Musculoskeletal

Question 1

Axillary nerve injury

Answer 1

1) C5, C6
2) Fractured surgical neck of the humorous or dislocated humeral head
3) Deltoid atrophy, loss of sensation and loss of deltoid abduction

Question 2

Radial nerve injury

Answer 2

1) C5-T1
2) Injured by fractured humeral neck or “Friday night palsy”
3) Wrist drop with loss of sensation to posterior arm and hand dorsum

Question 3

Median nerve injury

Answer 3

1) C5-T1
2) Fracture of the supracondylar humerus
3) Ape hand, pope’s hand

Question 4

Klumke’s palsy

Answer 4

1) Childbirth defect -> C8, T1 -> cervical rib compresses subclavian artery and inferior trunk
2) Atrophy of thenar and hypothenar eminences, interosseous muscles -> total claw
3) Sensory deficits on medial forearms and hand
4) Disappearance of radial pulse upon moving the head towards ipsilateral side

Question 5

Obturator (L2-L4)

Answer 5

1) Anterior hip dislocation
2) Loss of thigh adduction
3) Loss of sensation to medial thigh

Question 6

Femoral (L2-L4)

Answer 6

1) Pelvic fracture
2) Loss of thigh flexion and leg extension
3) Loss of sensation to anterior tight and medial leg

Question 7

Superior gluteal (L4-S1)

Answer 7

1) Posterior hip dislocation or polio

2) Positive Trendeleburg sign

Question 8

Inferior gluteal (L5-S2)

Answer 8

1) Posterior hip dislocation

2) Can’t jump, climb stairs or rise from seated position

Question 9

Osteosarcoma

Answer 9

1) Male, 10-20
2) Knee metaphysis
3) Codman’s triangle, sunburst

Question 10

Ewing’s

Answer 10

1) Boys <15
2) Diaphysis
3) Onion skin
4) T (11;22)
5) Aggressive yet responds to chemotherapy
6) Small blue cell

Question 11

Chondrosarcoma

Answer 11

1) Men, 30-60

2) Expansile, glistening mass within medulla