4.0 of 75 Ratings
Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC.
A 36-year-old male injured his right arm after a fall. His injury radiograph is shown in Figure A. On physical examination, he was found to have a nerve injury. Which function is the last to return?
Pain sensation to the radial portion of the dorsum of the hand
Temperature sensation to the radial portion of the dorsum of the hand
Sensation of light touch to the radial portion of the dorsum of the hand
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A 16-year-old male presents with a gunshot wound to his right upper arm. On examination, he has a wrist drop and reports loss of sensation in his radial nerve distribution. There is a 1.5cm entrance wound on the lateral aspect of the arm with a 6.8 cm stellate exit wound anteromedially. Figures A and B are the radiographs of the injury. The patient is taken to the operating room for fixation, and the radial nerve is found to be completely transected. When is the optimal timing for definitive nerve repair?
At the time of initial debridement
At the time of definitive fracture fixation
After 3 months from the injury
After 1-3 weeks from the injury
Once a neuroma has formed on MRI
A 42-year-old male laborer sustains the injury shown in Figure A. He is taken to the operating room and found to have a partial laceration of the median nerve. Figure B shows a cross-sectional image of a nerve. Which of the following represents item D?
Which statement most accurately describes the physiology of peripheral nerve regeneration following an axonotmesic lesion?
The proximal nerve segment undergoes Wallerian degeneration
Axon growth occurs from the distal segment to proximal segment
Neurotrophic factors direct phagocytic activity
Proximal axon budding allows for antegrade (or distal) axon migration
Axoplasm and myelin are degraded distally predominantly by Schwann cells for the first 12 months following injury
Figure A shows a traumatic laceration of the distal forearm with a 5cm segmental median nerve defect. Which of the following repair or reconstruction techniques would allow for the best recovery of motor function?
Autogenous venous nerve conduit
Collegen synthetic nerve conduit
Biodegradable polyglycolic acid
Processed nerve allograft
A 55-year-old male laborer comes in with a chief complaint of clumsiness with his right hand for the past 3 months including difficulty using a hammer while at work. He has had no injury to the right upper extremity. On physical examination, he has persistent small finger abduction/extension with finger extension and active adduction. An EMG is performed and demonstrates ulnar nerve conduction velocities of 31 m/sec (normal >52m/sec). The patient symptoms are most accurately described as:
Axonotmesis with ischemia origin
Axonotmesis with myelin disruption
Neurapraxia with ischemia origin
Neurapraxia with endoneurium disruption
The patient sustains the injury seen in Figure A from a gunshot injury. The physical exam is notable for lack of sensation in his fourth and fifth digits as well as a positive Froment's sign. Which of the following factors has not been shown to be a significant prognostic indicator of functional recovery following nerve repair?
Duration to time of repair
Length of repair
Postoperative physical rehabilitation
Type of autograft used
You are seeing a 24-year-old male in the emergency room after he was involved in a knife fight. He has severed the common digital nerve to the index finger on his dominant hand, with an 8mm gap between nerve ends. In counseling him about repair, which of the following options is as good as autologous nerve grafting?
Glycolide trimethylene carbonate conduit
Primary end-to-end repair
Polyglycolic acid conduit
Which of the following nerves has the most favorable regenerative potential in restoring motor function after a graft repair within half a year after being injured?
Axon regeneration almost always occurs following a Sunderland second-degree nerve injury because which anatomic structure is not injured?
Vitamin B12 deficiency is a known cause of which the following?
Inability to whistle
Peripheral sensory neuropathy
Increased deep tendon reflexes
Which of the following peripheral nerve structures functions to cushion the nerve against external pressure?
Which of the following structures are slowly adapting skin receptors that detect pressure, texture, and low frequency vibration and are best evaluated by static two-point discrimination?
Free nerve endings