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Flashcards in Clincal Deck (179)
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1
Q

What is cervical Spondylosis

A

Degenerative osteoarthritis of IV joint in cervical spine- puts pressure on nerve roots - leads to radiculopathy….
(Myotomal mu weakness, dermatomal sensory symptoms)

2
Q

What is importance of surgical neck of humerus in children

A
  • region of epiphyseal growth- if damaged;asymetric growth
  • epiphyses solely dependant on supply from epiphyseal arteries- if disrupted- no compensation from metaphysical artery- Ischaemic necrosis
3
Q

How would you test for peripheral nerve lesions??

A

Sensation in skin Innervated by peripheral nerve

4
Q

What is usually injured in conjunction with medial collateral or ACL injuries

A

Menisci

5
Q

Where is safest for intramuscular injection

A

Ventrogluteal site

6
Q

OA XR shows…

A

Reduced joint space, osteophytes, calcification, bone cyst

7
Q

What is malignant. Hyperthermia

A

Point mutation in ryanodine receptor- susceptible to volatile anesthetic-> RR opens and massive Ca influx- to sequester, SERCA increases rate and ATP use- raises MET dramatically

  • raised temp, respiratory acidosis, tachycardia
    Antidote- dantrolene- binds RR to prevent Ca release (mu relaxant)
8
Q

The action of what muscle is also lost in ulnar nerve lesion at the elbow rather than the wrist

A

Flexor digitorum profundus

9
Q

What is the sign of Klumpkes palsy and why

A

Hand has clawed appearance

  • MCP joints are hyperextended and IP joints are flexed

And. Wrist extended

10
Q

Describe RA

A

Autoantibodies attack synovium –>synovial inflammation -Pannus forms
Pannus erodes cartillage and bone

11
Q

How would you test for suspected femoral nerve damage ?

A

Test quadriceps femoris muscle

  • pat supine with knee slightly flexed
  • ask to extend leg- resist movement - contraction of QF should be visible
12
Q

What digits are affected in ulnar nerve injury and what results

A

Little and ring

Ulnar claw

13
Q

What two tests can be done to test for. Carpal tunnel syndrome

A

1- Tinel’s sign- tap nerve in carpal tunnel to elicit pain in median nerve distribution \

2- phalen’s manoeuvre- hold wrist in Flexion for 60 sec to elicit numbness /pain in median nerve distribution

14
Q

What is the normal curvature of spine?

A
2 kyphoses (anterior flexions)- thoracic and sacrococcygeal
2 Lordoses (posterior flexions) - cervical and lumbar
15
Q

What can you fracture if you fall onto the shoulder or outstretched hand?

A

Clavicle

16
Q

What is the common cause and presentation of thoracic outlet syndrome

A

Cause- trauma ( fractured clavicle), repetative Adduction

Presentation - pain in shouder, neck arm , may be tingling , muscle weakness, discolouration

17
Q

How may collateral ligaments be torn and how would damage be assessed

A

Cause- force being applied to side of knee when foot placed on ground

Ask pat to rotate leg

  • pain on medial rotation - damage to medial ligament
  • pain on lateral - damage to lateral ligament
18
Q

Explain the presentation of hip fracture

A

Shortened limb- flexors/ adductors / extensors pulling distal fragment up

Externally rotated- Iliopsoas attached to lesser trochanter- externally rotate distal fragment

Abducted - Gluteus Medius/ minimus attached to greater trochanter - abduct distal fragment

19
Q

What does injury to the radial nerve in the AXILLA result in

A

Triceps and muscles in posterior compartment PARALYSED- unable to extend forearm, wrist, fingers–> wrist drop

Sensory loss- lateral and posterior upper arm, posterior forearm,
Dorsal surface of lateral 3 and half digits

20
Q

What can cervical Spondylosis lead to

A

Pressure on spinal cord and myelopathy- global weakness, gait dysfunction, loss of balance, loss of bladder/bowel control

21
Q

What is spinal bifida?

A

NTD- NT fails to develop or close properly - defects in s.cord and bones of spine

Most severe- myelomeningocele- babies spinal canal remains open along several vertebrae in lower/middle back

22
Q

What are the symptoms of carpal tunnel syndrome

A

Paresthesia in distribution of median nerve . Pain radiate to forearm (worse in am)

23
Q

What commonly causes elbow dislocation

A

Young child falls on hand with the elbow flexed

24
Q

What is IT band syndrome ?

