f Post graduate mcqs and discussion

Thursday, April 12

volkmann ischemic contractures

Q. Most common muscles involved in volkmann ischemic contractures are .

A. Flexor digitorum profundus
B. Flexor carpii ulnaris
C. Flexor digitorum superficialis
D. Flexor pollicis longus

Ans : Flexor digitorum profundus

Most commonly involved muscles are Flexor digitorum profundus( most common )  and Flexor pollicis longus.

Ischemic injury to the muscle and nerves on the flexor compartment of the forearms.  It is caused due to occlusion of the brachial artery by a supracondylar fractures.  The ischemic muscles are gradually replaced by fibrous tissue which contracts and draws the wrist and finger  into flexion. 

Clinical features :

Marked atrophy of forearm muscles
Flexion deformity of the wrists and fingers
Skin over the forehand and hand is dry and scally
Nail shows atrophy changes .

Treatment :

Mild deformities can be corrected by passive stretching of the contracted muscles using a turn buckle splint .

For moderate deformity a soft tissue sliding operations where the flexor muscles are released fromTheir origin at the medial epicondyles and ulna is performed ( max page operations ) .

For sever deformities bone opreation such as shortening of forearms bones , carpal bone excision etc. May be required.  

Monday, April 9

Superior gluteal nerve. MCQS .

Q . Which of the following nerve enters the gluteal region above the piriformis .

A. Superior gluteal nerves
B. Inferior gluteal nerve
C. Pudendal nerves
D. Sciatic nerves .

Ans : Superior gluteal nerves

Origin:  sacral plexus  ( posterior division of anterior rami of L4 -S1 spinal nerves )

Course : Enter the gluteal region via greater sciatic foramen  Superior to piriformis;  Courses laterally between gluteus medius and minimus as far as tensor fascia latae. 

Supplies :

Gluteus medius
Gluteus minimus
Tensor fascia latae muscles .