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Self-Assessment Questions

Orthopaedic Sports Medicine

Sports-Related Nerve Injuries: Review Questions

Francis H. Shen, MD, and Peter W. Thompson, BA

Dr Shen is an assistant professor, Department of Orthopaedic Surgery, and Mr. Thompson
is a medical student; both are at the University of Virginia, Charlottesville, VA.



Choose the single best answer for each question.

1. A 13-year-old girl falls during a cross-country race, striking her left arm on a rock. In the emergency department (ED), the patient holds her arm tightly to her chest, flexed at about 90 degrees. An obvious deformity of her elbow and forearm is evident on physical examination. Radiographic studies reveal a proximal ulnar fracture and dislocation of the radial head. This patient would most likely experience weakness or paralysis when performing which of the following movements?
  1. Flexion of wrist and fingers
  2. Abduction and adduction of fingers
  3. Opposition of thumb to the little finger
  4. Extension of the thumb
  5. Extension of the forearm
Click here to compare your answer.


2. A 35-year-old man presents to the ED with constant, excruciating pain in his left leg after completing a marathon. He denies any specific trauma, although he acknowledges that the race was the longest distance he has ever run. The physical examination is remarkable for nonfocal left leg tenderness, swelling, and loss of light touch sensation on the plantar aspect of the left foot; however, the patient still rates his pain at 10 of 10. Results of radiographic studies and bone scan are normal. Which of the following tests is most likely to provide a definitive diagnosis?

  1. Cardiac stress testing
  2. Computed tomographic scan of the leg
  3. Doppler sonogram
  4. Electromyography and nerve conduction study
  5. Intracompartmental pressure measurement with slit catheter
Click here to compare your answer.


3. An 11-year-old little league pitcher presents to the ED with a chief complaint of pain and numbness in the medial aspect of his elbow on his throwing arm. He also complains of a “locking sensation” in his elbow when pitching. Physical examination reveals mild crepitus, a positive Tinel’s sign in the cubital tunnel, and decreased sensation in the fourth and fifth digits. Radiographic evaluation reveals an olecranon osteophyte formation and a large posteromedial loose body. Which of the following statements regarding this patient’s condition is correct?
  1. There is no role for surgical excision of the olecranon osteophyte or loose body.
  2. The valgus extension overload (VEO) test is a helpful diagnostic aid.
  3. If left untreated, this patient will develop wrist extensor weakness.
  4. This patient’s elbow pain will be worst during the follow-through phase of a pitch.
  5. Medial ligamentous laxity decreases olecranon impingement within the olecranon fossa.
Click here to compare your answer.


4. A 24-year-old soccer player presents with a chief complaint of shoulder weakness and pain 1 week after sustaining an apparent anterior shoulder dislocation. He fell on his outstretched right arm during a match; the dislocation was then reduced on the field by a teammate. On physical examination, the patient’s left shoulder appears larger than the right, and he has decreased light touch and pinprick sensation over the upper lateral right arm. Which nerve is most likely affected?

  1. Axillary nerve
  2. Long thoracic nerve
  3. Musculocutaneous nerve
  4. Spinal accessory nerve
  5. Suprascapular nerve
Click here to compare your answer.


 

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