A

Continual rubbing of the iliotibial tract band over the lateral femoral epipcondyl + repeated Flexion and extension of knee

-> area inflammed

25
Q

What may cause swollen forearm, arm and shoulder with superficial venous distension, numbness and skin cyanosis

A

Axillary vein thrombosis- occlusion of Axillary /subclavian vein

26
Q

What is a boxers fracture

A

Fracture in 5th metacarpal neck

Distal part of fracture displaced posteriorly - shortening

27
Q

What is osteoporosis ?

What 2 types exist?

What are the risk factors?

A

Metabolic Bone disease- reduced mass of mineralised bone- no longer adequate support- fractures

T1- post menopausal women- low oe- increase OC
t2-elderly - attenuated OB function

RF- insuff ca intake./ absorption, insuff vit D absorption, smoking

28
Q

What is a hangmans fracture ?

A

Hyperextension of head on neck - axis fracture through pedicles - forward displacement of C1 and body of C2 on C3

Signifignant spinal cord injury - quadriplegic

29
Q

What is sciatica ?

A

Pain from compression or irritation of sciatic nerve - pain in buttocks/leg, leg weakness, burning/tingling down leg,

30
Q

What is golfers elbow

A

Epicondylitis - overuse strain of common tendon attaching the flexor muscles to the medial epicondyl

31
Q

What happens in a median nerve injury and what is a patient being asked to do

A

Hand of benediction

Asked to make fist

32
Q

How is a gynecoid pelvis adapted for childbirth

A

Greater pelvis outlet

  • oval inlet
  • less prominent ischial spine- greater bispinous diameter
  • sacrum shorter , more curved, less pronounced sacral promontory
33
Q

Which muscles are paralysed in median nerve injury ? What is the result?

A

Lateral two lumbricals and medial half of FDP

Inability to flex at MCP and IP joints in middle and index finger

34
Q

Where is a lumbar puncture done?

A

L2/3, L3/4, L4/5 - after conus medullaris- so only mobile spinal nerve roots, not cords

35
Q

How is the femoral artery palpated?

A

Inferior to where crosses inguinal ligament- midway between pubic symphysis and anterior superior iliac spine

36
Q

What may compress the brachial plexus and lead to paresthesia and mu weakness

A

Axillary artery aneurysm - compress BP

37
Q

Where is prone to fracture in the fibula and how

A

At ankle- lateral malleolus of fibula

  • forced external rotation of ankle ; spiral fracture
  • foot twisted outwards- transverse fracture
38
Q

What is tennis elbow

A

Epicondylitis- overuse strain of common tendon attaching extensor muscles to lateral epicondyl

39
Q

What is an avulsion fracture of the ischial tuberosity

A

Hamstring tendon tears off a fragment of ischial tuberosity

40
Q

What artery is at risk in NOF fracture

A

Lateral circumflex

41
Q

What muscles are paralysed in Erbs palsy

A

Supraspinatus , intraspinatus, subclavius, biceps brachii , brachialis, coracobrachialis, deltoid, teres minor

42
Q

What is the sign of Erbs palsy

A

Limb hangs limp, medially rotated (unopposed pec major), forearm pronated (loss of biceps brachii) -‘'’waiters. Tip”

43
Q

What is kyphosis

A

Excessive thoracic curvature - hunchback

44
Q

What is Paget’s disease. Of bone

A

Excessive breakdown and formation of bone–> disorganised bone remodelling-> weakened bone-> pain, misshapen bones, fractures and arthritis

45
Q

What may be damaged by upward movement of medical part of clavicle fracture ? What would result?

A

Suprascapular nerve
- Innervates lateral rotators (eg infraspinatus ) and so damage results in unopposed medial rotation of upper limb- waiters tip position .

