3b. Shoulder

Question 1

in the lat scap where should the AC joint be

Answer 1

in the entre of the HOH

Question 2

in the lat scap where should the coronoid point

Answer 2

point superiorly

Question 3

what are the 5 things that should be checked in a shoulder view such as AP shoulder

Answer 3

lung/pleura
ribs
clavicle
scapula
humerus

Question 4

what does a lipohaemarthrosis in the shoulder look like

Answer 4

fluid level in front of acromion

Question 5

what are the 3 shoulder dislocations and order them from most to least common

Answer 5

anterior - most
posterior
inferior - least

Question 6

where is the humeral head displaced in an anterior shoulder dislocation

Answer 6

HOH displaced anteriorly, inferiorly and medially

below the coracoid

Question 7

what does it mean when the HOH is locked in an ant dislocation

Answer 7

HOH impaled on glenoid rim

Question 8

what are 2 injuries that accompany ant shoulder dislocations

Answer 8

bankarts and hill sachs

Question 9

what does the HOH look like in a posterior dislocation of the shoulder

Answer 9

loss of articulation with the glenoid fossa

Question 10

what is the inferior dislocation for the shoulder and what does it look like

Answer 10

form of anterior dislocation with hyper abduction of the arm

HOH inf to glenoid

Question 11

what is a hill sach lesion and what does it look like

Answer 11

compression fracture of the posterolateral articular surface of the HOH

Question 12

what causes the hill sach lesion

Answer 12

ant dislocation of gleno humeral joint when HOH passes over the edge of the ant glenoid fossa

Question 13

what is the bankarts lesion

Answer 13

avulsion of the anteroinferior glenoid labrum which occurs with ant dislocation

Question 14

what is the greater tuberosity fracture

Answer 14

avulsion of the greater tuberoscity

Question 15

what is the AC joint separation judged by in terms of lines

Answer 15

should be horizontal line under distal end of clavicle in the plane with the AC joint

Question 16

what are the normal AC joint distance

Answer 16

0.3-0.8cm

Question 17

what is the normal distance for the coracoclavicular ligament

Answer 17

1-1.3cm

Question 18

what are the 3 grades for AC joint inuries

Answer 18

1, 2 and 3 with 3 being most severe

Question 19

what is seen in the rotator cuff tear (old injury) and what does the HOH look like

Answer 19

HOH migrates superiorly and lightbulb sign

flattening of the undersurface of the acromion

Question 20

why is the HOH in a lightbulb sign for the rotator cuff tear old injury

Answer 20

Greater tuberosity has prominence but when there is lack of tension where supraspinatus attaches, lose prominence of greater tuberosity so get lightbulb instead while in AP view

Question 21

where is the typical calcification of supraspinatus seen

Answer 21

just superiorly to the greater tuberosity of humerus where tendon inserts

Question 22

what are the 2 soft tissue structures that can be calcified in the shoulder

Answer 22

supraspinatus tendon and subscapularis

Question 23

what displacement does the middle 1/3 clavicle # have and why

Answer 23

upwards displacement of medial fragment due to sternocleidomastoid muscle pulling it superiorly and lateral fragment is pulled downward by weight of the limb

Question 24

what are 2 characteristics of scapular neck and glenoid fractures

Answer 24

extra-articular and impacted often

Question 25

what kind of glenoid fracture has poorer outcomes without surgery

Answer 25

displaced or angulated

Question 26

how do you treat scapula body #

Answer 26

Don’t do anything to treat them, just slightly immobilize and tend to heal themselves without any intervention

conservatively managed

Question 27

when is a HOH # labelled displaced - what are the 2 conditions

Answer 27

Head of Humerus is only called displaced if the angulation is about 45 degrees or the fragments are about a cm apart

Question 28

what are the 4 main proximal humerus fractures

Answer 28

greater and lesser tuberosity
head
shaft

Question 29

where do proximal humerus fractures often occur along

Answer 29

along embryonic fusion lines

Question 30

how are HOH fractures discussed

Answer 30

by number of fragments

Question 31

what is a reverse shoulder reconstruction

Answer 31

ball goes into shoulder and HOH has a cup

Question 32

what is the os acromiale

Answer 32

persistent ossification center at the end of the acromion that doesn’t fuse so looks like fracture but isnt a fracture

Question 33

what can acromial spurs do to tendons

Answer 33

impinge on tendons like the supraspinatus tendon

Question 34

where should you look for a acromial spur

Answer 34

area of humerus and under acromion