Sample Questions
A fracture shown on the radiograph will result in the following:
- Inability to oppose the thumb
- Problems with pronation of arm
- Difficulty with wrist extension
- Deltoid muscle paralysis
Answer C. Difficulty with wrist extension
A humerus fracture can be classified by the location of the humerus involved which may be upper end, mid-shaft or lower end
Upper end fractures- axillary nerve may be damaged. Axillary nerve injury results in deltoid muscle paralysis.
Mid-shaft fractures- RADIAL nerve may be damaged, closely associated with radial groove. Radial nerve (C6-8) injury results in problems with wrist extension and motor paralysis of supinator, triceps, brachialis and brachioradialis. There may also be radial neuropathy with numbness, tingling and burning pain.
Lower end fractures- median nerve(C6-8, T1) is damaged when fracture is in supracondylar area and ulnar nerve (C8-T1) if near the medial epicondyle. Median nerve injury results in problems with thumb pinch, thumb opposition or “ok” sign, pronation of arm. Ulnar nerve injury results in problems with abduction, flexor hand muscles and little finger.
Sample Keyword with Explanation
BUPRENORPHINE: RECEPTORS
Buprenorphine is a semisynthetic opioid that is a derivative of the morphine alkaloid thebaine. It has partial agonist activity at μ-opioid receptor and antagonist activity at κ- and δ-opioid receptors.
When used as an analgesic, its partial μ-opioid receptor agonism results in a ceiling effect for respiratory depression and causes less euphoria and less craving. The decrease in craving may also be associated with antagonism at the κ-opioid receptor. There is also less tolerance with buprenorphine.
Buprenorphine is 30-40 times more potent than morphine and has a half-life of 4-5 hours but because of the slow dissociation from the μ-opioid receptor, it can be used as a once a day dosing with prolonged duration of action in opioid treatment programs. Suboxone is buprenorphine and naloxone combined with a ratio of 4:1 given as sublingual dose. Subetex is buprenorphine without naloxone. Both can be used as alternative to methadone maintenance therapy.
Sample Key Concepts
Wide dynamic neurons- mostly in Lamina V
Meralgia paresthetica- lateral femoral cutaneous nerve involved
Closed kinetic chain exercises- more functional, done with distal ends of upper & lower extremities fixed to ground, ex: leg and bench press, push ups
Sample Imaging Studies
 MRI of Cervical myelopathy |
 MRI of Labrum tear of Hip |