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
   • HAND INNERVATION
     • 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
     • Types
       • 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

3. 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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