Clinical Cases

Question 1

A patient shows a positive trendelenberg sign. What is the nerve damaged? And which muscles were affected? What happened to the muscles?

Answer 1

• Superior Gluteal Nerve
• gluteus medius and the gluteus minimus.
• muscles are paralyzed and the pelvis becomes unsteady.

Question 2

A patient shows an unsteady pelvis. What is the nerve and muscle damaged ? Which test would you do?

Answer 2

• superior gluteal nerve
• gluteus medius and the gluteus minimus.
• Trendelenberg sign

Question 3

characteristic finding of gluteal muscle weakness?

Answer 3

Trendelenberg sign

Question 4

The apex of the axilla has beeen damaged , the nerves and vessels that pass have been compressed between the bones
What is the syndrome ?

Answer 4

Thoracic Outlet Syndrome

Question 5

A patient  raises his arm and the
medial border and inferior
angle of the scapula pull
markedly away from the
posterior thoracic wall, 

What is this deformation? What is the injury ? Which muscle is paralyzed ?

Answer 5

winged scapula
the long thoracic nerve .

serratus anterior

Question 6

During abduction inflammation
of the tendons of the rotator cuff muscles. Occurred
What is the condition? And what is the most effected muscle?

Answer 6

Rotator Cuff Tendonitis

supraspinatus

Question 7

? pulls the
4th and 5th fingers into partial
flexion.
What condition? And how?

Answer 7

Dupuytren contracture:
progressive shortening,
thickening, and fibrosis of the
palmar aponeurosis

Question 8

progressive shortening,
thickening, and fibrosis of the
palmar aponeurosis. It pulls the
4th and 5th fingers into partial
flexion.
?

Answer 8

Dupuytren contracture

Question 9

Inflammation of the tendon and synovial sheath, the digit swells and movement becomes painful.
Condition? And explain spread?

Answer 9

Tenosynovitis/ Tenosynovitis in (5) little finger may spread to the common sheath and thus through the palm and carpal tunnel to the anterior forearm.

Question 10

Pressure on median nerve because of tightly packed flexor digitorum tendons?

Answer 10

CARPAL TUNNEL SYNDROME

Question 11

is a compression neuropathy of the median nerve at the elbow between the two sections of the pronator teres muscle in the forearm. ?

Answer 11

PRONATOR TERES SYNDROME

Question 12

Median nerve territory in hand is affected leading to sensory motor symptoms and Weak pronation ?

Answer 12

=PRONATOR TERES SYNDROME

Question 13

develops when swelling or bleeding occurs within a compartment. ?

Answer 13

COMPARTMENT SYNDROME

Question 14

It is a painful condition that occurs when pressure within the muscles builds to dangerous levels and the Blood supply is disrupted and nerve compression can lead to abnormal sensations, muscular weakness and loss?

Answer 14

COMPARTMENT SYNDROME

Because the fascia does not stretch , this can cause increased pressure on the vessels, nerves, and muscles in the compartment .

Question 15

acute compartment syndrome, unless the pressure is relieved quickly ?

Answer 15

permanent disability and tissue death may result. =Injury, severe trauma, fracture and tight plaster cast are common predisposing factors.

Question 16

medial epicondylitis, is tendinosis of the medial epicondyle ? Which muscles ? Most common for?

Answer 16

Golfer’s elbow

The flexor compartemnt muscles come together at the medial epicondyle of the humerus . These include: pronator teres, flexor carpi radialis , flexor carpi ulnaris, flexor digitorum superficialis , and palmaris longus
is the most common elbow injury for rock climbers, construction and plumbing, golfers etc.

Question 17

Occur after fracture of the distal third of the radius. Roughening of the dorsal tubercle of the radius by the fracture line can cause excessive friction on the tendon, which can then rupture .
?

Answer 17

Rupture of the Extensor Pollicis Longus

Question 18

caused by a partial tearing or degeneration of the origin of the superficial extensor muscles from the lateral epicondyle of the humerus. It is characterized by pain and tenderness over the lateral epicondyle of the humerus, with pain radiating down the lateral side of the forearm; ?

