Question

THE CASE (adapted from “Shark Attack” by H. House) 8 year-old Jim Morris was swimming the Gulf off of Florida. While swimming, Jim was bit in the arm by a bull shark. Nearby family and swimmers grabbed Jim and shark, and after killing the shark, pried its’ jaws open to remove Jim’s arm. Lifeguard applied a tourniquet and began CPR on Jim until paramedics could arrive to stabilize Jim for transport to the hospital. The severed part of his right arm was packed in ice and taken with Jim in the event that it could be reattached. At the hospital, surgeons noted that the severed arm had little shredded tissue, and looked cleanly cut. The arm had been severed 4 inches above the elbow. Doctors worked to mark the muscles, blood vessels, and nerves in the arm and stump to be able to align everything back up for reattachment surgery. During the surgery, the orthopedic surgeon trimmed the bone on each side of the cut to attach plates to keep the arm together. This procedure would result in the right arm being 1 inch shorter than the left after the surgery was complete. After reattaching the bones, the muscles and nerves of the arm had to be reattached as well, including the blood vessels. The surgery was completed successfully, however the doctors cautioned Jim and his family that he would likely never regain full and complete use of his arm and hand.
THE QUESTIONS 1. Identify at least 5 organ systems (and their functions) that the surgeons had to mark for reattachment. 2. Jim’s arm was severed above the elbow. Which specific bone and muscles would have been severed by the shark bite? 3. Which major nerves of the brachial plexus would be have been severed? Which nerves of the brachial plexus are likely to not be affected by Jim’s injury? 4. After surgery, Jim is said to not be likely to regain full use of his right arm. What are the normal movements associated with the arm, forearm, wrist, and fingers? What joints are involved with these movements (functional, structural, and plane type)? 5. Why did the doctors say that full use of the arm would be unlikely? What types of movements and activities would Jim have problems with in the future? 6. Would the reattached nerves recover as quickly and completely as the reattached muscles after Jim’s surgery? Why or why not? 7. Imagine Jim were 80 instead of 8. Would the outcome of this situation have been the same? Why or why not?

Answer 1

1.) 5 organ systems that the surgeons had to mark for reattachment
a) integumentary system
b) muscular system
c) cardiac system
d) skeletal system
e) nervous system

2.)
a) extensor digiti minimi
b) extensor digitorum
c) extensor carpi ulnaris
d) brachioradiallis

These are just some result of my research.. better use search engines for further answers. there was an online presentation made on the above case study.