46
Q

What movements are lost in Erbs Palsy

A

Abduction of shoulder, lateral rotation of arm, suprination of forearm, Flexion of shoulder

47
Q

name 2 common distal humeral fractures

A

Medial Epicondyle , supracondylar

48
Q

What it’s the treatment of myelomeningocele

A

Surgery after birth- place s.cord and tissue inside babies body

49
Q

What may cause an upper brachial plexus injury

A

Excessive angle increase between neck and shoulder- stretch nerve roots
Eg- shoulder trauma, difficult birth

50
Q

Where would you test for sensation in a radial nerve lesion

A

Posterior surface of forearm and dorsolateral surface of hand (3 1/2 digits)

51
Q

What is the unhappy triad caused by

A

Lateral force to extended knee

52
Q

What can cause scoliosis

A

Primary (congenital) , idiopathic , secondary (nm disease)

Cosmetic difficulties, severe- decreased lung capacity

53
Q

How would you test C5 Dermatome?

A

Sensation of upper lateral region of arm

54
Q

What is a bakers cyst

A

Inflammation and swelling of Semimembranous bursa - sign of chronic knee effusion

  • usually assoc with arthritis
55
Q

Describe osteomalacia

A

During bone remodelling- deficient calcification of formed bones as decreased Ca per bone unit- bones soften

56
Q

What is a lower brachial plexus injury called ? What is it caused by, which nerves does it affect?

A

Klumpke Palsy - due to excessive abduction of arm

damaging nerves from T1 root
- ulna and median nerves

57
Q

What is the unhappy triad

A

Damage to medial collateral ligament - resulting (due to attachment) in damage to medial meniscus. ACL also affected

58
Q

What is the most common direction for shoulder dislocation and how does it occur

A

Anterior as least support inferiorly
Usually trauma on fully aducted arm

  • humeral head forced anteriorly and INFERIORLY (due to adductors) and medially (pec major)
59
Q

What is the risk with a proximal clavicular fracture?

A

Pneumothorax

60
Q

What end of the tibia is more vulnerable to damage? What may happen

A

Proximal - condyles may be broken up in fracture

- may be injury to ligaments of knee

61
Q

What is piriformis syndrome

A

Caused when piriformis muscle compresses sciatic nerve due to hypertrophy or spasm of piriformis muscle

More common if piriformis splits prematurely and pierces piriformis

62
Q

What neurovascular structures are at risk of damage in a intramuscular injection into the deltoid

A

Axillary nerve and posterior circumflex artery

63
Q

During what motion is pain present in painful arch syndrome

A

Arm abduction 50-130 degrees

64
Q

What nerves are affected in Erbs palsy

A

Nerves derived from C5 and C6 roots solely

- MC, Axillary , suprascapular and nerve to subclavius

65
Q

Where does the humerus move in a elbow dislocation

A

Distal end driven through joint capsule at anterior side
- ulnar collateral ligament usually torn

Often ulnar collateral ligament torn
(Called ‘posterior dislocation)

66
Q

How does fracture NOF present

A

Shorter, laterally rotated

67
Q

How would you test the C7 (spinal cord level 7) Dermatome?

A

Sensation on pad of the index finger

68
Q

How do you test median nerve ? (Motor)

A

1- test thumb- resisted palmar abduction

2- test opposition

69
Q

What is the nerve supply that may be damaged in a Shoulder injury

A

Axillary, suprascapular and lateral pectoral nerves (C5 and C6)- so Erbs palsy will affect shoulder joint function….

70
Q

How do you test myotome T1?

A

Abduction and Adduction of index, middle, and ring fingers

71
Q

How do you treat carpal tunnel pathology ?

A

Splint, steriods, carpal tunnel releases

72
Q

How do you test myotome C6?

A

Flexion of forearm at elbow

73
Q

What way does the nucleus pulposus usually herniate?

What is the risk

A

Posteriolaterally- may compress signal nerve roots

If herniates POSTERIORY- may cause spinal cord compression- neurosurgical emergency

74
Q

What may cause swelling in popliteal fossa? (5)

A
Bakers cyst
Popliteal aneurysm
DVT
Adventitial cyst of popliteal artery
Neoplasm
75
Q

How would you test the spinal cord level C8 (C8 dermatomes)

A

Sensation of pad of little finger

76
Q

What sensation if lost in Erbs palsy

A

Sensory innervation of MC and Axillary nerves- lateral side of arm

77
Q

What is congenital hip dislocation ?

