My Hands Are Aching

My Hands Are Aching

1. Anatomy of the hand

   • Bones
   • Intrinsic Muscles of the hand
     • 1st layer
     • 2nd layer
     • 3rd layer
     • 4th layer
   • Nerves
     • Median
       • COMPRESSION
         • CARPAL TUNNEL SYNDROME
       • INJURY
         • APE Hand Deformity
           • INABILYTY TO OPOSE THE THUMB
           • Atrophy
     • Ulnar
       • Lesion in the UPPER TRUNK
         • paralysis
           • PARTIAL CLAW HAND
     • Radial
       • COMPRESSION ON THE AXILLA
         • Wrist/Finger drop.
     • Innervation
   • Joints
     • Wrist Joint
       • Articulations
         • Distal radius with scaphoid & lunate.
       • Movements
         • Flexion
         • Extension
         • Abduction
         • Adduction
     • intercarpal joints
       • between two rows of carpal bones
     • Carpometacarpal joint
       • Between distal row of carpals and proximal end of the metacarpals.
     • Metacarpophalangeal joints
       • between distal metacarpals and proximal phalanges
     • Interphalangeal joints
       • allow mainly flexion and extension.
   • Synovial fluid
     • Functions
       • nutrition of articular cartilage
       • lubrication
     • Composition
       • hyaluronic acid
       • lubricin
       • proteinases

2. Rheumatoid Arthritis

   • OA vs. RA
   • autoimmune disease
     • Dependent on cross reactivity
     • Link with
       • MHC class II gene
         • HLA- DR4
         • HLA-DR1
     • Pathology
   • Risk Factors
     • Age
       • 40 & 60
     • Gender
       • Females
     • Family History
     • Smoking
     • Environmental Exposure
     • Obesity
   • Neurological examination
     • Motor and sensory function
     • Pain
     • Numbness
     • Paresthesias
     • Muscle spasm
   • Symptoms
     • Swelling
     • Stiffness
     • Numbness or tingling
     • Joint pain
     • Nodules
   • Investigations
     • X-ray
     • ESR
     • RF latex test
   • Complications
     • Fevre
     • Fatigue
     • Muscle atropy
     • Anemia
     • Sinus
   • Management of RA
     • Physiotherapy
       • Excercise
       • Cold treatment
       • Heating modalities
       • Hydrotherapy
       • Group therapy
     • NSAIDS
       • pathway
       • MoA
       • Clinical applications
         • Metastatic bone pain
         • Rheumatoid arthritis
         • Osteoarthritis
         • Acute gout
       • Adverse effects
     • DMARDs
       • Methotrexate
       • Hydroxychloroquine
       • Sulfasalazine
       • Leflunomide
       • Minocycline
       • TNF inhibitors
       • non-TNF inhibitors
     • Reasons for Noncompliance
       • Patient-based causes
       • Physician based causes
       • Medication based causes

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