Clinical Correlations

Question 1

Excess thoracic kyphosis

Answer 1

Hunchback
Can be postural or congenital

Question 2

Excessive lumbar lordosis

Answer 2

Swayback, arch butt
Can be idiopathic or from pregnancy

Question 3

Scoliosis

Answer 3

Abnormal lateral curvature

Question 4

Lumbar spinal stenosis

Answer 4

Narrowing of vertebral foramen
Repaired with laminectomy

Question 5

Intervertebral disc herniation

Answer 5

Protrusion of nucleus pulposus into annulus fibrosis
Common at L4/L5, L5/S1

Question 6

Lumbar puncture procedure

Answer 6

Remove CSF to diagnose
Must be between L3/L4 or L4/L5
Use iliac crest as landmark

Question 7

Clavicular fractures

Answer 7

Can be laterally, middle or medially
Usually middle
Common in children

Question 8

Fracture of proximal humerus

Answer 8

At surgical neck
Common in elderly
Can affect axillary n.
Ant. and post. circumflex arteries

Question 9

Acromioclavicular joint

Answer 9

Dislocation in contact sports
Shoulder separation

Question 10

Glenohumeral joint

Answer 10

Common in sports
Most common is subcoracoid
Damage to axillary nerve can cause flattened shoulder

Question 11

Winged scapula

Answer 11

Scapula moves away from thoracic wall
Serratus anterior paralysis due to long thoracic nerve injury

Difficult brushing hair

Question 12

Rotator cuff injury

Answer 12

Supraspinatus is most vulnerable to injury - cannot initiate abduction

Question 13

Shoulder tendinitis

Answer 13

Inflammation of shoulder tendon
(Often supraspinatus)

Question 14

Shoulder bursitis

Answer 14

Inflammation of one of four bursa
(Often subacromial)

Question 15

Erb’s palsy

Answer 15

Occurs during delivery caused by excess stretching of neck
Affects C5-C6 roots (superior trunk)
SAM - suprascapular n. axillary n. musculocutaneous
Adducted, medially rotated, flex hand

Question 16

Injury to axillary nerve

Answer 16

Can be caused by proximal humeral fracture
Cannot abduct between 15-90 degrees because deltoid affected

Question 17

Humeral shaft fracture

Answer 17

Radial nerve and profunda brachii a. affected

Question 18

Distal fracture

Answer 18

Can affect median nerve

Question 19

Distal medial epicondylar fracture

Answer 19

Can affect median nerve

Question 20

Olecranon bursitis

Answer 20

Student’s elbow

Question 21

Elbow dislocation

Answer 21

Radius and ulna move posteriorly

Question 22

Terrible triad

Answer 22

Elbow dislocation with lateral collateral ligament injury, radial neck fracture and coronoid fracture

Question 23

Cubitus varus

Answer 23

Elbow angled in
Malunion of humeral fracture

Question 24

Subluxation

Answer 24

Temporary/incomplete dislocation
Annular ligament shifts
Pulling on child’s hand/wrist

Question 25

Cubitus valgus

Answer 25

Elbow angled out Can stretch ulnar n Malunion of medial epicondylar fracture

Question 26

Tardy ulnar palsy

Answer 26

Stretching ulnar nerve, due to cubitus valgus

Question 27

Biceps tendinitis

Answer 27

Inflammation of long head

Question 28

Rupture of long head of biceps brachii

Answer 28

Popeye sign

Question 29

Bicipital myotactic reflex

Answer 29

Test integrity of musculocutaneous n. (C5, C6) Tendon at cubital fossa

Question 30

Brachial artery

Answer 30

For taking blood pressure/pulse

Question 31

Cubital fossa

Answer 31

Median cubital vein used for venipucture Meeting of cephalic and basilic v.

Question 32

Colles' fracture

Answer 32

Fracture of distal radius, wrist extended/out Dinner fork

Question 33

Smith's fracture

Answer 33

Fracture of distal radius, wrist flexed/in Garden spade

Question 34

Carpal bone fracture

Answer 34

Commonly scaphoid Pain and swelling in anatomical snuff box

Question 35

Medial epicondylitis

Answer 35

Golfer's elbow

Question 36

Lateral epicondylitis

Answer 36

Tennis elbow

Question 37

Mallet/baseball finger

Answer 37

Distal phalanx forcefully flexed, tearing tendon thus can extend

Question 38

Crutch palsy/Saturday night palsy

Answer 38

Radial nerve compression in axilla

Question 39

Dupuytren's contraction

Answer 39

Abnormal thickening of palmar aponeurosis pulls digits 4&5 into partial flexion

Question 40

Clawing of hands

Answer 40

Lumbricals and interossei lose function Affects ulnar and median nerve Inferior trunk

Question 41

Can't make OK sign

Answer 41

Flexor digitorum profundus lose function Affects anterior interosseous nerve [median n] (C6-T1)

Question 42

Clawing of 4th and 5th digits

Answer 42

Severed ulnar nerve Affects lumbricals 3&4, hypothenar muscles Can be caused by hook of hamate fracture in Guyon's canal Wrist laceration

Question 43

Thumb paralysis

Answer 43

Injury to recurrent median nerve

Question 44

Benediction attitude

Answer 44

Can't make fist, 1-3 stay extended Distal humeral fracture Injury to median nerve

Question 45

Wrist drop

Answer 45

Wrist can't extend Damage to radial nerve

Question 46

Compression of anterior interosseous nerve

Answer 46

Abductor pollicis brevis Tenderness along medial forearm Paresthesia over 1st and second digits

Question 47

Ulnar nerve injury

Answer 47

Most intrinsic hand muscles affected No thumb adduction