passmed 2

Question 1

nerve damage to femoral nerve

• what is weak
• what reflex is lost
• where is it numb

Answer 1

• weak knee extension
• patella reflex lost
• numb thigh

Question 2

nerve damage in lumbosacral trunk

• what is weak
• what is numb

Answer 2

• weak ankle dorsiflexion

- numb calf and foot

Question 3

nerve damage to sciatic nerve

• what is weak
• what is painful + numb

Answer 3

• weak knee flexion + foot movements

- pain + numbness from gluteal region to ankle

Question 4

nerve damage to obturator nerve

• what is weak
• what is numb

Answer 4

• weak hip adduction

- numb over medial thigh

Question 5

achilles tendon rupture features + how to dx

Answer 5

audible pop in the ankle
-sudden onset signif pain in calf or ankle or inability to walk or continue the sport
-examination using SIMMOND’S triad
1.angle of dangle (abn angle of declination)
2.feel for gap in tendon
3.calf squeeze (injured foot stays in neutral position)
DX = US

Question 6

what muscles are involved in arm ABDUCTION + to what degrees

Answer 6

0-15 degrees = SUPRASPINATUS
15-90 degrees = DELTOID
>90 degrees = SERRATUS ANTERIOR + TRAPEZIUS

Question 7

what are differentials of painful ARC

Answer 7

<90 = adhesive capsulitis  
60-120 = Subacromial impingement (commonly supraspinatus), rotator cuff tendonitis 
140-180 = Acromioclavicular OA

Question 8

what does a lateral C-Spine XR show and what does it need to be considered adequate

Answer 8

A lateral cervical spine X-ray in trauma should show the vertebral bodies from the OCCIPUT to T1
- the cervicothoracic junction must be demonstrated in order for the X-ray to be considered adequate and to exclude dislocation at C7/T1.

Question 9

What should the pre-vertebral soft tissue thickness be on a C-Spine XR at C1-4/5 AND C4/5- T1, why is this important

Answer 9

The prevertebral soft tissue thickness from C1-C4/5 should be a maximum of 7mm

• C4/5-T1 should be a maximum of one vertebral body width (21mm)
• NB. Soft tissue thickening may be the only sign of a vertebral fracture.

Question 10

what is a traumatic spondylolisthesis of C2 also known as

Answer 10

Hangman’s fracture

Question 11

if lytic bone lesions are found on Spinal XR where are the likely primaries from in M patients

Answer 11

In male patients carcinoma of the PROSTATE, LUNG, KIDNEY + MYELOMA are imp causes of lytic BONE lesions.

Question 12

if lytic bone lesions are found on Spinal XR where are the likely primaries from in FEMALE patient

Answer 12

secondary malignant bone tumours are BREAST, LUNG, KIDNEY, MYELOMA + lymphoma.

Question 13

Commonest sites of bony mets

Answer 13

spine, ribs, pelvis