Clinical applications

Question 1

What is a first degree burn?

Answer 1

Epidermis damaged but still intact

Question 2

What is a second degree burn?

Answer 2

Damage to dermis and epidermis

Question 3

What are the signs of a second degree burn?

Answer 3

Blisterring

Loss of heat and fluid

Inability to combat infection

Question 4

What is a third degree burn?

Answer 4

Destruction of both dermis and epidermis

Question 5

How is a blister formed?

Answer 5

Separation of dermis and epidermis due to prolonged friction causing fluid to move between layers

Question 6

What are langer’s lines and why are they useful to surgeons?

Answer 6

Tension/cleavage lines that follow the orientation of collagen fibres.

Incisions made parallel to these lines heal more rapidly and produce neater scars

Question 7

What happens to the skin to result in the visible signs of aging?

Answer 7

Flattening of dermoepidermal junction

Loss of elastin causing skin to become loose and lined

Question 8

Which vein is used for venepuncture to take blood?

Answer 8

Median cubital vein

Question 9

Which vein is used for cannulation and why?

Answer 9

Cephalic vein

Fairly large vein with a constant position

Question 10

Where is the most common region for biceps tendon rupture?

Answer 10

Proximal part of long head of biceps

Question 11

What happen when the biceps tendon is ruptured at the proximal region

What is observed?

Answer 11

Retracted muscle bunches up in the arm leading to a bulge (popeye muscle)

Question 12

What degree of functional loss is there in a ruptured biceps tendon?

Answer 12

Minimal

short head still intact

Question 13

What type of patients usually present with a ruptured biceps tendon?

Answer 13

Aged 40-60 with a history of shoulder problems, secondary to chronic wear an tear of tendon

Younger individuals may rupture tendon during a fall or when lifting weights

Question 14

Where does a distal biceps tendon rupture usually occur?

What are the affects of this?

Answer 14

Insertion on radial tuberosity

Reduced strength in forearm supination and elbow flexion (requires surgery)

Question 15

Which nerve can be damaged in a humeral shaft fracture?

What could this lead to?

Answer 15

Radial

Wrist drop

Question 16

What is a supracondylar fracture and how is it caused?

Answer 16

Fracture of distal humerus proximal to epicondyles

Fall on outstretched hand

Question 17

What are the complications associated with a supracondylar fracture?

Answer 17

Rupture or compression of brachial artery

Injury to median nerve

Question 18

What is the most common form of elbow dislocation?

Answer 18

Posterior

Question 19

What are the complications associated with posterior elbow dislocation?

Answer 19

Entrapment of ulnar nerve

(runs posterior to medial epicondyle)

Brachial artery and median nerve injured less frequently

Question 20

What region is damaged in erb’s palsy?

Answer 20

C5 and C6 of the brachial plexus

Question 21

What causes Erb’s palsy?

Answer 21

excessive downward traction on upper limb during a difficult delivery

Question 22

What are the signs of erb’s palsy?

Answer 22

Loss of shoulder abduction and elbow flexion and supination

leading to waiter’s tip sign

Question 23

what region is damaged in Klumpke’s palsy?

Answer 23

T1 of brachial plexus

Question 24

What causes klumpke’s palsy?

Answer 24

Hyperabduction of shoulder in breech delivery

Question 25

What are the signs of Klumpke’s palsy?

Answer 25

Wasting of intrinsic muscles of the hand

Question 26

What is the result of a distal lesion of the median nerve?

Answer 26

Carpal tunnel syndrome

Question 27

What is the result of a proximal lesion of the median nerve?

Answer 27

Carpal tunnel syndrome

Inability to flex index and middle fingers and distal phalanx of the thumb

Weakness/wasting of muscles in the thenar eminence

Inability to oppose and adduct the thumb

Impairment of precision grip

Ulnar deviation