Pregnancy-Related Carpal Tunnel Syndrome
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A Study on the Absence of Palmaris Longus in a Multi-Racial Population
108472 NV-OA7 pg26-28.qxd 11/05/2007 05:02 PM Page 26 (Black plate) Malaysian Orthopaedic Journal 2007 Vol 1 No 1 SA Roohi, etal A Study on the Absence of Palmaris Longus in a Multi- racial Population SA Roohi, MS (Ortho) (UKM), L Choon-Sian, MD (UKM), A Shalimar, MS (Ortho) (UKM), GH Tan, MS (Ortho) (UKM), AS Naicker, M Med Rehab (UM) Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ABSTRACT Most standard textbooks of hand surgery quote the prevalence of absence of palmaris longus at around 15%3-5. Palmaris longus is a dispensable muscle with a long tendon However, this figure varies considerably in different ethnic which is very useful in reconstructive surgery. It is absent groups. A study by Thompson et al6 on 300 Caucasian 2.8 to 24% of the population depending on the race/ethnicity subjects found that palmaris longus was absent unilaterally in studied. Four hundred and fifty healthy subjects (equally 16%, and bilaterally in 9% of the study sample for an overall distributed among Malaysia’s 3 major ethnic groups) were prevalence of absence of 24%. Similarly, George7 noted on clinically examined for the presence or absence of palmaris 276 cadavers of European descent that its absence was 13% longus. This tendon was found to be absent unilaterally in unilaterally, 8.7% bilaterally for an overall absence of 15.2%. 6.4% of study subjects, and bilaterally in 2.9% of study Another cadaveric study by Vanderhooft8 in Seattle, USA participants. Malays have a high prevalence of palmaris reported its overall absence to be 12%. -
Wrist Fracture – Advice Following Removal of Your Cast
Wrist Fracture – advice following removal of your cast A plaster cast usually prevents a fracture from moving, but allows your fingers to move. The cast also reduces pain. What to expect It usually takes four to six weeks for new bone to form to heal your fracture. When the cast is removed most people find that their wrist is stiff, weak and uncomfortable to start with. It may also be prone to swelling and the skin dry or flaky, this is quite normal. It is normal to get some pain after your fracture. If you need painkillers you should take them as prescribed as this will allow you to do your exercises and use your wrist for light activities. You can ask a Pharmacist about over the counter painkillers. If your pain is severe, continuous or excessive you should contact your GP. The new bone gradually matures and becomes stronger over the next few months. It is likely to be tender and may hurt if you bang it. The muscles will be weak initially, but they should gradually build up as you start to use your hand and wrist. When can I start to use my hand and wrist? It is important to try and use your hand and wrist as normally as possible. Start with light activities like fastening buttons, washing your face, eating, turning the pages of books over etc. Build up as pain allows. Avoid lifting a kettle for 4 weeks If I have been given a Wrist splint You may have been given a wrist splint to wear. -
Complex Regional Pain Syndrome Type I (Shoulder-Hand Syndrome) in an Elderly Patient After Open Cardiac Surgical Intervention; a Case Report
Eastern Journal of Medicine 16 (2011) 56-58 L. Ediz et al / CRPS type I after open cardiac Surgery Case Report Complex regional pain syndrome type I (shoulder-hand syndrome) in an elderly patient after open cardiac surgical intervention; a case report Levent Ediza*, Mehmet Fethi Ceylanb , Özcan Hıza, İbrahim Tekeoğlu c a Department of Physical Medicine and Rehabilitation, Yüzüncü Yıl University Medical Faculty, Van, Turkey b Department of Orthopaedics and Traumatology,Yüzüncü Yıl University Medical Faculty, Van, Turkey c Department of Rheumatology, Yüzüncü Yıl University Medical Faculty, Van, Turkey Abstract. We described the first case report in the literature who developed Complex Regional Pain Syndrome (CRPS type I) symptoms in his right shoulder and right hand within 15 days after open cardiac surgery and discussed shoulder-hand syndrome (CRPS type I) and frozen shoulder diagnosis along with the reasons of no report of CRPS type I in these patients. We also speculated whether frozen shoulder seen in postthoracotomy and postcardiac surgery patients might be CRPS type I in fact. Key words: Complex regional pain syndrome, cardiac surgery, frozen shoulder 1. Introduction Improper patient positioning, muscle division, perioperative nerve injury, rib spreading, and Complex Regional Pain Syndrome (CRPS) is consequent postoperative pain influence the complication of injuries which is seen at the patient's postoperative shoulder function and distal end of the affected area characterized by quality of life (5). In a study Tuten HR et al pain, allodyni, hyperalgesia, edema, abnormal retrospectively evaluated for the incidence of vasomotor and sudomotor activity, movement adhesive capsulitis of the shoulder of two disorders, joint stiffness, regional osteopenia, and hundred fourteen consecutive male cardiac dystrophic changes in soft tissue (1,2). -
