1. Panjabi konsep regarding the stability of spine ?
A. Passive : bone, ligaments
B. Active : all the B1.muscle surrounding
B2. neural ( nerve )
2. Why lower part of cervical spine commonly involved in facet dislocation ( area C3-C7 )?
3. Allen and Ferguson classification ?
4. If there is unifacet dislocation...at level C5/C6 ...what will the pt presented ( level of neurology involved ) ?
5. What is the x ray findings for
A. Unilateral facet dislocatio
B. Bilateral facet dislocation
C. ? Retropulsed disc
6. What is White & Panjabi classification for spine instability?
7. Indication?
Indication for operation?
8. How do you do awake closed reduction and traction for patient?
9. How do you surgically approach for facet dislocation...
Reason?
10.... controversies regarding approach of ;
A. MRI whether to do before or after reduction?
11. Contraindication of closed reduction with traction ?
12. How do do confirm whether there is end of spinal shock?
Why is it important to know regarding the end of spinal shock ( ESS )
13. Difference between spinal shock & neurogenic shock?
14. What vasopressor that you give during neurogenic shock and why?
15. What your opinion regarding methylpred drug administration ?
16. What is your opinion regarding early surgery in spinal shock patient?
17. Definition of degenerative disc disease ( DDD )?
Pathophysio of DDD?
18. Function of spine?
19. Definition of spinal instability?
20. Landmark for pedicle screw insertion?
Recurrent carpal tunnel

Look
-scar size. Is it beyond the distal wrist crease? Feel scar - in incomplete Ada area of fibrosis and the rest of scar is soft. Ask pt to grip-ade puckering of skin surface
Feel
Area of tenderness. Wasting
Move
No need to do LOAF, sensation median nerve, - sebab mmg soalan dia recurrent cts. Phalen & durkan pun X perlu buat
3 site of compression:
0. Cervical
0. Cubitel tunnel
0. Median nerve
Tinel sign : 2 function. For provocative & to monitor progression of repaired nerve
Is Tinel sign good? Yes coz in cts in shows nerve still firing the impulse
Double crush phenomenon-2 site of compression
High median nerve (compression)
1. Supracondylar process- 1% on Xray
0. Laceratus fibrosis-open arm, pronate, flex elbow
0. Arcade of struthers-
0. Pronator teres- lawan pronation
0. Fds finbrous arcade -test fds middle finger
What is recurrent motor branch variant anomaly?
-extraligament 50%
-sub ligament 30%
-transligament 20%
-from ulnar border of median nerve
-on top of tlc
How u do cts release?
Lumbrical syndrome?
-due to hyperthrophy of lumbrical. When pt flexion, lumbrical tend to get into compartment & cause numbness at median nerve
Endoscopic cts?
-less scar tenderness
-improved short term grip
Disadvantage : incomplete release tlc, neurapraxia, cannot see other pathology eg: ganglion, portal at ulna side so can injured structure at guyon canal
common question prof razak regarding LLD
1. Esp in clinical...
How to confirm pt ada LLD
A. By clinical
B. Bycradiological
2. When do you intervene
Atau... Mx when there is
A. LLD 1 to 3 cm
B. LLD >3 cm till 5 cm
C. LLD more than 5 cm..
When do you consider amputation in LLD pt ?
3. When you consider 😂
4. How to extrapolate the future LLD in children ( ada formula okay )
5. How many cm / percentage growth contibuted by
A. GT
B. Neck of femur
C. Distal femur
D. Prox tibia
E. Distal tibia
proximal femur - 3 mm / yr
distal femur - 9 mm / yr
proximal tibia - 6 mm / yr
distal tibia - 5 mm / yr
By clinical..
Leg length discrepancy (LLD) is a measurable difference in the overall length of the two legs, which can be true, apparent or functional:
True –an absolute difference in leg lengths, clinically measured from ASIS to medial malleolus.
Apparent –where there is a measurable difference owing to positioning but the actual limb lengths may be the same. Clinically measured from xiphisternum or umbilicus to the medial malleolus.
Functional –the difference the patient perceives (corrected clinically by blocks under the short limb).
By radiological:
1.Radiographs:teleoroentgenography (scanography) -measure discrepancy with single exposure from 2m away
2. bone age hand films
1. What is batson plexus
2. How does TB spine occur ( pathophysiology )
3. Which part of spine that is commenest to be involved in TB spine and why?
4. Why is it psoas abscess can occur in TB pt? How to differentiate due to pyogenic infection ?
5. What is the watershed area at the thoracic region
6. Define gibbus
7. Define cold abscess
8. TB spine cause what type of urinary incontinence?
Overflow incontinence? ( define ) or hypotonic bladder ?
Pathophysio?
Due to weakness in the muscle at the back...Petit triangle and .... triangle?
9. Radiological findings difference between pyogenic, TB spine and metastatic disease
10. Why disc not involved in TB or involved late in the disease...
Sebab... jawapan kontroversi 💪🏼
Soalan prof hafiz...
Portals for arthroscopy post TKR.
Clinical presentation & Mx of prosthetic joint infection at 1wk post-op, 2wk, 1month, >3months
Pathogenesis of osteomyelitis involving Staph aureus, TB & Pseudomonas.
1. Where is the mechanoreceptor / innervation of the meniscus situated
2. Hilton Law ?
3. Histology of the meniscus...
What is the function of the orientation of the meniscus?
: 4. What is the fuction of the meniscus?
Hilton law: nerve dat croses d joint will also supply d joint. This explains why injury to d nerve at the thigh causes pain over knee jt oso...yeke??...belasah je
5. What is the proprioception located in the meniscus?
Percentage of contibution ?
6. How does meniscus act as a load spreader?
( biomechanics )?
7. What is insertional ligaments...and how does it helps the meniscus?
8. How does meniscus help in lubricating the knee joint?
1.Shock absorber
2. Allow slight rotational motion at d knee
3. Increase surface area for knee jt articulation
Ni yg humprey n wrisberg tu ke miss?
Bagus adzhar...ada lagi satu function 🤔
2A. What rotational motion that you are talking about?
Yep 👏🏻👏🏻💪🏼
9. Teribble triad? Mechanism of injury?
1.acl injury
2.mcl
3.medial meniscus
10. What is common injury in acute knee?
Chronic injury...which part of ligament and meniscus involved and why?
11. Explain how to do Mc Murray examination of the knee ( favourite question masa clinical examination ) 😰
13. How do you do Thessaly test? The accuracy?
14. What or How do you classify the meniscus tear?
15. When do you decide to repair meniscus during scope?
16. Technique for suture repair?
17. How do you scope ? ( esp for final year)
