Medical Terminology guide Chapter 4 A.Elbow pain 1. Dignosis and comments -Lateral epicondylitis: Tennis elbow can also occur in patients who don' play tennis. Caused by over extension of extensor. Tendons of wrist and fingers.Tenderness lateral epicondyle. Pain when extending wrist/fingers-opening doors, lifting cups. -Medial epicondylitis: In golfers/ baseball pitchers. Tender over medial epicondyle, where flexors of vvrist and fingers originate. Pain increases on wrist/finger flexion. -Fracture lower end of humerus/ -Upper end of radius/ulna -Dislocation ulna -Subluxation head or radius -Ligamentous injury -Olecranon bursitis Swelling, tender posteriorly -Rheumatoid arthritis -Osteoarthritis -Gout -Myositis ossificans -Malignant deposits Hypertropic pulmonary Osteoarthropathy Periostitus of bone—elbow, wrist, fingers. Painful.Clubbing of fingers. Usually associated wit Lung/pleura/ diaphragm malignancy. Rarely benign -Malingering 2. Test and Reason -X—ray elbow joint: joint pathology -Rheumatoid factor: Rheumatoid arthritis -Serum uric acid:Gout B.Wrist and hand pain 1. Diagnosis and Comments -Fracture-scaphoic /colles Avascular necrosis of scaphoid, chronic pain. Colles -Tenosynovitis: de Quervain disease Tendons of wrist abductors and extensors involvedespecially thumb -Duputren contrracture Tendons of flexors of fingers involved. Pain base of middle and ring finger, up to distal crease of palm. Nodule present due to thickening of fascia.Seen in alcoholics, epileptics, diabetics, Celtic Population -Carpal tunnel syndrome Causes include Colles fracture, hypothyroidism, pregnancy, post hemodialysis, amyloidosis, ganglionof the wrist. Common in mail sorters, keyboard operators. Tingling sensation wakes patient at night.Shakes the hand for relief. Phalen sign positive (more reliable than Tinel sign). Wealmess of abduc-tor pollicis. Wasting thenar eminence, especially abductor pollicis -Thoracic outlet syndrome Positive Adson test. Percussion test in supraclaviculararea positive. Paresthesia over ulnar distribution.Weakness, pain in the hand -Pseudogout Usually involves wrist more often than gout -Hypertropic pulmonary -osteoarthropathy -Fingers -Osteoarthritis-Heberden nodes 2. Tests and Reason -CBC and diffferential: Hb/HCT WBC—infective process -Rheumatoid factor: Rheumatoid arthritis -Free T4 and TSH level: Hypotheridism -Pregnancy test: Pregnancy -Serum uric acid: Gout -Joint fluid cytology: Birefringent strongly negative needle shaped urate crystals in gout. Birefringent weakly positive pleomorphic crystals of calcium pyrophosphate drate Pseudogout -Nerve conduction studies: Carpal tunnel syndrome/thoracic outlet syndrome -X-ray wrist: Wrist pathology -X—ray thoracic outlet: Thoracic outlet syndrome

Medical Terminology Guide For Nurse Students Chapter 4

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