If You're Going To Walk The Walk, You Need To Talk The Talk!



First of all, you shouldn't be required to learn a lot of lingo. Lingo is for doctors. Medical terms ought to be translated into to normal language for you.

That said, there are some terms you need to know to facilitate your own understanding.

There really is no better way to specify your bones than with the proper names.

There are several little bones that make up the wrist. Once upon a time, there was a mnemonic for remembering them. It went:

"Never Lower Tommy's Pants,
Grandmother Might Come Home."

Navicular, Lunate, Triquetrum, Pisiform,
Greater multangular, lesser Multangular, Capitate, Hamate.

That corresponds to the placement of the bones if you start at the base of your thumb and move toward the pinky, NLTP: then return to the thumb side and move up toward the fingers to begin the second row from thumb to pinky, GMCH.

The NLTP row, the one closest to the arm, is called the Proximal Row.The GMCH row, the row nearest the fingers, is called the Distal Row.

Having said that (and likely confusing the poo out of you), the names have changed somewhat.

The Navicular is now the Scaphoid. The rest of the Proximal Row is the same.

The Greater Whatnot and Lesser Whatnot have thankfully been renamed as well. They are now Trapezium and Trapezoid, respectively.

So, the Proximal Row from thumb to pinky is:
Scaphoid, Lunate Triquetrum, Pisiform (SLTP)

And the Distal Row is
Trapezium, Trapezoid, Capitate, Hamate (TTCH)

Here is a site with graphics that may be helpful:

http://www.gwc.maricopa.edu/class/bio201/hand/awrist.htm

For a newer but more adult version of the mnemonic, click here.

You will hear about things like STT fusion, which is surgically fusing together the Scaphoid, Trapezium, and Trapezoid, or an SC fusion, which involves, you guessed it, the Scaphoid and Capitate. Knowing the names of the bones gives a mental picture of the procedure. (A total fusion involves all the wrist bones and leaves the joint immobile.)

The wrist bones are called Carpals. You'll see references to a PRC. That's a Proximal Row Carpectomy, which means, literally, the removal (-ectomy) of the Proximal Row of Carpals.

The thicker forearm bone is called the radius and is on the thumb side. The ulna is the thinner forearm bone and is on the pinky side. It is somewhat common for a person with KD to have a "variance" in the length of these bones. You'll read terms like "Ulnar Variance" which means that the ulna is longer or shorter than the radius, or "Neutral Variance" which means that the bones are the same length.

A radial shortening and an ulnar lengthening are exactly what they sound like. The radius is surgically shortened or the ulna is surgically lengthened.

A graft refers to taking a piece of healthy bone from somewhere else, like the radius, and attaching it to another place, like the lunate.

Revascularization is attempting to give the lunate a new blood supply. It is sometimes done with a vascular graft from a nearby source.

Sometimes you'll see things like "pronation" and "supination". Those are fancy words for palm up and palm down. Don't worry too much about them. There's no real need for lay people to use them. Same for words like dorsiflexion (bending the wrist backwards) and subluxation (something shy of a dislocation, a bone moving where it doesn't belong) and anything else you don't understand. Just say what you mean and leave the lingo to the docs.

If you say, "I have pain when I turn my palm up," you'll be understood and there's less likelihood you'll get confused or ask the wrong question or describe the wrong problem.

For a general description of many medical terms, particularly the prefixes and suffixes, go to the Medical Library Association: Medspeak.

Other odd vocabulary used to describe the particulars are:

ADLs
Activities of Daily Living - the general stuff you have to do to lead a normal life

avascular necrosis
without blood, death - the blood supply is lost and the tissue dies. In the case of Kienbock's Disease, the tissue is the lunate. It occurs most frequently in the hip. Having it in the hip does not make one more or less likely to develop it in the wrist, and vice versa.

bone stimulator
A device that works to stimulate bone growth, commonly used to help repair the donor site of a graft.

carpal
refers to any wrist bone. Carpal Tunnel refers to a tunnel that runs through the carpals. A carpectomy is the removal of one or more carpals.
dorsal
the top side of your arm - where the hair and freckles are likely to be

dorsiflexion
same as extension - bending the wrist backward like doing push-ups

external fixator
A device that fully immobilizes the joint during the healing process.

Lichtman stages
the stages of progression of Kienbock's Disease from 1 (possible fracture of the lunate), to 4 (collapse of the lunate, generalized arthritis, and other structural changes).

NSAIDs
Non-Steroidal Anti-Inflammatories - OTC or prescription medications that work to reduce swelling without the use of steroids. Common NSAIDs include Advil, Aleve, and aspirin, and the non-narcotic pain relieving prescriptions like Celebrex or Voltaren (there are too many of them to name). Tylenol is not an NSAID.

OTC
Over-the-counter - Medications that are available without prescription. Tylenol (acetaminophen), Advil or Motrin (ibuprofen), and Aleve (naproxyn sodium) are some examples.

pain scale
On a scale of 1-10, rate your pain with 1 being no pain and 10 being the worst pain imaginable. Childbirth, heart attacks, and kidney stones are frequently referred to as 10.
This scale is extremely subjective and personal. It is generally used in a hospital setting to evaluate the effectiveness of pain medications, however it is frequently used to gauge relative pain among sufferers. A person might say, "Yesterday I was 8/10, but today I'm 6/10," to show his improvement or general status. Expressed as, say, 6/10, it means 6 on a scale of 1-10.

palmar
the palm side of your arm - where your pulse is taken or a TB test given

palmar flexion
same as flexion - bending the wrist toward the "pulse point"

PCA
Patient Controlled Analgesic - used in the hospital or other controlled setting, it is a pump that delivers a narcotic pain medication through an IV.

radial deviation
wrists angled inward toward the thumb

ROM
Range of Motion - a general term for movement

ulnar deviation
the way your wrists are usually bent at the keyboard, angled sideways toward the pinky





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