Carpal Tunnel Syndrome
Information O from Your Family Doctor Carpal Tunnel Syndrome What is carpal tunnel syndrome? hands a lot. You may notice that over time your Carpal tunnel syndrome (KAR-pal TUN-el grip gets weaker and you tend to drop heavy SIN-drome) is a common, painful disorder objects. of the wrist and hand. It happens when the median nerve, which runs through the wrist, How is it diagnosed? gets squeezed under a band of tissue called a Talk to your doctor if you are having these ligament. This causes pain and other symptoms symptoms. He or she will ask questions about along the nerve (see drawing). the ways you use your hands and about specific What causes it? Anything that increases Shading indicates area pressure on the median where symptoms are felt nerve can cause carpal tunnel syndrome. Sometimes pregnancy and health conditions like arthritis and diabetes can increase the pressure. People who use their hands and wrists repeatedly in the same way (for example, Transverse typists, carpenters, and carpal cashiers) are more likely to get ligament carpal tunnel syndrome. What are the symptoms? Carpal tunnel syndrome Thenar may cause pain, numbness, muscles Wrist or tingling in your wrist and bone hand, mostly in the middle finger, index finger, and Tendon thumb. The symptoms are Median usually worse at night and nerve when you use your wrists and ILLUSTRATION BY KATHRYN BORN continued O Page 1 of 2 Information O from Your Family Doctor Carpal Tunnel Syndrome (continued) symptoms in each part of your hand and wrist. He or she may also test how your nerves and Notes: muscles respond to electrical stimulation. -
Wrist Fracture
Hand Conditions: WRIST FRACTURE A wrist fracture is a break in one or more of the bones in the wrist. The wrist is made up of the two bones in the forearm called the radius and the ulna. It also includes eight carpal bones. The carpal bones lie between the end of the forearm bones and the bases of the fi ngers. The most commonly fractured carpal bone is called the scaphoid or navicular bone. This fact sheet will focus on fractures of the carpal bones of the wrist. Causes A wrist fracture is caused by trauma to the bones in the wrist. Trauma may be caused by: • Falling on an outstretched arm • Direct blow to the wrist • Severe twist of the wrist Risk Factors Factors that increase your chance of developing a wrist fracture include: • Participating in contact sports, such as football or soccer • Participating in activities such as in-line skating, skateboarding, or bike riding • Participating in any activity which could cause you to fall on your outstretched hand • Violence or high-velocity trauma, such as an automobile accident Symptoms If you have any of these symptoms, do not assume they are due to a wrist fracture. Symptoms of a wrist fracture include. • Pain • Swelling and tenderness around the wrist • Bruising around the wrist • Limited range of wrist or thumb motion • Visible deformity in the wrist For more information visit us online at www.ptandme.com Hand Conditions: WRIST FRACTURE Diagnosis Your doctor will ask about your symptoms, physical activity, and how the injury occurred. The injured area will be examined. -
Study Guide Medical Terminology by Thea Liza Batan About the Author
Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails proficiencyincommunicatingwithhealthcareprofessionalssuchasphysicians,nurses, or dentists. -
Table 9-10 Ligaments of the Wrist and Their Function
Function and Movement of the Hand 283 Table 9-10 Ligaments of the Wrist and Their Function Extrinsic Ligaments Function Palmar radiocarpal Volarly stabilizes radius to carpal bones; limits excessive wrist extension Dorsal radiocarpal Dorsally stabilizes radius to carpal bones; limits excessive wrist flexion Ulnar collateral Provides lateral stability of ulnar side of wrist between ulna and carpals Radial collateral Provides lateral stability of radial side of wrist between radius and carpals Ulnocarpal complex and articular Stabilizes and helps glide the ulnar side of wrist; stabilizes distal disk (or triangular fibrocartilage radioulnar joint complex) Intrinsic Ligaments Palmar midcarpal Forms and stabilizes the proximal and distal rows of carpal bones Dorsal midcarpal Forms and stabilizes the proximal and distal rows of carpal bones Interosseous Intervenes between each carpal bone contained within its