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Old 08-14-2011
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Default Sequelae of Fracture

A 13-year-old figure skater botches a quadruple lutz and falls on her right outstretched hand. Several weeks later a cast is removed for a healed scaphoid fracture. She begins having episodes of intense burning pain, sweating, swelling, and redness that begin in her right hand and moves up her forearm, sometimes up to her shoulder. These episodes often occur when she is angry or upset. On exam her arm shows no visible abnormalities. Which of the following nerve types are involved in the pathogenesis of her disorder?

A. General somatic afferent
B. General somatic efferent
C. General visceral afferent
D. Special somatic afferent
E. Special visceral afferent
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i think ans s C.
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Originally Posted by drgsarunprasath View Post
A 13-year-old figure skater botches a quadruple lutz and falls on her right outstretched hand. Several weeks later a cast is removed for a healed scaphoid fracture. She begins having episodes of intense burning pain, sweating, swelling, and redness that begin in her right hand and moves up her forearm, sometimes up to her shoulder. These episodes often occur when she is angry or upset. On exam her arm shows no visible abnormalities. Which of the following nerve types are involved in the pathogenesis of her disorder?

A. General somatic afferent
B. General somatic efferent
C. General visceral afferent
D. Special somatic afferent
E. Special visceral afferent
A. General somatic afferent
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general somatic afferent
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Old 08-14-2011
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Hi, Can someone explain the underlying mechanisms of these symptoms after the removal of the cast? Thanks
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Quote:
Originally Posted by drgsarunprasath View Post
A 13-year-old figure skater botches a quadruple lutz and falls on her right outstretched hand. Several weeks later a cast is removed for a healed scaphoid fracture. She begins having episodes of intense burning pain, sweating, swelling, and redness that begin in her right hand and moves up her forearm, sometimes up to her shoulder. These episodes often occur when she is angry or upset. On exam her arm shows no visible abnormalities. Which of the following nerve types are involved in the pathogenesis of her disorder?

A. General somatic afferent
B. General somatic efferent
C. General visceral afferent
D. Special somatic afferent
E. Special visceral afferent
Its from Kaplan I guess,


Probably C...
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general visceral afferent
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Default c)General visceral afferent

Reflex sympathetic pain syndrome aka complex regional pain syndrome, is a mysterious disorder that often occurs after injury to an extremity. It is thought to be due to formation of an abnormal sympathetic reflex arc that becomes modulated by cortical inputs in times of stress. The key to this diagnosis is that it does not obey any specific nerve distribution and symptoms reflect vasospasm. Sympathetic reflexes are autonomic, consisting of a general visceral afferent (GVA) arm and general visceral efferent (GVE) arm. Even if you did not know the diagnosis, the episodic diaphoresis and vasodilation should point you towards an autonomic pathogenesis. Special somatic afferents (SSA) are only involved in sensation of vision, hearing and balance. General somatic afferents (GSA) provide sensation from all parts of the body except the gut, smooth muscle, and glands. Special visceral afferents (SVA) sense taste and smell. General somatic efferents (GSE) innervate somatic muscles. Do you really have to remember these dreaded 3-letter abbreviations? Unfortunately yes, you are expected to recognize them quickly and know what they do.
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Old 08-15-2011
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Quote:
Originally Posted by drgsarunprasath View Post
A 13-year-old figure skater botches a quadruple lutz and falls on her right outstretched hand. Several weeks later a cast is removed for a healed scaphoid fracture. She begins having episodes of intense burning pain, sweating, swelling, and redness that begin in her right hand and moves up her forearm, sometimes up to her shoulder. These episodes often occur when she is angry or upset. On exam her arm shows no visible abnormalities. Which of the following nerve types are involved in the pathogenesis of her disorder?

A. General somatic afferent
B. General somatic efferent
C. General visceral afferent
D. Special somatic afferent
E. Special visceral afferent
no clue but i will go with B!
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