A 24-year-old female visits her GP after having been in anautomobile accident three days prior. She reports that whiledriving in slippery conditions she rear-ended the car in front ofher and she was then rear-ended by the car behind her. She wastraveling at about 30 mph and her airbags did employ. She reportsfirst responders found no injuries but advised her to follow upwith her GP if she developed any unusual symptoms. The womanreports that she seemed fine after the accident but did wake themorning after with a bit of a stiff neck and a headache; she didn'tfeel 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 twoflights of stairs to her apartment and when almost to her door shefelt a zing all the way down her right arm. She immediately put thebags down. When she lifted the bags again her right arm felt numb.She woke this morning with a very stiff neck, stiffness in herupper arm, and “tingles†in her neck and down her entire arm.Musculoskeletal examination revealed limited ability to flex theneck – guarding by the posterior muscles of the neck, reducedability to extend and flex the elbow, reduced ability to extend thewrist and digit, and general peripheral neuropathy (loss of muscleinnervation and cutaneous sensation) to the arm. From yourknowledge to date from discussions in the class, and use ofcritical 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 haverealized a skeletal injury; what skeletal elements (bones) andfeatures would be associated with the effected muscles of the neck?In other words, what specific bones/bone features may have beeninjured?
5. If the woman was in a state of shock she might not haverealized a skeletal injury; what skeletal elements (bones) andfeatures would be associated with the effected muscles of thebrachium?
6. If the woman was in a state of shock she might not haverealized a skeletal injury; what skeletal elements (bones) andfeatures would be associated with the effected muscles of theantebrachium?
7. Given the woman has peripheral neuropathy (loss ofinnervation to muscle tissue and cutaneous sensation) of the neckand arm what axial skeletal region has likely been affected?
8. What specific feature of the axial skeletal element wouldhave caused compression of spinal nerves?
9. From the above information (case study and answering thequestions) what condition do you believe the woman has as a resultof her accident?
10. What diagnostics, if any, would you employ to furtherinvestigate the injury – and why or why not?
