NU 673 MidTerm_Final.
Musculoskeletal
What is the first type of motion that is lost as a person develops progressively
worsening osteoarthritis of the hip joint?
Internal Rotation
the earliest sign of the development of osteoarthritis of the hip is often the loss of
internal rotation. As the condition worsens, muscular contractures may develop which
hold the affected limb in a flexed and externally rotated position, which has great
consequence on the individual's gait and functioning level. Typically a person
experiencing this type of osteoarthritis will eventually develop an antalgic gait where the
time spent bearing weight on the affected limb is brief due to pain. Also, the gluteus
medius (which is a hip abductor and helps stabilize the pelvis) may become weakened
as the condition worsens, resulting in an abductor lurch as the trunk of the body sways
out over the affected limb when attempting to walk.
A fracture involving the medial epicondyle will most likely cause damage to which
nerve?
A Axillary
B Median
C Peroneal
D Radial
E Ulnar
Ulnar
Because the ulnar nerve passes through the cubital tunnel, which is a groove on the
posterior aspect of the medial epicondyle, any fractures involving the medial epicondyle
can also cause damage to the ulnar nerve. The median nerve is most susceptible to
injury at the carpal tunnel. Branches of the radial nerve can become entrapped on the
lateral side of the elbow and the associated symptoms are often confused with lateral
epicondylitis. Radial nerve injuries are more commonly associated with humeral shaft
fractures. The axillary nerve is significantly proximal to the medial epicondyle and the
peroneal nerve is in the leg.
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A 52-year-old male has a 200-pound file cabinet fall on his right leg. He comes to the
emergency department complaining of pain and swelling to the right leg. He is also
complaining of parasthesias to the leg also. Based on these findings on history, what
part of the leg would be the most likely site of compartment syndrome?
,NU 673 MidTerm_Final.
A Anterior compartment of the leg
B Deep posterior compartment of the leg
C Dorsal compartment of the forearm
D Lateral compartment of the leg
E Superficial posterior compartment of the leg
Anterior Compartment of the leg
Anterior compartment syndrome is most commonly found in the anterior compartment of
the leg, with the volar compartment of the forearm also a common location. The
,NU 673 MidTerm_Final.
mechanism is generally an acute crushing trauma to the affected area that causes an
increase in pressure within the compartment that inhibits venous outflow and a
decrease in arterial blood flow. This adversely affects tissue perfusion and ischemia of
the involved tissues can occur. The symptoms can also occur with chronic exertion or
when there is a dramatic increase in the amount of exercise being performed. Anterior
compartment syndrome of the leg is likely most common due to its vulnerable location
and susceptibility to injury in athletics and motor vehicle accidents. The rate of
occurrence of acute anterior compartment syndrome is also likely due to the fact that
the anterior compartment lies adjacent to the tibia and the tibia is the most frequently
fractured long bone. Compartment syndrome could occur in any compartment of the
upper or lower extremities if the necessary circumstances were in place (either acute
trauma to the area or excessive use of the muscles that are associated with each of the
compartments).
A 17-year-old female distance runner with no significant PMH complains that she has
diffuse, aching anterior knee pain that is worsened when she walks up or down stairs or
when she squats down. There has been no acute trauma, but she has been increasing
her running mileage. No effusion is present. What is the probable diagnosis?
A Anterior cruciate ligament tear
B Medial meniscal tear
C Osteoarthritis of the knee joint
D Patellofemoral syndrome
E Posterior cruciate ligament tear
D Patellofemoral syndrome is a common condition in active adolescents due to
repetitive stresses on the patellofemoral joint. This can be exacerbated by altered
patellofemoral tracking due to growth and development in adolescents. Other
biomechanical issues that may contribute to this problem include poor flexibility,
weakness of the vastus medialis muscle, which results in a more lateral tracking of the
patella, and excessive foot pronation. This condition does not produce an effusion.
Anterior and posterior ligament tears would be highly unlikely given that there was no
history of an acutely traumatic event and because ligaments are fairly vascular
structures, an effusion would be expected with any cruciate ligament tear. Meniscal
tears in a young patient are generally associated with a traumatic twisting event and
while not as vascular as a ligament, meniscal tears generally lead to the gradual
development of an effusion. Older patients may experience a degenerative tear with
minimal trauma, but that is unlikely in our 17-year-old patient. Osteoarthritis is generally
associated with gradual wear and tear after many years or the process can be
accelerated after a significant acute trauma to a joint. Neither scenario is applicable to
this patient.
A 56-year-old right hand dominant male presents with swelling to the right elbow. He
explains to you that he has had this type of swelling before and was diagnosed with
bursitis. Based on this description, where would the most likely site for the elbow bursitis
be located?
, NU 673 MidTerm_Final.
