lEARNING OBJECTIVES FOR THIS ON-LINE NARRATED, ANIMATED POWER POINT PRESENTATION
- Describe the joint surfaces and ligament anatomy of the thumb CMC joint
- Describe the natural history of thumb basal joint osteoarthritis
- Collect a good history and perform a good exam for basal thumb complaints
- Plan appropriate non-operative treatment
- Discuss surgical options
- Provide appropriate post-op rehabilitation
Then
- register below
- take the multiple-choice quiz below
and- submit your information for 2 hours
of free CE credit for correct answers
>70%. You will receive your certificate
in 4-6 weeks.
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QUIZ:
1.Which animals have opposable thumbs?
Which animals have opposable thumbs? A.just humans
just humansB.all primates
all primatesC.oppossums, some monkeys, humans
oppossums, some monkeys, humansD.all mammals
all mammalsE.bonobos, humans
bonobos, humans2.The carpometacarpal joint is best described as a
The carpometacarpal joint is best described as aA.hinge joint
hinge jointB.ball and socket joint
ball and socket joint C.ginglymous joint
ginglymous jointD.mortise and tenon
mortise and tenonE.biconcave joint
biconcave joint3.The structure responsible for stabilizing the CMC jiont is the
The structure responsible for stabilizing the CMC jiont is theA.postrior oblique (brow) ligament
postrior oblique (brow) ligamentB.anterior oblique (beak) ligament
anterior oblique (beak) ligamentC.posterior (suspensory) ligament
posterior (suspensory) ligamentD.mortise and tenon joint configuration
mortise and tenon joint configurationE.medial and lateral capsule
medial and lateral capsule4.CMC osteoarthrits is most likely found in
CMC osteoarthrits is most likely found inA.dominant hand, manual laborers
dominant hand, manual laborersB.dominant hand, northern European ancestry
dominant hand, northern European ancestryC.non-dominant hand, female, over 45 years old
non-dominant hand, female, over 45 years oldD.non-dominant hand, male and female equally
non-dominant hand, male and female equallyE.both hands equally, male and female equally
both hands equally, male and female equally5.A pinch 1 pound at the thumb tip results in how much force at the CMC joint?
A pinch 1 pound at the thumb tip results in how much force at the CMC joint?A.13 pounds
13 poundsB.1.3 pounds
1.3 poundsC.130 pounds
130 poundsD.7 pounds in men, 5 in women
7 pounds in men, 5 in womenE.7 pounds before age 40, 5 after
7 pounds before age 40, 5 after6.The differential diagnosis for OA at CMC joint includes
The differential diagnosis for OA at CMC joint includes A.scaphotrapezio trapezoid osteoarthritis
scaphotrapezio trapezoid osteoarthritisB.scaphoid nonunion
scaphoid nonunionC.radiocarpal arthritis
radiocarpal arthritisD.deQuervain tendinitis
deQuervain tendinitisE.all of the above
all of the above7. How strong is the evidence for treating hand OA with chondroitin?
How strong is the evidence for treating hand OA with chondroitin?A. Level 1, multiple studies
Level 1, multiple studiesB. Good
Good C. Shaky at best
Shaky at bestD. Non existent
Non existentE. Works in opposums
Works in opposums 8. Cortisone is effective treatment when administered
Cortisone is effective treatment when administeredA.by iontophoresis
by iontophoresisB. by phonophoresis
by phonophoresisC.sublingually
sublinguallyD.radiographically
radiographicallyE. by intraarticular injection
by intraarticular injection9. A thermoplastic short opponens splint
A thermoplastic short opponens splintA. is dishwasher safe
is dishwasher safeB. wicks moisture away from skin
wicks moisture away from skinC. helps seat the metacarpal on the trapezium
helps seat the metacarpal on the trapeziumD. fits either hand
fits either handE. avoids use of Velcro
avoids use of Velcro10.The Freehand CMZ brace is
The Freehand CMZ brace isA. waterproof
waterproofB. malleable
malleableC. Velcro-free
Velcro-freeD. dishwasher safe
dishwasher safeE. all of the above
all of the above11.Bracing of any sort probably helps by
Bracing of any sort probably helps by A. making the patient sufficiently self-sconscious to hide the hand and not use it
making the patient sufficiently self-sconscious to hide the hand and not use itB. making the hand heavy to tire it out before it has a chance to pinch forcefully
making the hand heavy to tire it out before it has a chance to pinch forcefullyC. seating the scaphoid securely on the radius
seating the scaphoid securely on the radiusD. seating the trapezium securely on the scaphoid
seating the trapezium securely on the scaphoidE. seating the first metacarpal securely on the trapezium
