation: abnormal movement of one of the bones that constitutes a joint

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Colles’ Fracture

Fracture of the distal radius or ulna just above the wrist

From falling on outstretched handSplint and refer to doctor

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Boxer’s Fracture

Fracture to the 5th metacarpalMost commonly seen in someone who has punched something solid

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Mallet Finger

Occurs when a ball strikes the tip of the finger

Also known as baseball fingerTearing of extensor tendon

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Jersey Finger

Occurs when grabbing a jersey Tearing of flexor tendonTreatment usually involves surgery

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Boutonniere Deformity

Caused by blow to bent finger or arthritis

The proximal interphalangeal joint is in flexion and the distal interphalangeal joint is in hyperextension

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Scaphoid Fracture

Pain over anatomic snuffbox

Common fracture in athleticsFall on outstretched handNot well vascularized

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Contusions

Subungual hematoma-bleeding under the nailPain is from the pressure createdPuncture nail to relieve pressure

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Gamekeeper’s Thumb

Sprain of ulnar collateral ligament of the

metacarpophalangeal jointCommon in skiingUse special test to diagnose Tape and protect

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deQuervain’s Tenosynovitis

Inflammation of the extensor pollicus brevis and abductor pollicus longusUse signs and symptoms to diagnosisSpecial testTreat with RICE or cortisone shot

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Carpal Tunnel Syndrome

Carpal tunnel is a passageway that runs from the forearm through the wristMedian nerve runs through CTS occurs when linings of tendons are inflamed or ligaments thicken

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Carpal Tunnel Syndrome

S/S: pain, numbness, tingling in

wrist, hand, and fingersMay drop objectsUsually caused by overusePhalan’s TestTreat conservatively, surgery if needed

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Ganglion Cyst

Ganglion cyst is a small, usually hard lump around a tendon or in a joint capsuleCommon in bowlers, tennis playersUsually on back of wristResolves on its own

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Rehab

Wrist ExtensionWrist FlexionWrist SupinationWrist PronationWrist Ulnar DeviationWrist Radial Deviation

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Rehab

Elbow Flexion

Elbow ExtensionHand Intrinsic MusclesGrip Strength


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