Download CHT Exam Prep - Trauma Wounds Tendon Transfers Questions And Answers Latest Update 2024 and more Exams Nursing in PDF only on Docsity!
CHT Exam Prep - Trauma/Wounds/Tendon
Transfers Questions And Answers Latest
Update 2024
Stages of wound healing - correct answers Inflammatory 3-5 days Fibroplasia 5-28 days Maturation day 28-2 years When selecting a donor tendon for transfer, the hand surgeon is concerned with what? - correct answers Expendability - Tendon must be strong enough to perform new function in an altered position. What muscle is typically used as donor tendon for wrist ext in pts with radial nerve palsy? - correct answers Pronator teres. What muscle is typically used as donor tendon for wrist ext in pts with CP? - correct answers Flexor carpi ulnaris. Wrist is typically postured in pronation and wrist flex due to increased flexor tone. Transfer of the FCU limits extend of UD and improves voluntary wrist ext.
4 Boyes transfers for radial nerve palsy - correct answers PT to ECRB FDS of middle to EDC FDS of ring to EPL FCR to abductor pollicis longus/EPB Order of repair of structures during digital replantation - correct answers Bony fixation, extensor or flexor tendon repair, nerve repair, skin coverage. What functions are lost in high median nerve palsy? - correct answers Thumb opposition, thumb flexion, and flexion of index and long fingers. Tendon transfers for high nerve palsy (3) - correct answers EDM to APB for thumb opposition Brachioradialis to FPL for thumb IP flexion FDP ring and small anchored to FDP of index and middle (side to side) After repair to completely transected nerve, stretching and gliding exercises should begin when - correct answers Week 4 3 signs present with low ulnar nerve palsy - correct answers Claw hand, jeanne's sign, froment's sign
Therefore, to get the suggested 5mm excursion, a joint must be moved through .5 radian, or 28.64 degrees of flexion. Note a joint with smaller moment arm produces less tendon excursion. Most important goals of thumb reconstruction is restoration of what two things? - correct answers Opposition and sensation. What is affected by low ulnar nerve palsy? - correct answers MP joint flexion, Thumb adduction, index abduction In low median nerve palsy, pt loses thumb opposition. What 3 motions make up thumb opposition? - correct answers abduction, flexion, and pronation. (note, thumb retroposition involves abduction, extension, and supination) What is the primary difference between high versus low ulnar nerve palsy? With high ulnar nerve palsy, what is the most common transfer to provide flexion of the DIP joints to the ring and small fingers? - correct answers Primary difference in high versus low ulnar nerve palsy is
the loss of the ability to flex the DIP joints of the ring and small fingers in high ulnar nerve palsy. FDP index and long tenodesis to FDP of ring and small Communicating branch between ulnar nerve to median nerve occurs high in the forearm. This is called what? - correct answers Martin-Gruber anastomosis. Riche-Cannieu anastomosis - correct answers Occurs in palm communicating branch between deep branch of ulnar nerve and recurrent branch of median nerve in thenar eminence Low ulnar nerve palsy splint places the 4th and 5th MP's in what degree of flexion? - correct answers 30- degrees. In order to be selected as a donor muscle for transfer, muscle should have what grade as a min on MMT? - correct answers 4 or higher - full ROM against gravity with some resistance. What is the strongest wrist extensor? - correct answers ECRB
inserts on the radial aspect of the proximal phalanx of the thumb. At what point after nerve repair will regeneration be initially apparent on sensory exam? - correct answers 6- weeks. Sequence of return in sensibility after nerve trauma - correct answers Deep pressure and pinprick, moving touch, static light touch, discriminative touch. Camitz tendon transfer - correct answers Palmaris longus to APB common for severe CTS assists w abduction vs true opposition. Median nerve Huber tendon transfer - correct answers Abductor digiti minimi insert at level of APB of thumb. used for reconstruction of congenital hypoplasia of thumb median nerve Zancolli lasso tendon transfer is used for what type of palsy? What is it? - correct answers For ulnar nerve palsy
- Uses FDS and passes it through window between A1 and A2 pulleys, then sutures it to the A1 pulley. Creates static tenodesis causing MP flexion, allowing PIP extension through the extrinsic extensor tendon insertion to the central slip.
Bunnell tendon transfer - correct answers opponensplasty tendon transfer using a pulley at the level of the pisiform to recreate opposition with the ring finger FDS tendon. L'Episcipo tendon transfer involve what muscles? - correct answers Latissimus Dorsi & Teres Major inserted to the new posterior and lateral insertion on the humerus for brachial plexus palsy.. Makes them external rotators, instead of internal ones. Boyes tendon transfer - correct answers For radial nerve palsy. Ring finger FDS to EDC to restore digital extension. Lacks synergy as a flexor is used as extensor and retraining may be difficult High radial nerve palsy is differentiated from low radial nerve palsy by what? - correct answers High RNP incl loss of triceps/loss elbow ext, along with all lower level radial nerve innervated muscles. High median nerve palsy is differentiated from low MNP by what? - correct answers High MNP involves loss of pronator teres and pronator quadratus (loss of pronation) along with all lower level MN innervated muscles.
mechanisms. Occurs naturally and can be facilitated by. Moist wound dressings (e.g. hydrocolloid, Latinate, hydrogel dressings) Define denuded - correct answers Loss of epidermis What are 2 unusual donor sites for full-thickness skin grafts? What are 4 more typical sites? - correct answers Unusual: leg and ankle Typical: volar wrist crease, hypothenar eminence, groin/lower abdomen, posterior ear. Key is that there is enough surrounding tissue to lose the donor site. Fibrous insoluble found in connective tissues that represents about 30% of total body protein - correct answers collagen movement of additional white blood cells to an area of inflammation in response to the release of chemical mediators by neutrophils, monocytes, and injured tissue. - correct answers chemotaxis accumulation of a fluid in a cavity, matter that penetrates thru vessel walls into adjoining tissue, or the product of pus or serum. - correct answers exudate
the fluid, semifluid, or solid material that occupies the intercellular space in fibrous connective tissue, cartilage, or bone. - correct answers ground substance Mildest type of cold injury - correct answers chilblains Temperature that tissues freeze at - correct answers - celcius - frostbite occurs with tissue freezing and resultant death. normal body temp is 37 celsius, or 98.6 deg Procedure for rewarming tissue after frostbite - correct answers Rapidly rewarming at 40degC to 44degC (104- 112 deg F) is most important step in salvaging the tissue and function of a frostbitten limb. Rewarming usually occurs within 30 mins and can be very painful. suppurative abbess on the fat pad of the finger that often decompresses spontaneously - correct answers felon - there is often an increase in pressure with throbbing and pain. usually a hx of a puncture wound or other penetrating injury. collar button infection - correct answers occurs in the webspace with a fissure in the skin and is treated with surgical drainage.