proximal or distal row Accessory Ligament Transverse carpal Stabilizes carpal arch and contents of the carpal tunnel Adapted from Hertling, D., & Kessler, R. (2006). Management of common musculoskeletal disorders: Physical therapy principles and methods. Philadelphia, PA: Lippincott, Williams & Wilkins.; Oatis, C. A. (2004). Kinesiology: The mechanics and pathomechanics of human movement. Philadelphia, PA: Lippincott, Williams & Wilkins.; Weiss, S., & Falkenstein, N. (2005). Hand rehabilitation: A quick reference guide and review. St. Louis, MO: Mosby Elsevier. The radial and ulnar collateral ligaments provide lateral and medial support, respectively, to the wrist joint. The ulnocarpal complex is more likely to be referred to as the triangular fibro- cartilage complex (TFCC) and includes the articular disk of the wrist. The TFCC is the major stabilizer of the distal radioulnar joint (DRUJ) and can tear after direct compressive force such as a fall on an outstretched hand. -
PE1897 Wrist and Hand Stretches
Patient and Family Education Wrist and Hand Stretches How can I help my child do the stretches? Use these exercises to help stretch the You play an important role in your child’s therapy. Older children may need wrist and hand. reminders to do their stretches every day. You may need to help position your younger child for the stretches. Or you may need to help stretch your child’s hand or arm. Be sure to pay attention to your child’s alignment and posture to make sure each stretch is performed correctly. How often should my child do the stretches? These stretches should be done twice a day, or as instructed by your therapist: ______________________________________________________________ Stretches Wrist extension Hold arm out in front Use opposite hand to bend wrist up with fingers straight Option to straighten elbow for increased stretch Hold for 30 seconds or _______ Repeat 2 times or ___________ VHI Wrist extension Sit with elbows on table Place palms together Slowly lower wrists to table Hold for 30 seconds or ______ Repeat 2 times or __________ VHI Wrist flexion Hold arm out in front Use opposite hand to bend wrist down Option to straighten elbow for increased stretch Option to curl fingers for increased stretch Hold for 30 seconds or ______ VHI Repeat 2 times or __________ 1 of 2 Wrist and Hand Stretches Wrist radial/ulnar deviation To Learn More Hold arm at side of body with palm • Occupational/Physical facing forward Therapy 206-987-2113 Use opposite hand to straighten wrist toward the thumb side Do not allow the wrist to flex forward to extend backward Free Interpreter Hold for 30 seconds or ______ Services Repeat 2 times or __________ • In the hospital, ask BioEx Systems Inc.* your child’s nurse. -
Hand, Elbow, Wrist Pain
Physical and Sports Therapy Hand, Elbow, Wrist Pain The hand is a wondrously complex structure of tiny bones, muscles, ligaments, and tendons which work together to perform tasks. The wrist and elbow are stabilizing joints that support the steady use of the hand and provide attachment points for the muscles that control the hand and wrist. All three of these areas are prone to injury from overuse or trauma. Their complexity requires the skills of an expert for proper rehabilitation from injury. Some Hand, Wrist, and Elbow Issues Include: Tennis/Golfer’s Elbow: Tendonitis, or inflammation of the tendons, at the muscular attachments near the elbow. Symptoms typically include tenderness on the sides of the elbow, which increase with use of the wrist and hand, such as shaking hands or picking up a gallon of milk. Tendonitis responds well to therapy, using eccentric exercise, stretching, and various manual therapy techniques. Carpal Tunnel Syndrome: Compression of the Median Nerve at the hand/base of your wrist. Symptoms include pain, numbness, and tingling of the first three fingers. The condition is well-known for waking people at night. Research supports the use of therapy, particularly in the early phase, for alleviation of the compression through stretching and activity modification. Research indicates that the longer symptoms are present before initiating treatment, the worse the outcome for therapy and surgical intervention due to underlying physiological changes of the nerve. What can Physical or Occupational therapy do for Hand, Wrist, or Elbow pain? Hand, wrist, and elbow injuries are commonly caused by trauma, such as a fall or overuse. -
Standing Shoulder Flexion with Resistance
