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Anatomy - MSK (UL) > 2: Anatomy of clavicel, humerus and scapula > Flashcards

2: Anatomy of clavicel, humerus and scapula Flashcards

1
Q

Pectoral girdle is a bony ring, incomplete posteriorly, formed by the …………… and completed anteriorly by the …………..

A

Posterior: scapulae and clavicle
Anterior: manubrium of the sternum.

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2
Q

The …(a)… surface of clavicle is smooth because it doesn’t have a lot of attachments, but the …(b)… surface is rough because it has a lot of attachments.

A

(a): anterior surface
(b): posterior surface

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3
Q

When you fall on a straight arm, this bone will absorb the shocks from your arm (transmits shocks from UL to axial skeleton)

A

Clavicle

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4
Q

What is the commonest area of fracture in clavicle?

A

connection between medial 2/3 & lateral 1/3

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5
Q

Medial end of clavicle is pulled superiorly by …..?

A

SCM

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6
Q

Lateral part of the clavicle & UL pulled inferiorly by ….?

A

Weight of arm and gravity (bcz trapezius is not strong enough to pull them superiorly)

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7
Q

Lateral part of clavicle and UL pulled medially by …?

A

Pectoralis major ❓

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8
Q

The scapula is overlying …..#….. ribs?

A

2nd to 7th
(So if Iam palpating the medial border and went more medial I will palpate T2 (2nd spine) Bcz it Extend from T2-T7)

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9
Q

Scapula has 3 borders:
a. Lateral border is called …….
b. Medial border is called …….
c. Superior border

A

a. Axillary
b. Verterbral

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10
Q
A
  1. Acromial fracture
  2. Coracoid fracture
  3. Scapular body fracture
  4. Glenoid fracture

Tafreegh: most fractures of scapula requires little treatment because it is covered on both sides by muscles, so if there is a fracture in your scapula you don’t even need to support it like other bone fractures

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11
Q

A. What is the largest bone in the upper limb?
B. What does it articulate with?
C. What is the commonest sites of fracture in this bone?

A

A. Humerus
B. Articulates with the scapula at the glenohumeral joint + articulates with the radius and ulna at the elbow joints.
C. Surgical neck

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12
Q

What artery + nerve are affected in case of humerus fracture at:
A. Surgical neck?
B. Midshaft?
C. Medial epicondyl?
D. Supracondylar?

A
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13
Q

(Idk if it’s important): areas that you can palpate in shoulder region?

A
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14
Q

The following picture shows X-ray in 1 year old child. What does it show? Fracture / normal?

A

Normal

Tafreegh: always check the age for the patient on X-rays, you may think it’s a fracture but maybe it’s a 1yrs old patient his bones are not ossified yet

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15
Q

In case of fracture is in the middle of the humerus, what muscle will pull (abduct) that part of the bone superiorly and the rest weight of the hand will fall down?

A

Deltoid

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16
Q

What is comminuted fracture?

A

A fracture with alot of small peices

17
Q

In case of avulsion fracture at greater tubercle of humerus, what muscles will pull this part of bone superiorly?

A

Rotator cuff (Supraspinatus & infraspinatus)

18
Q

What part of humerus is fractured?

A

Greater tubercle

19
Q

What part of humerus is fractured?

A

Surgical neck

20
Q

This part of humerus forms joint with ulna?

A

Trochlea

21
Q

This is a process that takes part w/ articulation with the radius?

A

Capitulum

22
Q

what divides the posterior aspect of the scapula into 2 parts, supraspinatus fossa & infraspunatus fossa.

A

Spine of scapula

23
Q

Which part of the clavicle is fractured in case of downward blow on shoulder?

A

Distal clavicle fracture

24
Q

What structure can be affected in case of posterior fracture or dislocation of sternoclavicular joint?

A

Trachea

25
Q

What structures are related to the clavicle?

A

Subclavian artery and vein, brachial plexus
Tafreegh: (So if the clavicle is broken you should look for hemorrhage and paralysis because of the vessels and nerves)

26
Q

What part of the clavicle is convex and which part is concave?

A

Medial end is convex (anteriorly)
and the lateral half is concave (anteriorly)

27
Q

Mcq: A 20-year-old female presented with right shoulder pain after falling from a bicycle. X-ray revealed fracture of the clavicle. Upon examination, the arm was pulled forwards and medially rotated. Which of the following muscles is responsible for this position?

A

Pectoralis major

28
Q

Mcq: When there is a posterior clavicle dislocation what will happen? (2019)

a. Abducted arm & lateral rotation
b. Adducted arm & medial rotation
c. Abducted arm & medial rotation
d. Adducted arm & lateral rotation

A

b. Adducted arm & medial rotation

29
Q

(Greys Q): While walking to his classroom building, a first year medical student slipped on the wet pavement and fell against the curb, injuring his right arm.