A

Abnormality in either shape of femur, acetabulum or supporting structures
– > acetabulum and femur not in close contact

(Assoc with breech )

78
Q

How may fracture to the femoral shaft occur and with what consequences

A

Traumatic injury

  • spiral fracture- leg shortening as fragments overriding
  • soft tissue damage
  • femoral nerve palsy
  • comprimise to femoral artery b supply
79
Q

What 3 nerves may be damaged in relation to humerus fracture and why>

A

Axillary- around posterior aspect of surgical neck
Radial - passes diagonally around post. Surface of middle of humerus ( radial groove).
Ulnar- posterior to medial epicondyl at distal end f humerus

80
Q

What is Amelia and meromelia

A

Amelia- complete absence of limb

Meromelia- partial absence of one/ more limb structures.

81
Q

What happens with vitamin A deficiency

A

Affects endochondrial bone growth- reduced growth

82
Q

Which nerves are at risk in the following humeral fractures?

  • surgical neck
  • shaft
  • medial epicondyl
  • supracondylar fracture
A

Axillary
Radial
Ulnar
Medial

83
Q

What is myotonia congenita

A

Mut in Cl channel- Can’t relax muscles at will)-

84
Q

What is a Bennetts fracture ?

What is it caused by

A

Fracture of 1st metacarpal base extending into carpometacarpal joint

Caused by hyperabduction of thumb

85
Q

Describe rickets

A

Childhood- lack vitamin D- lower Ca uptake- decreased calcification of osteoid - poorly mineralised bones
-bones distort, grow slow, prone to fracture

86
Q

Which knee menisci is more likely damaged

A

Medial

87
Q

What is the treatment for sciatica

A

NSAIDS, ibuprofen, epidural steroid injection , physiolog, surgery

88
Q

What neurovascular structures are at risk of damage in a shoulder dislocation or humeral surgical neck fracture?

A

Axillary nerve, circumflex artery

89
Q

What movement is affected with ulnar nerve lesion

A

Unopposed extension at MCP joints (from posterior forearm)

Unopposed Flexion at IP joint (unopposed Flexion from flexors of anterior forearm)

90
Q

Where is commonly fractured in clavicle ? What happens to the fragments

A

Junction of medial 2/3 and lateral 1/3

Lateral end of clavicle - displaced inferiorly (arm weight),& medially ( pec major)
Medial end - pulled superiorly by sternocleidomastoid muscle

91
Q

What is syndactyly and polydactyly?

A

Syndactyly- fusion of digits- cutaneous or osseous

Polydactyly - extra digits

92
Q

What is the. risk with scaphoid fracture and why

A

Scaphoid b supply is distal to proximal

Risk of avascular necrosis - > future arthritis

93
Q

Explain trendelenburgs sign

A

-pat stand unassisted on each leg- pelvic drop on unsupported leg

  • indicates superior gluteal nerve damaged (on other side)
  • muscles of G min/Medius paralysed- cannot prevent pelvis drop on other side
94
Q

What happens with damage to long thoracic nerve

A

Paralysed serratus anterior (pulls costal face of scapula against throracic cage)-
Winging of scapula when pushing with arm against wall

95
Q

What are some causes of carpal tunnel syndrome

A

Diabetes, pregnancy, trauma, RA, idiopathic, neoplasm (MEDIAN TRAP)

96
Q

What 3 structures are damages in the unhappy triad

A

ACL, medial collateral ligament, medial meniscus

97
Q

What is a Colles fracture

A

Fracture of distal radius- dorsal displacement of distal fragment

Dinner fork deformity

98
Q

How do you test the ulnar nerve (motor)

A

1- test Adduction (. Against your index and middle finger )
2- Froment’s test
-> pat grip paper with thumb and index finger- ask them to resist you pulling paper away- LESION: can stop but will flex thumb to compensate)

99
Q

What is ‘groin strain’ due to

A

Strain of the adductor muscles - mostly proximal part

Treat- RICE (rest, ice compression elevation)

100
Q

What is a femoral hernia, what are the risks?

