Blue box

Question 1

Weakest part of the clavicle most prone to fracture

Answer 1

The junction of its middle and lateral thirds

Question 2

What happens after a clavicle fracture

Answer 2

The SCM elevates the medial fragment of the bone. The lateral fragment can’t be held up by the trapezius and the shoulder drops

Question 3

The clavicle is the first long bone to ______

Answer 3

ossify

Question 4

What is the most frequently fractured part of the humerus

Answer 4

The surgical neck

Question 5

What is a humeral fracture more commonly seen in middle aged and elderly people

Answer 5

An occlusion of the greater tubercle.

Question 6

List the parts of the humerus that are in direct contact with the indicated nerves

Answer 6

Surgical neck - Axillary nerve
Radial groove - radial nerve
Distal end of humerus - median nerve
Medial epicondyle - Ulnar nerve

Question 7

A UE fracture more commonly seen in women> 50, why?

Answer 7

Fracture of the distal end of the radius. . Due to osteoporosis.

Question 8

What is a Colles fracture (claim to fame)

Answer 8

A complete transverse fracture of the distal 2cm of the radius. Its the most common fracture of the forearm

Question 9

What is a dinner fork deformity

Answer 9

occurs with a Colles fracture of the radius, a posterior angulation occurs in the forearm proximal to the wrist. The bending is due to a posterior displacement of the distal fragment of the radius

Question 10

Most frequently fractured carpal bone. What can happen due to it

Answer 10

the Scaphoid. Due to poor blood supply healing could take 3 months. That could result in bone death and degenerative bone disease

Question 11

What is boxer’s fracture

Answer 11

Fracture of the 5th metacarpal - from punching something

Question 12

A wing in the scapula is caused by

Answer 12

Serratus anterior paralysis due to injury to the long thoracic nerve;

Question 13

What happens due to spinal accessory nerve (CN11) palsy

Answer 13

An ipsilateral weakness in the shoulders when elevated (shrugged) against resistance

Question 14

What happens with there is an injury to the Thoracodorsal nerve

Answer 14

It supplies the latissimus dorsi. Injury to that would mean paralysis to the lats causing the person to be unable to raise the trunk with the upper limbs (when climbing)

Question 15

Benefits of collateral circulation

Answer 15

when one artery is occulded the blood can reverse and go in a different direction to get to the needed site

Question 16

when may compression of the axillary artery be needed (which part should be compressed)

Answer 16

During profuse bleeding (the 3rd part)

Question 17

Where does the axillary vein lie

Answer 17

Anteriorly and inferiorly to the axillary vein (superficial) and parts of the brachial plexus

Question 18

Two nerves at risk during axillary node dissection

Answer 18

The long thoracic and the thoracodorsal

Question 19

What is a prefixed brachial plexus and a post fixed b.p.

Answer 19

Prefixed - When the superior most root is C4 and inferiormost is C8.
Post fixed - when the superior root is C6 and posterior is T2

Question 20

Injuries to the superior parts of the brachial plexus (C5 and C6) usually result in

Answer 20

an excessive increase in the angle btwn the neack and shoulder. Medial trunk injury can create a ‘waiter’s tip’ position where the limb hangs by the side in medial rotation. It also results In paralysis of delts, bicps and brachialis (adducted sholder, medially rotated arm and extended elbow)

Question 21

Injuries to the inferior parts of the brachial plexus

Answer 21

Less common but would results in affecting the short muscles of the hand and result in a closed hand.

Question 22

What is ischemic compartment syndrome

Answer 22

A flexion deformity usually due to occlusion of the brachial artery for more than 6 hours. After a fibrous scar tissue replaces necrotic tissue causes the muscles around to shorten permanently

Question 23

Classical clinical sign of a radial nerve injury

Answer 23

A wrist drop or inability to extend the wrist and fingers at the metacarpophalangeal joints

Question 24

Elbow tendonitis is usually due to

Answer 24

strain of the superficial extensor muscles. THe pain is felt over the lateral epicondyle and radiates down the posterior surface of forearm

Question 25

A ‘fractured elbow’ usually is

Answer 25

a fracture to the olecranon

Question 26

What happens in a median nerve injury

Answer 26

Loss in finger flexion 1-3 lost, 4-5 weakened . OK sign looks pinched

Question 27

What happens in an injury to the ulnar nerve

Answer 27

Usually in elbow - numbness in palm and medial 1/2 of fingers . Trouble making fist and claw hand when trying to straighten fingers

Question 28

Dupuytren Contracture

Answer 28

A disease of the palmar fascia resulting in progressive shortening, thickening and fibrosis of the plamar fascia and apeneurosis. Can’t straighten hand. Usually 50+

Question 29

Carpal tunnel syndrome

Answer 29

Any lesion that significantly reduces the size of the carpal tunnel or increase the size of some of the 9 structures or their coverings that pass thru it. Median nerve is the most sensitive structure in the tunnel

Question 30

Dermatoglyphics

Answer 30

the science of studying ridge patterns in the palm (can detect downs syndrome)

Question 31

Apophyses

Answer 31

Bony projections that lack a secondary ossification center.

Question 32

Coxa vara and Coxa valga

Answer 32

Concerns the angle of inclination between the long axis of the femoral neck and the femoral shaft. Coxa vara is when the angle of inclination is decreased. Coxa valga is when it is increased

Question 33

A psoas abscess can result from

Answer 33

A retroperitoneal pyogenic infection maybe with TB

Question 34

when does the patella ossify

Answer 34

During the 3rd to 6th years

Question 35

The patellar tendon reflex is testing the intergrity of

Answer 35

the femoral nerve

Question 36

Saphenous Varix

Answer 36

A localized dilation of the great saphenous vein, it may cause edema in the femoral triangle

Question 37

Where can the Femoral vein be located

Answer 37

Inferior to the inguinal ligament

Question 38

Test for gluteal nerve injurty

Answer 38

Trendleburg test - stand on one leg and the pelvis on the unsupported side descends indicated ithe gluteus medius and minimus on supported side are weak

Question 39

Where is the safe place to do an intraglutal injection

Answer 39

only in the superolateral quadrant of the buttocks (superior to the PSIS)

Question 40

Best way to find a popliteal pulse

Answer 40

person in prone position with knee flexed to relax the popliteal fascia and hamstrings