Radiographic images showed a midshaft fracture of the humerus. Which pair of structures was most likely injured at the fracture site?

A. Median nerve & brachial artery
B. Axillary nerve & posterior circumflex humeral artery
C. Radial nerve & deep brachial artery
D. Suprascapular nerve & artery
E. Long thoracic nerve & lateral thoracic artery

A

C. Radial nerve & deep brachial artery

30
Q

(Greys Q): An 18-year-old man is brought to the emergency department after an injury while playing rugby. Imaging reveals a transverse fracture of the humerus about 1 inch proximal to the epicondyles. Which nerve is most frequently injured by the jagged edges of the broken bone at this location?

A. Axillary
B. Median
C. Musculocutaneous
D. Radial
E. Ulnar

A

B. Median

31
Q

(Greys Q): A 31-year-old male hockey player fell on his elbow and is admitted to the emergency department. Radiographic examination reveals a fracture of the surgical neck of the humerus, producing an elevation and adduction of the distal fragment.

Which of the following muscles would most likely cause the adduction of the distal fragment?
A. Brachialis
B. Teres minor
C. Pectoralis major
D. Supraspinatus
E. Pectoralis minor

A

C. Pectoralis major

32
Q

(Greys Q): A male skier had a painful fall against a rocky ledge. Radiographic findings revealed a hairline fracture of the surgical neck of the humerus. The third-year medical student assigned to this patient was asked to determine whether there was injury to the nerve associated with the area of injury.

Which of the following tests would be best for checking the status of the nerve?

A. Have the patient abduct the limb while holding a 10 lb weight
B. Have the patient shrug the shoulders
C. Test for presence of skin sensation over the lateral side of the shoulder
D. Test for normal sensation over the medial skin of the axilla
E. Have the patient push against an immovable object like a wall and assess the position of the scapula

A

C. The axillary nerve passes dorsally around the surgical neck of the humerus (accompanied by the posterior circumflex humeral artery) and can be injured when the humerus is fractured at that location. The axillary nerve provides sensation to the skin over the upper, lateral aspect of the shoulder. There- fore, although the patient might not be able to abduct the arm because of the injury, a simple test of skin sensation can indicate whether there is associated nerve injury of the axillary nerve.

33
Q

(Greys Q): A 24-year-old female basketball player is admitted to the emergency department after an injury to her shoulder. Radiographic examination reveals a shoulder dislocation.

What is the most commonly injured nerve in shoulder dislocations?
A. Axillary
B. Radial
C. Median
D. Ulnar
E. Musculocutaneous

A

A. Axillary

(Explanation: A. The axillary nerve is a direct branch of the posterior cord and wraps around the surgical neck of the humerus to innervate the teres minor and the deltoid muscles. With this anatomic arrangement, the axillary nerve is tightly “tethered” to the proximal humerus. When the head of the humerus is dislocated, it often puts traction on the axillary nerve)

34
Q

(Greys Q): A 65-year-old man is admitted to the emergency department after falling on his outstretched hand. The patient complains of severe right shoulder pain. Upon physical examination, the patient holds his arm externally rotated and slightly abducted. There is also flattening and sensory loss over the right deltoid muscle.

Which of the following is the most likely diagnosis?
A. Anterior dislocation of the humerus
B. Acromioclavicular joint subluxation
C. Clavicular fracture
D. Spiral fracture of the humeral midshaft
E. Rotator cuff tear

A

A. Anterior dislocation of the humerus (axillary nerve affected)

35
Q

(Greys Q): An emergency department physician examines a patient who fell from a motorcycle and injured his shoulder. The clinician notices a loss of the normal contour of the shoulder and an abnormal appearing depression below the acromion.

Which of the following injuries did the patient most likely sustain?
A. Avulsion of the coronoid process
B. Dislocated shoulder joint
C. Fracture of the midshaft of the humerus
D. Fracture of the surgical neck of the humerus
E. Laceration of the axillary branch of the posterior cord

A

B. Dislocated shoulder joint

(Explanation: B. The glenohumeral joint is an extremely mobile joint with a wide range of motion. Anterior dislocation of the humerus is most common and usually associated with an isolated traumatic incident. When the head of the humerus is displaced anteriorly and inferiorly, flattening of the deltoid prominence occurs, leading to loss of the normal contour of the humerus. There is protrusion of the acromion, and the slope of the shoulder lateral to the acromion is depressed and has a “dented” appearance. )

36
Q

(Greys Q): A 67-year-old woman with osteoporosis injured her left shoulder/arm in a fall. Examination reveals bruising and dimpling of the upper part of the arm with exquisite tenderness over the affected area. The shoulder radiograph is shown in Figure 6-13. Which nerve is most likely to be injured?

A. Radial
B. Axillary
C. Ulnar
D. Median

A

B. Axillary

Anatomy - MSK (UL) (17 decks)

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