Formative assessment 3

Question 1

Name four of the anatomical features that stabilise the normal hip preventing dislocation

Answer 1

muscles, ligament, labrum, joint capsule, congruity

Question 2

Name the three compartments of the knee

Answer 2

1) medial tibiofemoral compartment
2) lateral tibiofemoral compartment
3) patellofemoral

Question 3

Name 4 groups of individuals who manage osteoarthritis

Answer 3

nurses, patients, GPs, physiotherapists, occupational therapists, orthopaedic surgeons

Question 4

Name 2 non pharmacological treatments for osteoarthritis

Answer 4

• aids and devices
• thermotherapy
• electrotherapy

Question 5

what myotome is responsible for shoulder abduction

Answer 5

C5

Question 6

what nerve roots are responsible for the knee jerk reflex

Answer 6

L3/4 nerve roots

Question 7

what nerve roots are responsible for the ankle jerk reflex

Answer 7

S1/2 nerve roots

Question 8

what myotome is responsible for finger abduction

Answer 8

T1 myotome

Question 9

In an ulnar nerve palsy due to compression at the elbow, what is the area of skin in the hand where sensation is altered

Answer 9

the medial 1.5 digits and aspect of both sides of the palm

Question 10

What is Hiltons law?

Answer 10

A sensory nerve that supplies a joint also supplies the area of skin that overlies that joint and the muscles that act upon that joint

Question 11

Name 3 common joint dislocations and the common direction they dislocate

Answer 11

Hip - posteriorly

Shoulder - anteriorly

Knee - anteriorly or posteriorly

Elbow - posteriorly

Ankle - lateral

Question 12

Name 3 indications for patients who require urgent orthopaedic surgery ie within 6 hours

Answer 12

• polytraumatised patent
• marine/farm yard environment
• gross contamination
• neuromuscular compromise
• compartment syndrome (this is when there is an excessive build up of pressure in an affected area - e.g. a muscle group - and as a result the blood flow to that area is compromised)

Question 13

A young netball player lands awkwardly after receiving the ball. A sharp pain and a “pop” is felt in the knee. The joint is seen to swell rapidly over the next 30 minutes. The cause of the swelling is most likely to be?

Answer 13

A build up of blood - immediate swelling is usually the result of blood (haemarthrosis)

Question 14

Asking a patient to perform a straight leg raise as part of the examination of an injured knee is important. A successful manoeuvre by the patient will indicate?

Answer 14

That they have an intact extensor mechanism of the knee

Question 15

33yr old man involved in a knife attack is brought into A&E. On inspection he has a stab wound to his back over the thoracic spine. He is unable to move is right lower limb and unable to feel pain and temperature in the left lower limb. What is the diagnosis?

Answer 15

Brown-Sequard syndrome

Question 16

A 40yr old woman is found in a field after falling off her horse. She complains to the paramedics of neck pain. She is unable to move any of her limbs but when log rolled onto a spinal board is able to feel pain around her sacrum. What is the diagnosis?

Answer 16

Quadriplegia incomplete

Question 17

A 19yr old boy is brought into A&E after falling of his mountain bike. On examination his pulse is 60, BP 120/80 and sats 95% on air. He has no power or sensation at all in the lower limbs. His bladder scan shows 1500ml and hence is catheterised. He is unable to feel a catheter tug. What is the diagnosis?

Answer 17

Paraplegia complete

Question 18

A 65yr old man with a previous history of Ankylosing Spondylitis sustains a trip at home. He manages to get himself of the floor but complains of a very sore neck. His is brought into A&E. He is has significantly weak grip strength and decreased sensation in the hands and arms. However he is able to stand. What is the diagnosis?

Answer 18

Central cord syndrome

Question 19

A 55yr old man after a fall from building site. The patient fell over 20 meters. At the scene he was unable to move his lower limbs .He also complained of thoracic back pain and hence underwent CT imaging of the spine. This has revealed a T6/7 fracture dislocation. He has been assessed by the spinal surgeons who plan to reduce and stabilise his spine. He has also been discussed with the regional spinal Injuries unit, who plan to take over his rehab care when a bed becomes available. However a nurse informs you that his BP is now 60/40 and HR 50. What is the diagnosis?

Answer 19

Neurogenic shock