Other

Question 1

What is rotator cuff tear?

Answer 1

Rotator cuff tears are common in elderly people and may occur following minor trauma or as a result of long standing impingement. Tears greater than 2cm should generally be repaired surgically.

Question 2

What is Parsonage-Turner syndrome?

Answer 2

This is a peripheral neuropathy that may complicate viral illnesses and usually resolves spontaneously and causes rapid onset, severe shoulder and arm pain.

Question 3

Musculocutaneous nerve (roots, motor supply, sensory supply, mechanism of injury)

Answer 3

• C5-C7
• elbow flexion (biceps brachii) and supination
• lateral forearm
• isolated injury rare (part of brachial plexus injury)

Question 4

Axillary nerve (roots, motor supply, sensory supply, mechanism of injury)

Answer 4

• C5-C6
• shoulder abduction (deltoid muscle)
• inferior region of deltoid
• injury due to humeral neck fracture/dislocation
• results in flattened deltoid

Question 5

Radial nerve (roots, motor supply, sensory supply, mechanism of injury)

Answer 5

• C5-C8
• extension (forearm, wrist, fingers, thumb)
• small area between dorsal aspect of 1st and 2nd metacarpals
• humeral shaft fracture
• palsy results in wrist drop

Question 6

Median nerve (roots, motor supply, sensory supply, mechanism of injury)

Answer 6

• C6, C8, T1
• LOAF muscles (lateral 2 lumbricals, opponens pollicis, abductor pollicis brevis, flexor pollicis brevis)
• wrist: paralysis of thenar muscles, opponens pollicis
• elbow: loss of pronation of forearm and weak wrist flexion
• palmar aspect of lateral 31/2 fingers
• wrist lesion - carpal tunnel syndrome

Question 7

Ulnar nerve (roots, motor supply, sensory supply, mechanism of injury)

Answer 7

• C8-T1
• intrinsic hand muscles except LOAF
• wrist flexion
• medial 1 1/2 fingers
• medial epicondyle fracture
• damage may result in claw hand

Question 8

Long thoracic nerve (roots, motor supply, sensory supply, mechanism of injury)

Answer 8

• C5-C7
• serratus anterior
• often during sport e.g. blow to the ribs
• complication of mastectomy
• damage results in winged scapula

Question 9

Most common site osteomyelitis in children?

Answer 9

metaphysis

Question 10

What are anterior shoulder dislocations associated with?

Answer 10

• FOOSH

- unilateral shoulder deformity

Question 11

What are posterior shoulder dislocations associated with?

Answer 11

• electric shocks
• seizures
• stuck in internally rotated position

Question 12

Analgesic to give to CKD patients for back pain?

Answer 12

codeine

Question 13

Foot drop after total hip replacement?

Answer 13

sciatic nerve

Question 14

Undergoes a low anterior resection with legs in the Lloyd-Davies position. Post operatively he complains of foot drop.

Answer 14

Peroneal nerve

Question 15

Features of acromioclavicular joint dislocation:

Answer 15

secondary to direct injury to the superior aspect of the acromion. Loss of shoulder contour and prominent clavicle are key features.

Question 16

Features of glenohumeral joint dislocation:

Answer 16

A Hill-Sachs lesion is when the cartilage surface of the humerus is in contact with the rim of the glenoid. About 50% of anterior glenohumeral dislocations are associated with this lesion.

Question 17

Features of supraspinatus tear:

Answer 17

• pain to 90 degrees on abduction

- most common of rotator cuff tears. It occurs as a result of degeneration and is rare in younger adults.

Question 18

What are the rotator cuff muscles?

Answer 18

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

Question 19

What does the supraspinatus do?

Answer 19

• abducts arm before deltoid
• most commonly injured

Question 20

What does the infraspinatus do?

Answer 20

rotates arm laterally

Question 21

What does teres minor do?

Answer 21

adducts and rotates arm laterally

Question 22

What does subscapularis do?

Answer 22

adducts and rotates arm medially

Question 23

The spectrum of disease with rotator cuff shoulder problems?

Answer 23

• subacromial impingement
• calcific tendonitis
• rotator cuff tears
• rotator cuff arthropathy

Question 24

What signs are present with rotator cuff injury?

Answer 24

• painful arc of abduction
• subacromial impingement: between 60 and 120 degrees
• rotator cuff tears: first 60 degrees
• tenderness anterior acromion