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Kaplan Qbank USMLE



Author7 Posts
  #1

A man falls and dislocates a carpal bone. Several weeks later he exhibits nerve compression. Which condition is he most likely to present with?

1 Wrist drop
2 clawing of index and ring finger
3 inability to spread and oppose fingers
4 weakness to oppose thumb
5 pain in palmar aspect of ring and little fingers


  #2

2 clawing of index and ring finger

___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."

  #3

Most common form of carpal dislocation is os lunatum and N. ulnar have 2 rami curved around it, one of which is ramus profundus, which is motor.

Answer would be 3, abduction and adduction of fingers are lost.

Not 2. because lesion of N. Ulnar results the clawing of 4th, 5th finger and N. medianus that of the 2nd and 3rd finger, and N. medianus is assumablly intakt.

PS weird question though, cant use it in practise at all. It all depends on whether the hand was dorsiflexed or plantarflexed and often there is no nerve injury.

Edited by Jackofknives on 04/12/07 - 09:04 AM

___________________
There are many things in this world that can’t be changed no matter how hard you try. That’s why you must not hesitate when the time comes where you have to give it all you’ve got.

  #4

Jack............. U r Absolutely right Man i totally Missed that it was the Clawing of the Index n Finger which obviously cant happen i was thinking in the same direction Ulnar Nerve Injury though its a pretty vague q.

___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."

  #5

hey guys,
answer would be 4-weakness to oppose thumb because lunate bone is the MC dislocated carpal bone right and it dislocates anteriorly into carpal tunnel and may compress Median nerve.so median nerve lesions would be seen.
well jacksonknives loss of abduction and adduction of fingers is Ulnar nerve lesion..............

  #6

Heh my carpal anatomy is not in place, you are absolutely right. My previous post was rubbish, I was thinking hamate bone while refering to lunate. Yes, lunate dislocation would compress carpal tunnel, so is 4.

Edited by Jackofknives on 04/12/07 - 01:58 PM

___________________
There are many things in this world that can’t be changed no matter how hard you try. That’s why you must not hesitate when the time comes where you have to give it all you’ve got.

  #7

Yes I got the answer,its 4, because lunate dislocation and median nerve involvement
Thank you all







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