A

Bowel pushes through into femoral canal , underneath the inguinal ligament
- borders of F Canal are tough - risk strangulation

101
Q

What causes muscle strain of the hamstrings …

A

Excessive stretching or tearing of the mu fibres

Grade 1- Overstretching wo tear
Grade 2- partial tear
Grade 3- severe/ complete rupture

102
Q

How can the lunate bone be dislocated

What is the risk

A

Falling on dorsiflexed wrist
Lunate forced anteriorly - can compress carpal tunnel- CP syndrome symptoms (paresthesia, weakness)
Also lunate can undergo avascular necrosis

103
Q

Where would you test for sensation in a median nerve lesion

A

Palmar surface of lateral 3 and a half digits

and also over nail beds on anterior side

104
Q

What would damage to radial nerve in midshaft fracture result in

A

Triceps WEAKENED, not paralysed,
Muscles in posterior forearm paralysed- can’t extend fingers/wrist - wrist drop
Sensory loss- o Bly on dorsal surface of lateral 3 and half digits and associated Palm area

105
Q

Where does the medial meniscus of the knee attach

A

Intercondylar attachment,
+fixed to TIBIAL COLLATERAL LIGAMENT and joint capsule

  • so damage to TC ligament–> tearing of medial meniscus
106
Q

What is common cause of sciatica?

A

Most due to spinal disc herniation pressing on one of lumbar or sacral nerve roots

(Or lumbar spinal stenosis, pregnancy )

107
Q

How do you treat extracapsular hip fracture

A

Dynamic screw- no disrupted blood supply- no avascular necrosis

108
Q

What is posterior draw test

A

Hold knee in flexed position and push shin posteriorly - If movement- ligament is torn

109
Q

where will pain be felt in scaphoid fracture

A

Anatomical snuffbox

110
Q

What happens with a atlas fracture

A

‘Jefferson’s fracture’- fracture of anterior and posterior arches of atlas- no neuro symptoms, but PAIN

111
Q

How can. ACL be torn

A
  • hyperextension of knee

- large force to back of knee with joint partly flexed

112
Q

What is pulled elbow?

A

Common in children- head of radius subluxates from annular ligament- head of radius move from articulation with humerus and ulna

  • children as bones continuing to ossify from cartillage
113
Q

How do you test myotome C8?

A

Flexion of fingers

114
Q

How would an anterior dislocation of shoulder present clinically?

A

Shoulder appears square, head of humerus lies below corocoid process, arm supported by other hand

115
Q

Which digits are affected in median nerve injury

A

Medial and index finger

116
Q

What can be damages in mid shaft humeral fracture. What will result?

*check

A
  • profunda brachii artery
  • radial nerve- Innervated extensors of wrist- paralysed- unopposed Flexion of wrist- wrist drop
  • sensory loss- dorsal aspect thumb, middle finger and index finger, and associated Palm
117
Q

How may surgical neck of humerus occur

A

Fall outstretch hand/ direct blow

118
Q

What are symptoms of congenital dislocation of femoral head

A
  • inability to abduct at hip joint
  • affected limb is shorter
  • +ve trendelenburg sign
119
Q

What is associated with dislocation of acromioclavicular joint?

A

Soft tissue damage

Blow to joint , fall outstretched hand

120
Q

How can the PCL be torn ?

A

‘Dashboard injury’- knee flexed and large force to shins- push tibia posteriorly

-hyperextension of knee joint

121
Q

Why may axilla lymph nodes be biopsied if suspected Br Ca?

What is risk of Axillary clearance

A

75% lymph drain s into axilla lymph nodes

Long thoracic nerve damage- winged scapula

122
Q

What are XR features of RA

A

Narrowing joint space, periarticular osteopenia, juxta-articular bony erosions , subluxation and gross deformity

123
Q

What is Smiths fracture

A

Fall onto back of hand

Distal radius fracture- distal fragment placed ANTERIORLY

124
Q

What is the allens test

A

Occlude radial artery with fingers and ulnar with thumb- pump hand- release ulnar- pink up- So have PATENT ulnar artery — can do radial a artery puncture

125
Q

What is the risk with a posterior hip dislocation

A

Damage to sciatic nerve- paralysis of hamstrings or muscles distal to knee

126
Q

How would you test accessory nerve?

