OCaPE: MMB #3
Timmy Crosses the Road...
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Student Scenario:
3-year-old Tommy comes into A&E with his mother, crying in pain. His mother says they were holding hands as they were crossing the road and she pulled his hand to cross, but he cried out in pain.
5 minutes
Q1)
Describe the elbow joint, including the names of the bones, ligaments, and movements.
Bones- humerus, radius, ulnar
Ligaments- annular ligament, ulnar collateral, radial collateral, quadrate
ligament
Movement- hinge joint (synovial) (3)
Which bone and ligament might be affected in Tommy’s arm?
Annular ligament- connects radius and humerus (1)
What is the name of this injury Tommy has, and how would you fix it?
Pulled Elbow (dislocated)- need to put the radius back in the annular ligament (1)
Why would Tommy’s mother not experience this same injury? You may use diagrams to help your explanation.
Adults have a larger radius head, so the radius isn’t pulled out (funnel-
shaped annular ligament).
Children have a smaller radius head (needs to grow into the annular
ligament) (1)
Tommy is treated by Marcus, a junior doctor who is black.
Tommy’s mother asks if it would be possible to switch doctors.
5. Name and outline two types of discrimination with examples.
Direct discrimination- individual treats you worse for a particular reason
Indirect discrimination- an organisation has a particular policy that treats a group of people differently in a negative way
Failure to make reasonable adjustments– allows people to be able to
access the same opportunities as others
Discrimination arising from disability– being treated differently because of a disability
Harassment- when someone treats you in a way that makes you feel humiliated, offended or degraded
Victimisation– when you are treated badly because you have made a complaint of discrimination under the Equality Act 2010
What law protects Marcus from discrimination?
Equality Act 2010
Outline three other protected characteristics from this law other than race.
Age, disability, gender reassignment, marriage and civil partnership, religion or belief, sex, sexual orientation (3)
Outline the differences between harassment and victimisation.
Harassment- when someone treats you in a way that makes you feel
humiliated, offended or degraded
Victimisation- when you are treated badly because you have made a complaint of discrimination under the Equality Act 2010 (2)
Key Concepts for this station:
• The ulnar articulates with the humerus = trochlea
• The radius articulates with the humerus = capitulum (memory aid: the river
Thames is the radius of the Capital city, London)
• Annular ligament holds the radius in place- pulling a child’s arm may cause
dislocation (“pulled elbow”). Children’s bones are still growing, and the head of
their radius needs to grow into the annular ligament.
• Equality Act 2010- protected characteristics
• Types of discrimination

Search terms: NSBEar Clinical Skills, Ear Exam Ear examination
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