Anatomy

Question 1

Du-pa-trens!( viking’s disease )

(F)ormation of thickened (f)ibrous tissue within the Palmar (F)ascia

Answer 1

(F)ibrous tissue , 
palmar (F)ascia 
(F)ourth , (F)ifth finger 
(F)lexed (F)ixed position 
(F)amily History , 

other (F)actors :

DM, alcohol ,smoking

(F)asciotomy if (F)unctional disability

Dupuyteren`s CONTRACTURE , is a progressive disorder of thickened fibrous tissue within the palmar fascia usually in line with the fifth or the ring fingers
Results ultimately in flexion position of the affected fingers .

TT only for those who are disabled from the condition which includes fasciotomy and release the affected fascia

Houston’s Tabletop Test - When there is 30° of flexion deformity at the MCP joint, the patient is unable to place their palm and fingers flat against a hard surface - for example, a table

Question 2

Substantial Nigeria : Parkinsonism

Globus pallidus: Huntington

Answer 2

Inability to produce Dopamine form the substantial Nigeria

Impairment of neuroneis in the SUBSTANTIAL NIGERIA - low levels of dopamine

Question 3

During Laparscopic surgery when Trocher is inserted between

the Umbicus and the ASIS or PUBIC SYMPHISIS

Answer 3

If the question says
b/w umbilicus and ASIS, internal oblique and external oblique aponeurosis.

If b/w umbilicus and pubic symphysis, then Linea alba is the answer.

Question 4

Sciatic Nerve injury in which Fractures

Answer 4

Acetabular fracture

Femoral shaft fractrue

Question 5

Monetggia Fracture

Answer 5

Radius DIslocation at the elbow (Ant dislocation of the head of the radius )
Ulnar Fracture (Proximal 1/3) (Near the elbow )

Question 6

No Abd or Add of the 4 and 5 fingers / WHICH NERVE

Loss of sensation over the 5 th finger and a variable area of the 4th ring finger both dorsal and palmar aspects / WHICH LEVEL

Answer 6

Ulnar CLAW HAND

C8 to T1 level

Question 7

1) Loss of MOTOR to Extensor of the THUMB, FINGE , WRIST, FOREARM -
2) Saturday Night Palsy / Crutch Palsy
3) Loss of the Sensory of the Dorsal aspect of the thumb and a small area between the 1st and 2nd fingers

Answer 7

1) Wrist Drop
2) Compression of the radial nerve at the Medial aspect of the Arm

Can also be compressed against the operation theatre
Can also be compressed against the spiral groove on the medial aspect of the humerus

Answer 8

Above the Carpel tunnel - Fascia of the Palmaris Longus
IN the Carpel Tunnel - Flexor DIgitorum Superficialis (Super = Power )
Flexor digitorum Profundus ( Pro = Undefeated )

Question 9

Person stabbed in the back of the LEFT SIDE neck

Lungs Paradoxic movement (asymmetrical rise and fall of his chest )

Answer 9

The Phrenic Nerve (Main is C4 / also contain 3 and 5)

Phrenic nerve: Cervical 345 , keep me ALIVE.

the Right Phrenic nerve from the right cervical 345 innervates the right side of the diaphragm.

the Left Phrenic nerve from the left cervical 345 roots, innervates the left side of the diaphragm.

Question 10

Pt cannot Add or Abd his fingers

which level

Answer 10

FEEFA— Flex Extend Extend Flex Add and abd

C5,6,7,8, T1,

Elbow flexion, Wrist extension, Elbow extension, Finger flexion and Finger Abduction, Adduction.