A

Test trapezium funciton - ask to shrug shoulders

127
Q

How is diagonal conjugate of pelvis measured

A

From inferior border of pubic symphysis to sacral promontory

128
Q

What is the risk in a medial epicondyl fracture of the humerus ?

A

Damage to ulnar nerve- ulnar claw

Loss sensation over medial 1 and half fingers (both palmar and dorsal surfaces)

129
Q

What is marginal osteophytosis

A

nucleus pulposus dehydrates with age - height IV disc decreases- reactive marginal osteophytosis ajacent to affected end plates =Osteocytes at periphery of vertebra.

130
Q

What is thoracic outlet syndrome?

A

Vessels and nerves (Axillary artery/vein and cords of Br.Plexus) become compressed between the bones in the apex of the axilla region
(Clavicle, 1st rib and scapula)

131
Q

What is at risk of damage in a surgical neck (humerus) fracture

What is the result

A

Axillary nerve damage
Paralysed deltoid and teres minor- can’t abduct arm
Sensory loss over regimental badge area

(Also risk damage to posterior circumflex artery)

132
Q

Where is the brachial pulse felt?

A

Median to biceps tendon in cubital fossa

133
Q

What prevents anterior/posterior movement of tibia on femur

A

Anterior dislocation - ACL prevents

Posterior - PCL

134
Q

What is a Galeazzi’s fracture?

A

Fracture to radial shaft ( usually distal)

Ulnar head dislocating at distal radio-ulnar joint

135
Q

Where would you test for sensation in a ulnar nerve lesion

A

Medial one and half digits

136
Q

Where is accessed for venepuncture ?

A

Median cubital vein

137
Q

What is a ‘slipped disc’?

A

Herniation of the nucleus pulposus- breaks through annulus fibrosus and lies outside disc space in spinal cord

138
Q

What are the two types of #NOF

A

Intracapsular (fracture within capsule of hip joint)

ExtracapsulAr

139
Q

What type of aquired femoral head dislocation is most common

A

Posterior dislocations - femoral head forced posteriorly - tear through inferior and posterior part of joint capsule

140
Q

What is lordosis

A

Excessive lumbar curvature- swayback deformity

141
Q

What is lumbosacral plexopathy

A

Disorder affecting either lumbar or sacral plexus- damage to nerve bundles.

Caused by- diabetic amyotrophy-> high b sugars damage nerves

  • idiopathic.
  • tumours –> compression
142
Q

Where would you test for sensation in a Musculocutaneous nerve lesion?

A

Anterolateral side of forearm

143
Q

What can occur from falling on a flexed elbow? What is the risk?

A

Supracondylar fracture (transverse)
Risk
- displaced fragments impinging on /damaging C.fossa contents
- median/radial nerve damage
- VOLKMANNS ISCHAEMIC CONTRACTURE- damage/swelling interfere with b. Flow from brachial artery to forearm- ischemic- flexors become fibrotic and shorten- uncontrolled Flexion of hand

144
Q

Describe OA

A

Erosion of articular cartilage- over expr matrix degrading Enz- reduced ability to shock absorb- bones exposed and rub. Tendons/lig stretch giving pain. Bone remodels and forms ostrophytes (limit movement)

145
Q

How would you test for Axillary nerve damage in a fractured humerus

A

Test sensation on regimental badge region

Nb Not able to abduct arm as loss sensation of deltoid

146
Q

What is ulnar paradox

A

Ulnar nerve lesion at elbow- less deformity, more disability

  • as lost FDP so no Flexion at DISTAL IP joints- lesser deformity
147
Q

What is the motor and sensory loss of klumpkes palsy

A

Motor- all small mucles of hand - interossei, THENAR and hypothenar
Sensory - along medial side of arm

148
Q

What is scoliosis

A

Lateral curvature of the spine

149
Q

What is clergyman’s knee

A

Friction between skin and tibia- inflamed infrapatellar bursa

150
Q

What can be damages in shoulder dislocation ? How would you check?

A

Axillary nerve damage
- loss of sensation in regimental badge area

  • NOT test motor function - could cause soft tissue damage and injure Axillary nerve
151
Q

How would you test Dermatome T1?

A

Sensation of skin on medial aspect of elbow

152
Q

How may the radial nerve be damages at the axilla?

