Viva snippets

Question 1

What are the boundaries of Guyon’s canal

Answer 1

Floor - flexor retinaculum and hypothenar muscles
Roof - TCL
Ulnar - Pisiform and pisohamate ligaments
Radial - hook of hamate

Question 2

What are the zones of Guyon’s canal

Answer 2

1 - Proximal to bifurcation - mixed
2 - Ulnar - deep motor branch FPB & intrinsics (not 2 Lumbrs)
3 - radial - Superficial sensory branch

Question 3

Indications for upper limb reimplantation

Answer 3

Absolute - thumb, multiple digits, children, central single digit distal to FDS

Relative - RIng avulsion, distal to DIPJ

Contraindication - single border digit, mangled, severe illness, prolonged warm ischaemia time

Question 4

Risk factors of CTS

Answer 4

Pregnancy
Female
Obesity
Hypothyroid
RA
Age
CRF
Smoking
Alcohol
Repetitive motion
Mucopolysaccaridosis
Mucolipidosis 

Space occupying lesions
Gout
Lipoma

Question 5

NPS for carpal tunnel

Answer 5

Increased latencies
Motor >4.3
Sensory >3.2 m/s

Decreased conduction velocities

Question 6

If motor loss is preceded by intense shoulder pain and viral prodrome

Answer 6

Parsonage Turner syndrome

Then AIN signs can be bilateral

Question 7

Bouviers test

Answer 7

Bring claw out of hyper extension. Does PIPJ correct

If yes, claw is intrinsic positive
If no, positive test
Volar subsided lateral bands
Central slip attenuation or adhesion to PIPJ

Question 8

What else to test with ulna nerve exam to rule out proximal root lesion

Answer 8

APB to rule out T1

C8/T1 from median

Question 9

NOF evidence

Answer 9

Nice 2011

1. No Cognitive impairment
2. Independent mobility
3. Fit and well for Gas

Baker 2006 JBJS a
The better than Hemi decreased revision, complications and better functional outcomes

Question 10

Hang mans C2 #

Answer 10

Levine and Edwards
1 - traumatic pats # 3mm - reduce and halo

2a - more angled than displaced - NO TRACTION. Reduce and halo

3 - subsided C2/3 facets. Halo or ACDF

Question 11

C1/2 instability measurements 
AADI
PADI
Ranawat
McRae etc

Answer 11

AADI - 7 all logs gone. >10neurology

PADI - c1-2 14 normal, 10-13 neurology recover,