Clinical Notes

Question 1

Jefferson (Burst) fracture

Answer 1

Fracture of both arches of the Atlas from a blow to the top of the head or driving accident. Dues not usually damage the spinal cord, but if the Transverse L. is ruptured, the Odontoid process may hurt the SC.

Question 2

Hangman’s fracture

Answer 2

Fracture of the vertebral arch of the Axis from hyperextension of the head on the neck.

Question 3

Spondylosis

Answer 3

Edges of vertebral body are calcified and cause localized pain and stiffness.

Question 4

Spondylolysis

Answer 4

Separation of the vertebral arch from vertebral body.

Question 5

Spondylolisthesis

Answer 5

Anterior displacement of the vertebral body.

Question 6

Lumbar puncture

Answer 6

Needle is inserted between L3/L4 or L4/L5 at the level of the iliac crest. Draws CSF from lumbar cistern.

Question 7

Sacralization

Answer 7

Partial or complete incorporation of L5 into the sacrum.

Question 8

Lumbarization

Answer 8

Separation of S1 from the sacrum.

Question 9

Hyperextension or “Whiplash”

Answer 9

Excessive stretching or tearing of the Anterior longitudinal L. Recoil may cause hyperflexion injury. Common in car accidents.

Question 10

Second number rule

Answer 10

Prolapse at disc L4/5 will affect nerve L5. Only occurs in cervical and lumbar regions.

Question 11

Back sprain

Answer 11

Injury to ligamentous attachments between bone often from inadequate stretching. Muscles can also be torn.

Question 12

Damage of SC at C1-C3

Answer 12

No function below the head. Respirator required for life.

Question 13

Damage of SC at C4-C5

Answer 13

No function of limbs, but can respire on own.

Question 14

Damage of SC at C6-C8

Answer 14

Loss of hand and variable upper limb function. May be able to operate wheelchair.

Question 15

Damage of SC at T1-T9

Answer 15

Paralysis of both lower limbs.

Question 16

Damage of SC at T10-L1

Answer 16

Some thigh muscle function. May allow walking with long leg braces.

Question 17

Damage of SC at L2-L3

Answer 17

Most lower limb functions present. May only require a short leg brace.

Question 18

Muscular pain is usually the result of:

Answer 18

Ischemia of tissues due to spasm.

Question 19

Fibroskeletal pain is usually the result of:

Answer 19

Fractures or dislocations.

Question 20

Joint pain is usually the result of:

Answer 20

Some form of arthritis.

Question 21

Greenstick fracture

Answer 21

Fracture of the clavicle in young children.

Question 22

Common fractures of the Humerus:

Answer 22

Most common at surgical neck. Greater tubercle is often susceptible to avulsions due to the numerous attachments there.

Question 23

Fractured elbow

Answer 23

Fracture of the olecranon, commonly from falling. Considered an avulsion.

Question 24

Colle’s fracture

Answer 24

Fracture of distal end of radius.

Question 25

Scaphoid fracture

Answer 25

Most common of carpal bones. Often diagnosed as severe sprain as it is difficult to see on X-ray.

Question 26

Guyon Tunnel (Ulnar Canal)

Answer 26

Groove between Pisiform and Hamate that the Ulnar N. passes through.

Question 27

Boxer’s fracture

Answer 27

Fracture of the head of the 5th metacarpal.

Question 28

Glenoid labrum tears

Answer 28

From sudden contraction of Biceps brachii M. and occurs in the anterosuperior part of labrum.

Question 29

Paralysis of Serratus Anterior M.

Answer 29

From problems with the Long thoracic N. and results in movement of the scapula away from thoracic wall, making ABduction difficult.

Question 30

Popeye deformity

Answer 30

When supraglenoid tubercle dislocates and creates a ball in the middle of the upper arm.

Question 31

Tennis elbow

Answer 31

From repetitive use of extensors in forearm. Pain is localized over the Lateral Epicondyle

Question 32

Aneurism of region one of the Axillary A.

Answer 32

Common in repeated rapid arm movements.

Question 33

Erb-Duchenne Palsy

Answer 33

Dramatically increasing the angle of between neck and shoulder. Can cause rupture of spinal roots. Pt wil have an ADducted and medially rotated arm with extended elbow (“waiter’s tip”).

Question 34

Klumpke Paralysis

Answer 34

Injury to the inferir part of brachial plexus by increasing the angle between trunk and upper limb. Typically affects muscles of hand and results in “claw hand”.

Question 35

Ape’s Hand

Answer 35

Due to injury to the Median N. Results in ADducted thumb and thenar eminence atrophy.

Question 36

Hands of Benediction

Answer 36

Due to injury of Median N. at the elbow inhibits flexion of 2nd and 3rd digits.

Question 37

Handlebar neuropathy

Answer 37

Compression of the Ulnar N. from pressure is placed over the Hamulus of the Hamate.

Question 38

Wrist drop

Answer 38

From injury to the Radial N. Impairs elbow extension and thumb ABduction and extension.