Anatomy- Exam 2 Clinical Questions (Week 2 & 3)

Front 1

A man is unable to unlock his knee. What muscle is likely damaged?

Back 1

Popliteus

Front 2

A patient comes into the trauma ER with forearm muscles that are completely cut/removed. What muscle from the lower limb can be transplanted into the forearm to give function forearm back to the patient?

Back 2

Gracilis

Front 3

A patient complains of pain in their T10 dermatome. If the patient is having appendicitis, what is this dermatomal pain called

Back 3

Referred pain. the cutaneous sensory neuron and the visceral sensory neuron both synapse on the same pain neuron in the dorsal root ganglion. Visceral pain presents as dermatomal pain of the spinal level the visceral afferent enters the dorsal root ganglion

Front 4

In a patient with Klumpke's Palsy, why do we typically see Horner's syndrome as well?

Back 4

Klumpke's palsy refers to the damage to C7-T1 spinal nerves. But damage to the T1 white communicating ramus also occurs (Part of the autonomic nervous system so we see small pupils etc.)

Front 5

A patient is on a stretcher in the ER with a lower limb that appears shortened and is MEDIALLY rotated. What is your immediate preliminary diagnosis?

Back 5

Dislocated Hip

Front 6

A patient is on a stretcher in the ER with a lower limb that appears shortened and is LATERALLY rotated. What is your immediate preliminary diagnosis?

Back 6

Femoral neck fracture

Front 7

A patient has the inability to flex their Distal Phalanges of their digits 4-5. They also have weak adduction of the wrist. What nerve is damaged? Is this a spinal or peripheral nerve?

Back 7

Ulnar, peripheral

Front 8

A patient presents with the inability to flex any part of digits 1-3, and poor proximal phalanges flexion of digits 4-5. What is the patients symptom called? What nerve is damaged? What is this patients likely disorder?

Back 8

Hand of Benediction, Pronator's syndrome (median nerve is compressed between 2 heads of pronator teres)

Front 9

During pronation, the patient has trouble abducting the ulna and keeping the axis of rotation. What nerve is affected? What muscle?

Back 9

Radial (muscle is the anconeous)

Front 10

A football player has severe trauma to the lateral knee. Upon examination, his damaged lower leg moves further laterally than his normal leg. Which knee ligament is damaged?

Back 10

Medial Collateral Ligament

Front 11

A football player has severe trauma to the lateral knee. He is unable to dorsiflex his feet. What nerve is damaged?

Back 11

Common fibular (or deep/superficial branches)

Front 12

You perform a biceps brachii reflex test on a patient. You rate their response a 1. What spinal nerve is bad?

Back 12

C6

Front 13

A female patient presents with a big toe that is severely pushed laterally. A bunions has formed. What is the diagnosis?

Back 13

Halux Valgus

Front 14

A patient is unable to dorsiflex. Are pre-axial or post axial muscles deficient?

Back 14

Post axial, even though they are in the anterior compartment. Axis switches during development

Front 15

As an orthopedic surgeon repairing the femoral head, which single artery do you want to be sure to keep intact for the cruciate anastomoses?

Back 15

medial femoral circumflex is the most important in the anastomoses, but also the inferior gluteal, lateral femoral circumflex and 1st perforating artery

Front 16

A patient has a stab wound on the right side of their spinal cord near T5. What motor and sensory deficits do we expect to see?

Back 16

Motor deficits on the right, ipsilaterally. Discriminative touch , proprioception and vibration deficit on the right. Pain, temp and crude touch deficit on the left.

Front 17

A patient complains was recently hit by a car on the lateral knee. He now walks with a "steppage gait". Why does he walk with a steppage gait?

Back 17

Damage to the lateral knee affects the common fibular nerve and dorsiflexion is impaired. To avoid tripping while walking, the patient lifts his entire limb.

Front 18

A patient walking away from you exhibits a severe pelvic drop with each step he takes. What is this called? What Muscle is damaged? What nerve could be damaged?

Back 18

Trelendenberg Gait/Sign. Gluteus medius, superior gluteal nerve

Front 19

A patient complains that he is unable to climb stairs or get out of a chair easily. What nerve is damaged?

Back 19

Inferior gluteal nerve (gluteus maximus problems)

Front 20

As an interventional cardiologist using a catheter to reach the heart, what area would you palpate to begin the procedure?

Back 20

Femoral triangle to find the femoral artery.

Front 21

A patient who regularly runs on uneven surfaces like sand complains of plantar foot pain. You can palpate a "heel spur" forming. What is the likely diagnosis?

Back 21

Plantar Fasciitis

Front 22

A patient stabbed in the lateral chest is unable to abduct his arm above 90 degrees. What muscle is deficient?

Back 22

Serratus Anterior

Front 23

You see a small protrusion from the saphenous opening. It is decided that this is a femoral hernia. Why is this patient at risk for infection and ischemia?

Back 23

The bulging hernia can cut circulation (ischemia) and spread intestinal bacteria (infection)

Front 24

A patient has a torn achilles tendon. What motion is now deficient?

Back 24

Plantarflexion

Front 25

A patient stabbed in the femoral sheath will still keep what structure intact in the femoral triangle?

