Clinical Questions

Question 1

How would you fracture your clavicle?
Weakest part?
What muscles will elevate?
What happens to the trapezius?

Answer 1

• Indirect force transmitted from an outstretched arm during a fall
• Fall directly on the shoulder
• Junction of its middle and lateral thirds
• SCM muscle elevates
• Shoulder drops because the trapezius cannot hold up the weight of the limb

Question 2

Fracture of scapula causes a protruding ____?

Accompanied by _____?

Answer 2

• Subcutaneous acromion

- Fractured ribs

Question 3

Fractures of the radius and ulna usually occurs?

Fracture of one results in …?

Answer 3

• Transverse fractures, often in the middle third of the bones
• Dislocation of the other bone or the nearest joint

Question 4

Fracture of the scaphoid occurs when?

Answer 4

Fall with the hand abducted

Question 5

Fracture of the hamnate causes injury in the ___ nerve

Answer 5

Causes the injury of the ulnar nerve

Question 6

Paralysis of Serratus anterior?

Arm?

Answer 6

Because of the long thoracic nerve
Medial border of scapula move laterally and posteriorly from the thoracic wall
Arm cannot be abducted above the horizontal position because it cannot rotate glenoid cavity superiorly

Question 7

Injury to the axillary causes atrophy in?

What happens to the contour of the shoulder?

Answer 7

The deltoid

Disappears, asymmetry in shoulder

Question 8

Injury to MC nerve

Answer 8

• Paralysis to coracobrachialis, biceps, brachialis
• Flexion at the elbow and supination of the forearm are weakened
• ## Loss of sensation on the lateral surface of the forearm

Question 9

Injury to radial nerve

Answer 9

• Paralysis in the BR, Supinator, extensor muscles of the wrist and fingers

Question 10

Compression of the brachial artery

Answer 10

• Controlling hemorrhage is near the middle of the arm

- Bicep is pushed laterally to detect pulsations

Question 11

Testing the FDS

Answer 11

• One finger is flexed at the IP joint against resistance

- Other 3 fingers are held to inactivate the FDP

Question 12

Infection in the digital synovial sheaths

Little Finger?

Answer 12

• Digit swells (Confined to the digit because tendons of the 2nd through 4th digit have separate synovial sheaths
• Will spread to the carpal tunnel

Question 13

What happens with FDS and FDP enlarge?

Answer 13

Person is unable to extend their fingers

Question 14

Carpal tunnel injury:

• Most sensitive part?
• Where would you have tinging or absence of tactile sensation?

Answer 14

• Median nerve

- Everywhere but the centre of the palm

Question 15

Laceration of the median nerve at the wrist?

Forearm?

Answer 15

• Causes paralysis of the thenar muscles and the first 2 lumbricals - no opposition of the thumb fine movements of the 2nd and 3rd digit are impaired
• Causes loss in flexion and distal interphalangeal joints of 2nd and 3rd digits

Question 16

Ulnar nerve injury:
Occurs where?
What happens?

Answer 16

• Posterior to the medial epicondyle of the humerus, the wrist and the hand
• Elbow wrist and hand: extensive loss in motor function
• Distal part of forearm: deinnervates most muscles in the intrinsic hand

Question 17

Radial nerve injury

Answer 17

Fracture in the humeral shaft causes disability of the hand

Question 18

Rotator cuff injury

Answer 18

Cannot initiate abduction of the arm

Question 19

Dislocation of the A-C joint:

- Shoulder separation?

Answer 19

• Hard fall on shoulder

- When C-C lig also tears and the shoulder separates from the clavicle and falls because of the weight of the upper limb