A

Humeral dislocation, fracture of proximal humerus

153
Q

What is the risk with intracapsular fracture , who is it common in

A

Elderly - esp women

Risk damage to medial femoral circumflex artery - avascular necrosis - need total hip replacement or hemiarthroplasty

154
Q

Dislocation of sternoclavicular joint is rare…. But what direction is more common

A

Anterior (blow to anterior shoulder)

155
Q

How would you test the C6 Dermatome?

A

Palmar pad of the thumb

156
Q

What is olecranon bursitis

A

bursa at olecranon of elbow- inflamed/ filled with fluid- limit movement and cause pain

Cause- prolonged pressure , trauma, infection

157
Q

How do you test C7 myotome

A

Extension of forearm at elbows

158
Q

What is the anterior draw test?

A

Attempt to pull tibia forwards- if it moves, the ACL has been torn

159
Q

What is the risk of an aneurysm in the popliteal artery

A

Popliteal fascia relatively tough- tibial nerve susceptible to compression- paresthesia/loss motor function

(May see pulsation in popliteal fossa

160
Q

What is schuermanns disease

A

Kyphosis of thoracic or lumbar spine due to uneven vertebral growth (wedge shaped) -

161
Q

How does the patella usually dislocate

A

Laterally.

Direct trauma/ twisting movement

162
Q

What is the commonest type of intra capsular fracture of the proximal femur

A

Subcapital fracture - fracture line extends through the junction of the head and neck of femur

163
Q

What. Is painful arch syndrome

A

Pain on abduction of arm from 50-130 degrees due to
-supraspinatus tendon rubbing under the coraco-Acromial arch –> causes irritation and inflammation of SS tendon / subacromial bursa

Leads to - subacromial bursitis, SS tendonitis

164
Q

How may median nerve be damaged

A

Supracondylar fracture of humerus

165
Q

What muscles are paralysed in ulnar claw (from damage at the wrist)

A

Medial 2 lumbricals

166
Q

Which 3 bursa can become inflamed in the hip

A

Trochanteric bursa, iliopsoas bursa, ischiogluteal

167
Q

What causes whiplash

A

Hyperextension and hyperflexion- bones move long way and back into place- may be impingement on spinal cord.

168
Q

Describe a fracture of the tibia at the ankle

A

Medial malleolus can be fractured when ankle is twisted inwards ( overinversion)

  • talus forced against medial malleolus–> spiral fracture
169
Q

What is housemaids knee?

A

Friction between skin and patella- prepatella bursa inflamed (anterior knee)

170
Q

What are the risks with myelomeningocele

A
  • neural tissue exposed- life threatening infection

- neuro impairment - mu weakness, bowel/bladder prob, seizures, ortho prob- scoliosis, deformed feet

171
Q

What causes cubital tunnel syndrome ? What are symptoms?

A

Aka ulnar neuropathy…

Compression of ulnar nerve at elbow.
Numbness and tingling in ulnar half of palm and dorsum of hand and ulna 1 and half digits

172
Q

What is a sign of radial nerve damage

A

WRIST DROP
Paralysis of triceps and wrist extensors –> unopposed Flexion

Loss of sensation of posterior & lateral upper arm, and posterior forearm

173
Q

How may a posterior hip dislocation appear and why

A

Shortened. Limb- extensors/adductors pull femur up external surface of ilium

Internal rotation- gluteus Medius and minimus attached to greater trochanter - anterior fibres pull greater trochanter medially

174
Q

What causes carpal tunnel syndrom

A

Compression of median nerve within carpal tunnel
Causes
- tendonitis in carpal tunnel - pressure on nerve
- thickening of flexor retinaculum

175
Q

How do you test myotome C5

A

Abduction of arm at glenohumeral joint

176
Q

What is senile kyphosis

A

Secondary curvature dissapear- continuous primary curvature re-established.

177
Q

What is a ‘peg fracture’

A

Blow to back of head- fracture axis - seen in open mouth XR

178
Q

What is a Monteggia’s fracture

A

(Force from behind ulna)

  • proximal shaft of ulna is fractured
  • head of radius dislocated anteriorly at elbow
179
Q

How do you test the radial nerve (motor innervation )

A

Flex wrist and isolate forearm- get pat to push against you with back of hand