Back 25

Femoral nerve

Front 26

A patient who regularly runs on uneven surfaces like sand complains of plantar foot pain. You can palpate a "heel spur" forming. What is the likely diagnosis?

Back 26

Plantar Fasciitis

Front 27

A patient stabbed in the lateral chest is unable to abduct his arm above 90 degrees. What muscle is deficient?

Back 27

Serratus Anterior

Front 28

You see a small protrusion from the saphenous opening. It is decided that this is a femoral hernia. Why is this patient at risk for infection and ischemia?

Back 28

The bulging hernia can cut circulation (ischemia) and spread intestinal bacteria (infection)

Front 29

A patient has a torn achilles tendon? What motion is now deficient?

Back 29

Plantarflexion

Front 30

A patient stabbed in the femoral sheath will still keep what structure intact in the femoral triangle?

Back 30

Femoral nerve

Front 31

A patient has difficulty adducting the thigh against resistance. What nerve is damaged?

Back 31

Obturator

Front 32

As an orthopedic surgeon, you are about to perform total hip arthroplasty. What 2 components are being replaced?

Back 32

Acetabulum and femoral head

Front 33

A patient's lab work shows high levels of neutrophils in the CSF. What is your most likely diagnosis?

Back 33

Meningitis

Front 34

A deficient blood-nerve barrier is a sign of which nerve layer deficits?

Back 34

Perineurium

Front 35

In a patient with compartment syndrome, why is it important to perform a fasciotomy quickly?

Back 35

Compartment swelling can pinch nerves and cut circulation

Front 36

Which vein are you looking for when drawing blood during venupuncture (forearm)?

Back 36

Medial cubital vein

Front 37

A patient complains of sharp wrist pain and has weakened digit flexion. What is this disorder and how is it repaired?

Back 37

Carpal Tunnel Syndrome. Transverse carpal ligament is cut and re-sutured

Front 38

A patient complains of a common sprained ankle. What ligament is stressed?

Back 38

Talofibular ligament

Front 39

A newborn baby had too much torsion on its head as it was being born. What spinal segments of the brachial plexus are likely damaged? What is this disorder called?

Back 39

C5, C6. Erb's Palsy

Front 40

A patient is stabbed in the axilla. He can no longer feel sensation on his forearm, but can feel sensation on his upper arm. His scapula is stable. He also has trouble adducting the wrist. Where specifically is his nerve injury?

Back 40

Medial cord of brachial plexus after medial brachial cutaneous nerve

Front 41

A man is stabbed in the axilla. He has trouble abducting his arm up to 15 degrees, his clavicle is unstable, but his scapula can retract. Where specifically is his nerve injury?

Back 41

Superior trunk before Nerve to subclavius and suprascapular. dorsal scapular is intact

Front 42

A man was stabbed in the axilla. He is unable to abduct to 90 degrees. He has a functional Latisimuss Dorsi. Where specifically was he stabbed?

Back 42

Right before the axillary nerve on the posterior cord of the brachial plexus.

Front 43

A patient complains of pain in his thumb as he moves it. What carpal bone is involved with this arthritis?

Back 43

Trapezium

Front 44

A man is stabbed above the caudal medulla on the right and survives. What motor deficits will he have?

Back 44

He will lose left side (contralateral) motor function below the lesion.

Front 45

A foot ball player suffers severe ankle eversion. What collection of ligaments is probably damaged? Because these are very strong, what will likely happen to the boney attachment?

Back 45

Deltoid ligaments. avulsion occurs when the ligaments are so strong that a force doesn't break the ligaments, but instead rips a part of the bone off

Front 46

As an anesthesiologist, you are administering epidural anesthesia. What meningeal layers are you going to penetrate?

Back 46

None. Epidural is outside of the dura mater.

Front 47

As an anesthesiologist, you are administering spinal anesthesia. What meningeal layers are you going to penetrate?

Back 47

Dura mater, arachnoid mater. Spinal anesthesia goes into the CSF/Sub arachnoid space

Front 48

A patient has severed an axon from his elbow to his wrist (10 inches). How many days will it take to regenerate this axon (1 inch = 25mm)?

Back 48

total of 250mm needs to be made. 1-3 mm/day. about 80-250 days

Front 49

A patient regularly runs marathons and is feeling pain between his toes. There is some swelling visible between the toes on the plantar surface of the foot. What is a likely diagnosis?

Back 49

Morton's neuroma

Front 50

A man is stabbed in the upper chest area. His pectoralis minor is clearly damaged. What 2 blood vessels branching off the axillary artery are at risk?

Back 50

Thoracoacromial and lateral thoracic artery

Front 51

A teenage boy fractured his tibia. There is swelling visible. What is this disorder? What part of the growing bone is responsible for this disorder?

Back 51

Osgood Schlatter disease. epiphyseal plate is damaged during growth.

Front 52

A patient is having trouble abducting their thumb, what nerve may be damaged?

Back 52

Radial (abductor pollicis longus)

Front 53

During abdominal surgery, you notice a large artery around T12 to the spinal cord. What is it?

Back 53

Artery of Adamkiewicz

Front 54

To test for a broken ACL or PCL, what is the name of the test you would use?

Back 54

Drawer's Test

Front 55

A patient complains of loss of sensation in an area. You determine that sensation is lost only in the autonomous zones. What type of nerve injury is this?

Back 55

Radiculopathy