Case Study 2 PNS A 17 year old female presents herself to her GP with a complain
ID: 92802 • Letter: C
Question
Case Study 2 PNS A 17 year old female presents herself to her GP with a complaint of numbness on the dorsum of her right foot and difficulty in lifting her foot; specifically, her toes don't want to lift up. She reports that 2 days ago she was riding her bike and she had unexpectedly hit the edge of a pot hole and fell hitting her leg on the curb. She reports that it really hurt at that time and later that day she noticed some swelling and bruising. She is concerned because the numbness has become worse and it is becoming more difficult to walk. Upon examination you find that there is a large hematoma (bruise) and edema (swelling) at the right proximal and lateral fibula that is painful to the touch. Sensory deficits are noted across the dorsum of her foot and she has difficulty dorsiflexing and everting her right foot against resistance in comparison to her left. She has a stable knee joint and quadriceps tendon reflex and a stable ankle joint with normal calcaneal tendon reflex Radiographic analysis revealed a non-displaced fracture at the neck of the right fibula. In practice questions-Explanation / Answer
Answer:
4) Pectoral gridle in the shoulder consists of Clavicle and scapula. If the gal have fallen and struck the point of her shoulder Calvicle bone of the pectoral girdle would most likely have broken also Acromioclavicular joint would have got affected.
5) Long thorasic nerve, Suprascapular nerve , Subclavius nerve, Lateral pectoral nerve, thoracodorsal nerve , Axillary nerve would have been affected.
6) Humerus fracture is fracture in the upper arm bone. Based on the location it may occure in the proximal region(Shoulder), middle region(Shaft of the humerus) or distal region(near to the elbow).
Radial nerve would be affected.
7) Significant swelling and pain in the arm. The arm can not moved/raised easily.
There is usually bleeding from the fracture into the tissues of the upper arm. Significant swelling commonly occurs from the shoulder to the hand. Patient may feel the bone fragments shift as you move.
Sometimes surgery is required to fix the bone, A plate and screws on the side of the bone would be fied or sometimes a thin nail is inserted in the middle of the bone.
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