My Hands Are Aching

Anatomy of the hand
1. Bones
2. Intrinsic Muscles of the hand
  1. 1st layer
  2. 2nd layer
  3. 3rd layer
  4. 4th layer
3. HAND INNERVATION
  1. Nerves
    1. Median
      1. COMPRESSION
        CARPAL TUNNEL SYNDROME
      2. INJURY
        APE Hand Deformity
        INABILYTY TO OPOSE THE THUMB
        Atrophy
    2. Ulnar
      1. Lesion in the UPPER TRUNK
        paralysis
        PARTIAL CLAW HAND
    3. Radial
      1. COMPRESSION ON THE AXILLA
        Wrist/Finger drop.
    4. Innervation
4. Joints
  1. Types
    1. Wrist Joint
      1. Articulations
        Distal radius with scaphoid & lunate.
      2. Movements
        Flexion
        Extension
        Abduction
        Adduction
    2. intercarpal joints
      1. between two rows of carpal bones
    3. Carpometacarpal joint
      1. Between distal row of carpals and proximal end of the metacarpals.
    4. Metacarpophalangeal joints
      1. between distal metacarpals and proximal phalanges
    5. Interphalangeal joints
      1. allow mainly ﬂexion and extension.
5. Synovial fluid
  1. Functions
    1. nutrition of articular cartilage
    2. lubrication
  2. Composition
    1. hyaluronic acid
    2. lubricin
    3. proteinases
Rheumatoid Arthritis
1. OA vs. RA
2. autoimmune disease
  1. Dependent on cross reactivity
  2. Link with
    1. MHC class II gene
      1. HLA- DR4
      2. HLA-DR1
  3. Pathology
3. Risk Factors
  1. Age
    1. 40 & 60
  2. Gender
    1. Females
  3. Family History
  4. Smoking
  5. Environmental Exposure
  6. Obesity
4. Neurological examination
  1. Motor and sensory function
  2. Pain
  3. Numbness
  4. Paresthesias
  5. Muscle spasm
5. Symptoms
  1. Swelling
  2. Stiffness
  3. Numbness or tingling
  4. Joint pain
  5. Nodules
6. Investigations
  1. X-ray
  2. ESR
  3. RF latex test
7. Complications
  1. Fevre
  2. Fatigue
  3. Muscle atropy
  4. Anemia
  5. Sinus
Management of RA
1. Physiotherapy
  1. Excercise
  2. Cold treatment
  3. Heating modalities
  4. Hydrotherapy
  5. Group therapy
2. NSAIDS
  1. pathway
  2. MoA
  3. Clinical applications
    1. Metastatic bone pain
    2. Rheumatoid arthritis
    3. Osteoarthritis
    4. Acute gout
  4. Adverse effects
3. DMARDs
  1. Methotrexate
  2. Hydroxychloroquine
  3. Sulfasalazine
  4. Leflunomide
  5. Minocycline
  6. TNF inhibitors
  7. non-TNF inhibitors
4. Reasons for Noncompliance
  1. Patient-based causes
  2. Physician based causes
  3. Medication based causes

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My Hands Are Aching

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	Created by Dua Ga almost 7 years ago