C5- elbow flexion 
C6 wrist extension 
C7 elbow extension 
C8 fingers flexion 
T 1 fingers add and abd

Question 11

Lymphatic drainage of genitals
superficial
deep
paraortic

Answer 11

Scrotum , Vulva , perineum&raquo_space;»»»»SUPERFICIAL INGUINAL LNs (Superficai)

Gonads (Testis and Ovary)»»»»»» PARA-AORTIc LNs (Near Renal )

Glans and Clitoris»»»»»» DEEP INGUINAL (EXTERNAL ILIAC)

rectum and urethra= INTERNAL ILIAC LN

Question 12

Boy fall on KNEE and swollen and inflamed Which bursa is affected
Pain localized below the knee cap

Answer 12

Swelling on your kneecap&raquo_space;»»>The Prepatellar bursa (“housemaid’s knee”)
**Most Common *******

Swelling below your kneecap&raquo_space;»The 2 infrapatellar bursa (Superficial and Deep )
clergyman’s

Swelling above your kneecap»»Suprapatellar bursa

jumper’s knee&raquo_space;> Injury to the Patellar tendon

Question 12

Boy fall on KNEE and swollen and inflamed Which bursa is affected
Pain localized below the knee cap

Answer 12

Swelling on your kneecap&raquo_space;»»>The Prepatellar bursa (“housemaid’s knee”)
**Most Common *******

Swelling below your kneecap&raquo_space;»The 2 infrapatellar bursa (Superficial and Deep )
clergyman’s

Swelling above your kneecap»»Suprapatellar bursa

jumper’s knee&raquo_space;> Injury to the Patellar tendon

Question 13

Brachial Plexus

Upper lesion C5/6 - Unable to SHOULDER Externally rotate and ABDuction
Increase in angle between the neck and shoulder (Motor cycle accident to neck / pulling baby head during birth )

Lower Lesion C8/T1 - excessive upward pull (hanging from tree / pulling baby arm )

Answer 13

Upper lesion = Erb’s palsy = Waiter’s tip position (shoulder add and internally rotated )
C5/6 (shoulder dystocia)

C5 - Supraspinatus muscle (shoulder abduction and external rotation )
C5 - Deltoid and teres minor (abduction of shoulder)

Lower lesion = C8/T1-Klumpke’s palsy -
C8/ T1 = Ulnar nerve and also medial nerve = intrinsic muscles and flexors of the hand /Abd and Add muscles (all intrinsic muscles )
FULL ULANR CLAW HAND
Weakness paralysis and atropy of the Intrinsic muscles of the hand

IF T1 is Compressed or injured - Horner’s Syndrome - Eye constricted / eye lid falls / not able to sweat (Ptosis , Meiosis and Anhydrosis )

Theses symptoms can also occur in Thoracic outlet syndrome

Question 14

Add and Abd of the FIngers and Thumbs

Answer 14

All the INTEROSSEI - ulnar nerve..
PAD - Proximal Interossei is AD of fingers
DAB- Dorsal Interossei is AB of fingers

The Lumbricles - Between the RIng and the Littler Metacarple bone - Ulnar nerve (flexion of the MCP and Extension of the PIP joint )-
if dmg - Extension of the MCP and Flexion of the PIP - Claw hand

Thumb abduction - radial & median
Thumb adduction - ulnar

ULNAR Nerve injury - Clawing of the hand
C8- T1 level injury - Full clawing of the Hand / Kulpsey contracture

Question 15

Lung Cancer patient with Hoarseness of Voice

About 18% of Lung cancer patients experience hoarseness of voice due to compression of the recurrent laryngeal nerve.

Answer 15

Injury to
1)Superior Laryngeal nerve–> change in Pitch( unable to screen and sing opera) so,

2)Inferior(Recurrent) laryngeal nerve: 
one branch(either right or left)-->hoarseness 
both branches(right and left)-->aphonia,difficulty in swallowing and breathing. 

Vagus nerve –>no parasympathetic innervation.

vagus nerve gives three main branches:
1-superior laryngeal nerve :splits into external and internal
2-inferior laryngeal nerve(also called recurrent laryngeal nerve): splits into right and left recurrent laryngeal nerve. right loops aroung right subclavian artery, whilst left loops around aortic arch.

3-vagus branch itself that gives parasympathetic to viscera.

Question 16

Herpes Zoster Maxillary Branch

Which single Mucosa will be affected along Dermatome

Answer 16

Palate