Prepared by Samantha Bohy Michigan STEP 1 STEP 2 Standing Shoulder Flexion with Resistance REPS: 15 | SETS: 2 | WEEKLY: 5x | Setup Begin in a standing upright position holding one end of a resistance band anchored under your foot with your thumb pointing forward. Movement Lift your arm straight forward to shoulder height, then slowly lower it back down and repeat. STEP 1 STEP 2 Single Arm Shoulder Extension with Resistance REPS: 15 | SETS: 2 | WEEKLY: 5x | Setup Begin standing tall, holding the end of a band that is anchored in front of you. Movement Pull your arm back, bringing your hand behind you. Return to the starting position and repeat. STEP 1 STEP 2 Standing Single Arm Shoulder Abduction with Resistance REPS: 15 | SETS: 2 | WEEKLY: 5x | Setup Begin in a standing upright position holding one end of a resistance band anchored under your feet with your thumb pointing up. Movement Lift your arm straight out to your side, to shoulder height, then lower it back down and repeat. Tip Make sure to maintain good posture and do not shrug your shoulder during the exercise. STEP 1 STEP 2 Shoulder Adduction with Anchored Resistance REPS: 15 | SETS: 2 | WEEKLY: 5x | Setup Begin in a standing upright position holding the end of a resistance band in one hand with your arm straight and palm facing downward, to the side of the anchor point. Movement Pull your arm down against the resistance band to your side, then slowly return to the starting position and repeat. STEP 1 STEP 2 Shoulder External Rotation with Anchored Resistance REPS: 15 | SETS: 2 | WEEKLY: 5x | Setup Begin standing upright with your elbow bent at 90 degrees and a towel roll tucked under your arm, holding a resistance band that is anchored out to your opposite side. -
REVIEW ARTICLE Osteoarthritis of the Wrist
REVIEW ARTICLE Osteoarthritis of the Wrist Krista E. Weiss, Craig M. Rodner, MD From Harvard College, Cambridge, MA and Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT. Osteoarthritis of the wrist is one of the most common conditions encountered by hand surgeons. It may result from a nonunited or malunited fracture of the scaphoid or distal radius; disruption of the intercarpal, radiocarpal, radioulnar, or ulnocarpal ligaments; avascular necrosis of the carpus; or a developmental abnormality. Whatever the cause, subsequent abnormal joint loading produces a spectrum of symptoms, from mild swelling to considerable pain and limitations of motion as the involved joints degenerate. A meticulous clinical and radiographic evaluation is required so that the pain-generating articulation(s) can be identi- fied and eliminated. This article reviews common causes of wrist osteoarthritis and their surgical treatment alternatives. (J Hand Surg 2007;32A:725–746. Copyright © 2007 by the American Society for Surgery of the Hand.) Key words: Wrist, osteoarthritis, arthrodesis, carpectomy, SLAC. here are several different causes, both idio- of events is analogous to SLAC wrist and has pathic and traumatic, of wrist osteoarthritis. been termed scaphoid nonunion advanced collapse Untreated cases of idiopathic carpal avascular (SNAC). Wrist osteoarthritis can also occur second- T 1 2 necrosis, as in Kienböck’s or Preiser’s disease, may ary to an intra-articular fracture of the distal radius or result in radiocarpal arthritis. Congenital wrist abnor- ulna or from an extra-articular fracture resulting in malities, such as Madelung’s deformity,3,4 can lead malunion and abnormal joint loading. -
Wrist and Hand Examina[On
Wrist and Hand Examinaon Daniel Lueders, MD Assistant Professor Physical Medicine and Rehabilitaon Objecves • Understand the osseous, ligamentous, tendinous, and neural anatomy of the wrist and hand • Outline palpable superficial landmarks in the wrist and hand • Outline evaluaon of and differen.aon between nerves to the wrist and hand • Describe special tes.ng of wrist and hand Wrist Anatomy • Radius • Ulna • Carpal bones Wrist Anatomy • Radius • Ulna • Carpal bones Wrist Anatomy • Radius • Ulna • Carpal bones Wrist Anatomy • Radius • Ulna • Carpal bones Inspec.on • Ecchymosis • Erythema • Deformity • Laceraon Inspec.on • Common Finger Deformies • Swan Neck Deformity • Boutonniere Deformity • Hypertrophic nodules • Heberden’s, Bouchard’s Inspec.on • Swan Neck Deformity • PIP hyperextension, DIP flexion • Pathology is at PIP joint • Insufficiency of volar/palmar plate and suppor.ng structures • Distally, the FDP tendon .ghtens from PIP extension causing secondary DIP flexion • Alternavely, extensor tendon rupture produces similar deformity Inspec.on • Boutonniere Deformity • PIP flexion, DIP hyperextension • Pathology is at PIP joint • Commonly occurs from insufficiency of dorsal and lateral suppor.ng structures at PIP joint • Lateral bands migrate volar/palmar, creang increased flexion moment • Results in PIP “buTon hole” effect dorsally Inspec.on • Nodules • Osteoarthri.c • Hypertrophic changes of OA • PIP - Bouchard’s nodule • DIP - Heberden’s nodule • Rheumatoid Arthri.s • MCP joints affected most • Distal radioulnar joint can also be affected