Upper limb
Supraclavicular region
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Allen, a 45 year old post man has been living with a police man tip deformity for almost a year now. He recalls a heavy branch of a tree falling on his left shoulder which rendered him unconscious immediately, after which he was unable to perform certain shoulder movements. Nerves arising from which nerve roots of his brachial plexus were injured following that accident? *
Raj recovered quickly from his humerus fracture and the cast was completely removed in 4 weeks. Although no surgical notes were recorded on the nerve injuries,  his physiotherapist wanted to confirm that the axillary nerve is perfectly alright, as the fracture was across his surgical neck. Which muscle will the physiotherapist test to confirm the integrity of the axillary nerve? *
Maria was brought to the emergency department following her fall on outstretched hand. Her friends reported that the incident while they were trying to move a heavy couch down the stairs. Maria couldn't move her right shoulder. Her shoulder contour was still round suggesting a normal glenohumeral joint, but on palpation, the registrar could feel a 'step' on her clavicle, suggesting a fracture at its middle third. An x-ray of the shoulder confirmed both findings. Attachment of which major force transmitting structure at this site of the clavicle could have predisposed the fracture? *
Rebecca was referred for an ultrasound examination, following inability to initiate shoulder abduction. The sonographer dicovered an ossified transverse scapular ligament that has narrowed Rebecca's suprascapular foramen. What structure(s) pass through the suprascapular foramen? *
Following the compression of C7 nerve root from her long standing cervical spondylosis, Olivia complained of tingling, parasthesia (altered sensation) and occasional numbness over the skin of one of her fingers. From your understanding of dermatomes, which finger do you think is involved? *
Raj, a 22 year old medical student man was rushed to the emergency department following a serious injury during his basket ball practice. He couldn't move his left shoulder, and was guarding it with the other arm. Following an x-ray confirmation of a fractured humerus, it was decided to perform an ORIF (open reduction and internal fixation). A high level brachial plexus block (anesthesia) was performed at the base of his neck with ultrasound guidance. Between which two muscles is the needle inserted for this procedure?   *
Olivia, after 30 years of her job as a front office admin staff, has been suffering from cervical spondylosis that has severely compressed her C7 nerve root on both sides. Facet joints of which cervical vertebrae are degenerated which has narrowed the intervertebral foramina and compressed these roots? *
Rebecca, a 43 year old diabetic and a mother of three kids, visited her physician following her inability to abduct the shoulder. She also reported a vague pain deep to her shoulder region. The physician, however, ruled out any shoulder problems that could limit abduction- the passive range of motion was normal. She also found that only the initiation of abduction was affected. Which muscle is probably affected that leads to Rebecca's symptom? *
Raj's fracture was across the surgical neck of his left humerus; it was carefully fixed by an ORIF (open reduction and internal fixation). However, due to the longer duration of the surgery, his unaffected right arm was compressed against the edge of the operating table for a few hours. Raj woke up only to find out that he couldn't extend his right 'unaffected' wrist, but elbow extension was OK. Which nerve do you think has been compressed and affected in this case? *
Olivia, due to her severe cervical spondylosis, complains of pain/ parasthesia over her fingers, weakness of hand grip, and occasional vertigo. What do you think is the anatomical reason for her vertigo in this case? *
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