A Capitellum
B Lateral epicondyle
Musculoskeletal
What is the first type of motion that is lost as a person develops progressively
worsening osteoarthritis of the hip joint?
Internal Rotation
the earliest sign of the development of osteoarthritis of the hip is often the loss of
internal rotation. As the condition worsens, muscular contractures may develop which
hold the affected limb in a flexed and externally rotated position, which has great
consequence on the individual's gait and functioning level. Typically a person
experiencing this type of osteoarthritis will eventually develop an antalgic gait where the
time spent bearing weight on the affected limb is brief due to pain. Also, the gluteus
medius (which is a hip abductor and helps stabilize the pelvis) may become weakened
as the condition worsens, resulting in an abductor lurch as the trunk of the body sways
out over the affected limb when attempting to walk.
A fracture involving the medial epicondyle will most likely cause damage to which
nerve?
A Axillary
B Median
C Peroneal
D Radial
E Ulnar
Ulnar
Because the ulnar nerve passes through the cubital tunnel, which is a groove on the
posterior aspect of the medial epicondyle, any fractures involving the medial epicondyle
can also cause damage to the ulnar nerve. The median nerve is most susceptible to
injury at the carpal tunnel. Branches of the radial nerve can become entrapped on the
lateral side of the elbow and the associated symptoms are often confused with lateral
epicondylitis. Radial nerve injuries are more commonly associated with humeral shaft
fractures. The axillary nerve is significantly proximal to the medial epicondyle and the
peroneal nerve is in the leg.
Upgrade to remove ads
Only $1/month
A 52-year-old male has a 200-pound file cabinet fall on his right leg. He comes to the
emergency department complaining of pain and swelling to the right leg. He is also
complaining of parasthesias to the leg also. Based on these findings on history, what
part of the leg would be the most likely site of compartment syndrome?
,NU 673 MidTerm_Final.
A Anterior compartment of the leg
B Deep posterior compartment of the leg
C Dorsal compartment of the forearm
D Lateral compartment of the leg
E Superficial posterior compartment of the leg
Anterior Compartment of the leg
Anterior compartment syndrome is most commonly found in the anterior compartment of
the leg, with the volar compartment of the forearm also a common location. The
,NU 673 MidTerm_Final.
mechanism is generally an acute crushing trauma to the affected area that causes an
increase in pressure within the compartment that inhibits venous outflow and a
decrease in arterial blood flow. This adversely affects tissue perfusion and ischemia of
the involved tissues can occur. The symptoms can also occur with chronic exertion or
when there is a dramatic increase in the amount of exercise being performed. Anterior
compartment syndrome of the leg is likely most common due to its vulnerable location
and susceptibility to injury in athletics and motor vehicle accidents. The rate of
occurrence of acute anterior compartment syndrome is also likely due to the fact that
the anterior compartment lies adjacent to the tibia and the tibia is the most frequently
fractured long bone. Compartment syndrome could occur in any compartment of the
upper or lower extremities if the necessary circumstances were in place (either acute
trauma to the area or excessive use of the muscles that are associated with each of the
compartments).
A 17-year-old female distance runner with no significant PMH complains that she has
diffuse, aching anterior knee pain that is worsened when she walks up or down stairs or
when she squats down. There has been no acute trauma, but she has been increasing
her running mileage. No effusion is present. What is the probable diagnosis?
A Anterior cruciate ligament tear
B Medial meniscal tear
C Osteoarthritis of the knee joint
D Patellofemoral syndrome
E Posterior cruciate ligament tear
D Patellofemoral syndrome is a common condition in active adolescents due to
repetitive stresses on the patellofemoral joint. This can be exacerbated by altered
patellofemoral tracking due to growth and development in adolescents. Other
biomechanical issues that may contribute to this problem include poor flexibility,
weakness of the vastus medialis muscle, which results in a more lateral tracking of the
patella, and excessive foot pronation. This condition does not produce an effusion.
Anterior and posterior ligament tears would be highly unlikely given that there was no
history of an acutely traumatic event and because ligaments are fairly vascular
structures, an effusion would be expected with any cruciate ligament tear. Meniscal
tears in a young patient are generally associated with a traumatic twisting event and
while not as vascular as a ligament, meniscal tears generally lead to the gradual
development of an effusion. Older patients may experience a degenerative tear with
minimal trauma, but that is unlikely in our 17-year-old patient. Osteoarthritis is generally
associated with gradual wear and tear after many years or the process can be
accelerated after a significant acute trauma to a joint. Neither scenario is applicable to
this patient.
A 56-year-old right hand dominant male presents with swelling to the right elbow. He
explains to you that he has had this type of swelling before and was diagnosed with
bursitis. Based on this description, where would the most likely site for the elbow bursitis
be located?
, NU 673 MidTerm_Final.
A Capitellum
B Lateral epicondyle
