A 24yearold female visits her GP after having been in an aut

A 24-year-old female visits her GP after having been in an automobile accident three days prior. She reports that while driving in slippery conditions she rear-ended the car in front of her and she was then rear-ended by the car behind her. She was traveling at about 30 mph and her airbags did employ. She reports first responders found no injuries but advised her to follow up with her GP if she developed any unusual symptoms. The woman reports that she seemed fine after the accident but did wake the morning after with a bit of a stiff neck and a headache; she didn\'t feel this was unusual given the accident and went on about her day. At the end of the next day she had to carry heavy bags up two flights of stairs to her apartment and when almost to her door she felt a zing all the way down her right arm. She immediately put the bags down. When she lifted the bags again her right arm felt numb. She woke this morning with a very stiff neck, stiffness in her upper arm, and “tingles” in her neck and down her entire arm. Musculoskeletal examination revealed limited ability to flex the neck – guarding by the posterior muscles of the neck, reduced ability to extend and flex the elbow, reduced ability to extend the wrist and digit, and general peripheral neuropathy (loss of muscle innervation and cutaneous sensation) to the arm. From your knowledge to date from discussions in the class, and use of critical reasoning, please answer the following questions.

1. What muscles of the neck have been affected?

2. What muscles of the brachium have been affected?

3. What muscles of the antebrachium have been affected?

4. If the woman was in a state of shock she might not have realized a skeletal injury; what skeletal elements (bones) and features would be associated with the effected muscles of the neck? In other words, what specific bones/bone features may have been injured?

5. If the woman was in a state of shock she might not have realized a skeletal injury; what skeletal elements (bones) and features would be associated with the effected muscles of the brachium?

Solution

Answer 1):

She lifted something too heavy – which triggers a neck strain. Because of the wide range of movements that the neck can perform, it is susceptible to injury.
Muscles responsible for:
1)The Trapezius muscle
2)he Levator Scapula is often noted as the “stiff neck” muscle where it is difficult and painful to turn the head and neck.
3)The Posterior neck muscles (Semispinalis and Multifidi) are often involved in “pain in the neck”.

Answer 2):

Muscles of the brachium have been affected
Coracobrachialis-Adduction and flexion at shoulder
Biceps brachii-Flexion at elbow and shoulder
Brachialis-Flexion at elbow
Triceps brachii (Lateral head, Long head, Medial head)-Extension at elbow

Answer 3):

muscles of the antebrachium have been affected
extensor carpi radialis muscle
extensor muscle
ulnaris lateralis muscle

Answer 4):

The hyoid bone might get affected by this injury.
The 7 cervical vertebrae form the bones of the neck that support the skull and organs of the head. The first cervical vertebra (atlas) supports and balances the head. The second vertebra (axis) allows the head to rotate laterally to the left and the right. Hollow spaces within the cervical vertebrae protect and conduct the spinal cord and vertebral arteries through the neck.

Answer 5):

Radius and Ulna bones might get affeted becuse of the injury.