seating the first metacarpal securely on the trapezium12.Good evidence supports the efficacy of
Good evidence supports the efficacy of A. day bracing on alternate days
day bracing on alternate daysB. day and night bracing of both symptomatic and asymptomatic thumbs
day and night bracing of both symptomatic and asymptomatic thumbsC. leisure time bracing for a year
leisure time bracing for a yearD. night bracing for a month
night bracing for a monthE. night bracing for a year
night bracing for a year13.Osteoarthrits is most common in
Osteoarthrits is most common inA. manual laborers, both thumbs equally
manual laborers, both thumbs equallyB. sedentary workers, both thumbs equally
sedentary workers, both thumbs equallyC. men over 50, nondominant thumb
men over 50, nondominant thumbD.women over 50, dominant thumb
women over 50, dominant thumbE. women over 50, nondominant thumb
women over 50, nondominant thumb14. When the CMC joint subluxates and stiffens in adduction, the
A. scaphotrapezial joint becomes more supple
scaphotrapezial joint becomes more suppleB. ulnar collateral ligament at the MP joint stretches out
ulnar collateral ligament at the MP joint stretches outC. MP joint tends to trigger
MP joint tends to triggerD.MP joint stiffens in flexion
MP joint stiffens in flexionE. MP joint hyperextends
MP joint hyperextends 15.The shape of the CMC joint could be best likened to
The shape of the CMC joint could be best likened to A. two Fritos
two Fritos B. two Pringles
two PringlesC. two candy corns
two candy cornsD. a pretzel and a bagel
a pretzel and a bagelE. stale gumdrops
stale gumdrops16.What does LRTI stand for?
What does LRTI stand for?A. ligament reconstruction tendon interposition
ligament reconstruction tendon interpositionB. ligament reconstruction trapezoid incision
ligament reconstruction trapezoid incisionC. lengthy reconstruction technically involved
lengthy reconstruction technically involvedD. ligament repair and transfer intra-articularly
ligament repair and transfer intra-articularlyE. ligate, repair, tranfer, interpose
ligate, repair, tranfer, interpose17.What does HDA stand for?
What does HDA stand for?A. hematoma and distraction arthroplasty
hematoma and distraction arthroplastyB. hamate dissection arthroplasty
hamate dissection arthroplastyC. hematoma drainage and aspiration
hematoma drainage and aspirationD. hand digit apposition
hand digit appositionE. Harold David Austen, strong proponent for LRTI
Harold David Austen, strong proponent for LRTI18. A CMC arthrodesis might be better than an arthroplasty for a
A CMC arthrodesis might be better than an arthroplasty for aA. 34 year-old laborer
34 year-old laborerB. 78 year-old person with osteoporosis
78 year-old person with osteoporosisC. dominant thumb with a history of triggering
dominant thumb with a history of triggeringD. patient without insurance coverage for therapy
patient without insurance coverage for therapyE. patient with scaphotrapezial arthritis
patient with scaphotrapezial arthritis19.Failed trapezial replacements have been made from
Failed trapezial replacements have been made fromA. silicone
siliconeB. polyethylene and stainless steel
polyethylene and stainless steelC. ceramic
ceramicD. pyrocarbon
pyrocarbonE. all of the above
all of the above20.The common denominator for all the effective surgical procedures seems to be
The common denominator for all the effective surgical procedures seems to beA. location of the skin incision
location of the skin incisionB. choice of FCR over APL for tendon weave and interposition
choice of FCR over APL for tendon weave and interpositionC.secure stabilization of the thumb MC base
secure stabilization of the thumb MC base D.therapy beginning on post-operative day 3
therapy beginning on post-operative day 3E. early surgery before joint stiffens from splinting
early surgery before joint stiffens from splinting21. The effective surgical procedures at the CMC joint typically
A.are durable for only several years before requiring revision
are durable for only several years before requiring revisionB. allow for unrestricted use by one week after surgery
allow for unrestricted use by one week after surgeryC.predispose the patient to late carpal tunnel syndrome
predispose the patient to late carpal tunnel syndromeD. do not implant artificial materials
E.automatically correct any compensatory MP joint hyperextension
automatically correct any compensatory MP joint hyperextensionPlease provide you comments about the course. Would you recommend it to
others? Why or why not?
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Find out what Pringles have to do with osteoarthritis.
