Week 6 Formative

Question 1

what is the incidence of brachial plexus injury in newborns during vaginal delivery?

Answer 1

0.2%

Question 2

periosteum is thicker or thinner in children?

Answer 2

thicker

means more likely to splinter, buckle and bend than completely snap

Question 3

which nerve is at risk of injury in anterior shoulder dislocation?

Answer 3

axillary nerve

Question 4

mortality rate 1 year after hip fracture?

Answer 4

30%

Question 5

what is the injury in mallot finger?

Answer 5

avulsion of extensor tendon from the distal phalanx causing inability to extend DIP

Question 6

boxers fractures are usually treated conservatively apart from when what deformity is present?

Answer 6

rotational deformity

requires manipulation and possibly fixation

Question 7

how are extra capsular hip fractures often managed?

Answer 7

dynamic hip screw

- doesnt include open surgery

Question 8

what criteria must be met to clear the cervical spine of injury?

Answer 8

no history of loss of consciousness
GSC 15 with no alcohol intoxication
no significant distracting injury (head injury, chest trauma, distal spinal fractures etc)
no neurological symptoms in upper or lower limbs
no midline tenderness on palpation of C spine
no pain on gentle active neck movement (ask patient to gently flex forward and rotate to each side)

Question 9

name 3 tendons ruptures which can be treated conservatively?

Answer 9

long head of biceps
achilles tendon
rotator cuff

Question 10

name 2 tendon ruptures which require surgical repair?

Answer 10

quadriceps tendon

patellar tendon

Question 11

what are the characteristics of chronic regional pain syndrome?

Answer 11

constant burning or throbbing
sensitivity to stimuli not normally painful including light or cold touch
chronic swelling
stiffness
painful movement
skin colour changes

Question 12

what can cause chronic regional pain syndrome?

Answer 12

can be caused by a peripheral nerve injury (type 2)
can have no known cause (type 1)
common in people with history of chronic pain issues
commonly occurs after fractures

Question 13

how is chronic regional pain syndrome managed?

Answer 13

specialist pain services
analgesics, antidepressants, anti convulsants and steroids
TENS machines
physio
lidocaine patches
sympathetic nerve block injections

Question 14

what is wolfs law?

Answer 14

potential of bone to change shape with bone laid down along areas of stress

Question 15

what types of salter harris fractures are intra-articular?

Answer 15

3 and 4

Question 16

how are salter harris fractures 3 and 4 managed?

Answer 16

reduction and stabilization to ensure a congruent articular surface and minimise growth disturbance

Question 17

which nerve is at risk in a humeral shaft fracture?

Answer 17

radial nerve

Question 18

impaired grip strength is associated with loss of flexion or extension at the wrist?

Answer 18

extension

Question 19

why is there a risk of non-union in scaphoid fractures?

Answer 19

retrograde blood supply so risk of AVN

Question 20

what nerve is at risk in a supracondylar fracture of the distal humerus?

Answer 20

median nerve

Question 21

what is the cardinal clinical sign of compartment syndrome?

Answer 21

increased pain on passive stretching of the involved muscle

also ischaemic pain, parasthesia and sensory loss and swelling

Question 22

what does loss of pulses in compartment syndrome indicate?

Answer 22

end stage ischaemia

diagnosis has been made too late