Answer 18

Tennis Elbow

Question 19

Sudden severe tension on a long extensor tendon may avulse
part of its attachment to the phalanx. • This deformity results from the distal interphalangeal joint
suddenly being forced into extreme flexion leading to avulsion
of extensor expansion tendon from base of the distal phalanx.
As a result,?

Answer 19

Mallet or Baseball Finger
result, the person cannot extend the distal interphalangeal
joint.

Question 20

a patient came from a motorbike accident

which plexus is damaged? what happened to the limb?

Answer 20

Damage to the whole plexus​

it is rare​

It can occur with : motorbike accidents ​

If all roots are damaged : the whole limb is immobile and anesthetic​

Question 21

what condition Leads to paralysis of: ​
Abductors (deltoid& supraspinatus) and lateral rotators (teres minor& infraspinatus) of the shoulder and supinators are paralyzed​? and which roots are injured ?

Answer 21

Traction injury to the upper roots (C5& C6) and trunk (Erb’s paralysis) (Erb-Duchenne paralysis)​

It is the most common traction injury​

It includes Birth injury​

Person fall on shoulder with undue separation of head and shoulder​

Leads to paralysis of: ​

Question 22

Person fall on shoulder with undue separation of head and shoulder​ resulted in sensory loss over lower part of deltoid (supplied by axillary)​ which condition? and what deformity will be displayed ?

Answer 22

Erb’s
Deformity: (policeman’s tip hand) or Waiter taking tip​

In which the arm hangs by the side(adducted) and is rotated medially. The forearm is extended and pronated at the elbow​

Question 23

Femoral Hernia

Explain

Answer 23

• It is more common in women than in men (possibly because of their wider pelvis and femoral canal). • The hernial sac passes down the femoral canal, it expands to form a swelling in
the upper part of the thigh deep to the deep fascia • The neck of the sac always lies below and lateral to the pubic tubercle • The neck of the sac is narrow and lies at the femoral ring • The femoral vein lies lateral to the hernial sac • femoral hernia is a dangerous condition and should always be treated
surgically.

Question 24

Middle Foot pain

Muscle ?

Answer 24

peroneus longus

Question 25

pain, swelling and heat with a visual or feeling of popping or snapping of the tendon by the outside at the ankle. Pain isolated to the lateral aspect of the heel can be difficult to diagnose, particularly in the growing child. Patients can complain of their ankle feeling unstable, or just severely painful on activity

What problem?

Answer 25

PERONEAL TENDON PROBLEMS

Question 26

condition diagnosed? X-Rays can sometimes show a flake of bone from the ankle bone if the tendon has dislocated or calcium build up around the tendon
Name of ?

Answer 26

peroneal tubercle.

/ PERONEAL TENDON PROBLEMS

Question 27

Injuries of Radial Nerve?

Answer 27

Motor;
• Triceps, anconeus and long
extensors of the wrist are
paralyzed
• Unable to extend the elbow joint,
wrist joint and fingers
• Wrist drop
• Unable to flex the fingers firmly
for gripping
• sensory
• Sensory loss on the lateral part of
dorsum of the hand
• Sensory loss on the dorsal surface
of the roots of the lateral 3 & ½
fingers

Question 28

LESION OF ULNAR NERVE ABOVE ELBOW

?

Answer 28

Motor deficit:
• loss of flexion of the 4th and 5th
digits
• Atrophy of hypothenar muscles. •  Loss of adduction  of hand &
thumb
• Sensory deficit:
•  Loss of sensation in ulnar half of
the palm and dorsum of hand, and
the medial 1½ digits on both palmar
and dorsal aspects of the hand

Question 29

LESION OF ULNAR NERVE ABOVE WRIST

?

Answer 29

• 1- Inability to adduct
thumb • 2- Inability to put the
hand in writing position • - Sensory loss to fingers
only • - Partial claw hand
deformity is more
prominent

Question 30

Adducting the fingers to grasp an object placed between

them are innervated by the ?

Answer 30

deep branch of the ulnar nerve

Question 31

The ability to grasp an object between the pad of the thumb
and the pad of one of the fingers depends on normal
functioning of the thenar muscles, which are innervated by
the ?

Answer 31

recurrent branch of the median nerve