Anatomy
Muscles that make up the thenar eminence
Abductor pollicis brevis, flexor pollicis brevis, opponens pollicis
Arthrokinematics of MCP joints in abduction, adduction
Concave on convex and then going to depend on which finger for radial or ulnar
1st MCP radial roll/glide
Pinky will be ulnar roll/glide
ICF Classifications for wrist and hand
Wrist pain with mobility deficits, hand/thumb/finger pain with mobility deficits, hand sensory deficits, thumb pain with muscle power deficits
What is the point in nerve damage, where the nerve is no longer working?
Axonal degeneration
Dermatome for C5
Lateral deltoid
What runs through the carpal tunnel?
Median nerve, FPL tendon, 4 FDS tendons and 4 FDP tendons
Explain arthrokinematics for flexion and extension of the thumb
Flexion: ulnar roll/glide
Extension: radial roll/glide
Concave on convex
Which test can rule in and out for TFCC
Ulnar fovea sign
What is the conservative management for ulnar sided wrist pain
NSAID and steroid injection
Rupture of central slip
MCP ext, PIP flex, DIP ext
2 major ligaments in the wrist that help maintain stability. When these are injured it leads to VISI and DISI
Scapholunate and lunotriquetral ligaments
IP joints arthrokinematics
Concave on convex
Flexion: palmer roll/glide
Extension: dorsal roll/glide
Supination goni placement and norm
Norm: 80
Goni on palmar side, ulnar styloid, midline of humerus
What happens for symptoms and sensory testing whenever there is axonal degeneration
Symptoms: numbness, atrophy
Sensory testing: abnormal 2 point discrimination
What position should a wrist orthosis be in for carpal tunnel syndrome
Neutral position, worn at night
Extensor compartment 1, 4, 5
1: APL and EPB
4: ED, EI
5: EDM
Arthrokinematics of radiocarpal joint
Convex carpals on concave radius
Figure of eight landmarks
Ulnar styloid, radial styloid, 5th MCP, ventral MCPs, back to ulnar styloid
Tendon healing rate after lacerations
Up to 3-6 months
For diagnosis of CTS what is supported by the CPG with A evidence
Semmes Weinstein, 2 point discrimination
Explain claw hand pathology and presentation
Loss of intrinsic muscle strength across ulnar and median nerves
Stocking/glove loss of sensation, intrinsic minus position
Midcarpal joints arthrokinematics
Glide and roll in opposite directions with all motions
Common mechanism and examination considerations for ulnar sided wrist pain
Which is the best option for tendon repair rehab: passive motion, active motion, synergistic motion
Synergistic gives benefits of both active and passive motion
What are four things we should not do for people with CTS
Magnets, iontophoresis, low level laser therapy, thermal ultrasound