Arm

Question 1

What passes through the carpal tunnel?

Answer 1

Flexor pollicis longus, the four flexor digitorum superficialis and the four flexor digitorum profundus

Question 2

Which digits does the median nerve innervate?

Answer 2

thumb and radial 2½ fingers

Question 3

Most cases of carpal tunnel are idiopathic

Answer 3

T

Question 4

Which tests can be conducted to reproduce symptoms of carpal tunnel?

Answer 4

Tinel’s test: percussing over the median nerve

Phalen’s test: holding the wrists hyper‐flexed which decreases space in the carpal tunnel.

Question 5

How do patients with carpal present?

Answer 5

parathesiae in the median nerve innervated digits which is usually worse at night
loss of sensation
weakness of the thumb or clumsiness in the areas of the hand supplied by the median nerve.

On examination there may be demonstrable loss of sensation and/or muscle wasting of the thenar eminence

Question 6

Non-operative treatment for carpal tunnel syndrome?

Answer 6

use of wrist splints at night to prevent flexion. Injection of corticosteroid can also be used.

Question 7

Surgical treatment for carpal tunnel syndrome?

Answer 7

Decompression involving division of the transverse carpal ligament under local anaesthetic

Question 8

In cubital tunnel syndrome, what is compressed and where

Answer 8

ulnar nerve at the elbow behind the medial epicondyle

Question 9

Which fingers does the ulnar nerve innervate?

Answer 9

ulnar 1½ fingers

Question 10

In cubital tunnel syndrome what test is usually +ve? How is this performed

Answer 10

TInel’s

percussion over cubital tunnel

Question 11

Which muscles of the hand are innervated by the ulnar nerve?

Answer 11

1st dorsal interosseous (abduction index finger) and adductor pollicis

Question 12

What is Froment’s test?

Answer 12

Tests adductor pollicis function

patient is asked to hold a piece of paper between the thumb and a flat palm as the paper is pulled away

Question 13

Where does compression usually happen in cubital tunnel syndrome?

Answer 13

tight band of fascia forming the roof of the tunnel
tightness at the intermuscular septum as the nerve passes through or between the two heads at the origin of flexor carpi ulnaris

Question 14

What is the elbow joint composed of?

Answer 14

Humero ulnar joint and radio‐ capitallar joint

Question 15

What is the humero-unlar joint responsible for?

Answer 15

flexion/extension

Question 16

What is the radio‐ capitallar joint responsible for?

Answer 16

supination/pronation along with the proximal and distal radioulnar joints

Question 17

Which muscles flex the elbow?

Answer 17

Biceps and brachialis

Question 18

Which muscle extends the elbow?

Answer 18

Triceps muscle

Question 19

Where does the triceps muscle insert?

Answer 19

Olecranon

Question 20

How is pronation performed? By which muscles?

Answer 20

contraction of the pronator teres muscle proximally and the pronator quadratus muscle distally

Question 21

Which muscles perform supination?

Answer 21

Supinator and biceps

Question 22

The elbow is commonly affected by which type of arthritis?

Answer 22

RA

Question 23

The common extensor and flexor origin arise from which epicondyles on the humerus?

Answer 23

lateral and medial

Question 24

What is enthesopathy? What can it lead to?

Answer 24

Pain in origins of flexor and extensor muscles

can lead to epicondylitis

Question 25

Tennis elbow is laymans term for?

Answer 25

Lateral epicondylitis

Question 26

repetitive strain injury in tennis players and others whom regularly perform resisted extension at the wrist causes?

Answer 26

Lateral epicondylitis

Question 27

painful and tender lateral epicondyle and pain on resisted middle finger and wrist extension.

Answer 27

Lateral epicondylitis

Question 28

Lateral epicondylitis is not a self limiting condition

Answer 28

F

Question 29

Treatment of lateral epicondylitis is mainly conservative

Answer 29

period of rest from the activities that exacerbate the pain, physiotherapy, NSAIDs, steroid injections and use of a brace (known as an elbow clasp)

Question 30

What is golfer’s elbow?

Answer 30

Medial epicondylitis is a consequence of repeated strain or degeneration of the common flexor origin

Question 31

Which epicondylitis is most common?

Answer 31

lateral

Question 32

Medial epicondylitis is a self‐limiting condition with physio, rest & NSAIDs the mainstay of treatment

Answer 32

T

Question 33

You can treat medial epicondylitis with injection

Answer 33

F

Injection in this area carries a risk of injury to the ulnar nerve.

Question 34

Primary OA of the elbow is common

Answer 34

F

but it can occur after fracture

Question 35

Failing non-operative management, how can arthritic change in the radio- capittellar joint be treated?

Answer 35

surgical excision of the radial head which affords good pain relief with minimal functional limitation.

Question 36

Failing non-operative management, how can arthritic change in the humero‐ulnar joint be treated?

Answer 36

Total Elbow Replacement