46. Shoulder

Question 1

Most common part of clavicle injury

Answer 1

Middle 1/3

Question 2

Test of sense of C5

Answer 2

Lateral arm

Question 3

Test of sense of C6

Answer 3

Lateral arm and thumb

Question 4

Test of sense of C7

Answer 4

Tip of long finger

Question 5

Test of sense of C8

Answer 5

Tip of little finger

Question 6

Test of sense of T1

Answer 6

Medial arm

Question 7

3 types of clavicle #

Answer 7

1. Stable and minimal displacement
2. Torn coracoclavicular ligament and displaced
3. Involve articular surface

Question 8

MGMT of most clavicle

Answer 8

Simple sling

Question 9

Indications for urgent ortho in clavicle #

Answer 9

1. Open
2. NV injury
3. Skin tenting
4. Severely comminuted

Question 10

2 main types of scapula #

Answer 10

1. Extra-articular

2. Intra

Question 11

MGMT of scapula

Answer 11

o Most heal rapidly without complication
o Displaced acromial impinging GHJ need OR
o Severely displaced coracoid usually need OR

Question 12

4 segments of prox humerus #

Answer 12

 articular surface
 greater tuberosity
 lesser tuberosity
 humeral shaft

Question 13

What is Neer’s classification of humerus #

Answer 13

minimal displacement
2 part displacement
3 three part displacement
4 part displacement

Question 14

MGMT of humerus #

Answer 14

o Undiplaced (majority)
 Sling with early physio
o Displaced 2-4 part # need OR
o Fracture dislocation should get ortho consult

Question 15

2 complications of humerus #

Answer 15

o AVN

o Adhesive capsulitis

Question 16

3 types of SC dislocations

Answer 16

1. Mild sprain
2. Subluxation of joint due to tearing of ligament
3. Complete rupture and dislocation

Question 17

MGMT of SC dislocation

Answer 17

Grade 1
	Sling and GP followup
Grade 2
	Longer sling 4-5 weeks
Grade 3
	Closed reduction, with possible open
	Can be done in ED

Question 18

MGMT of posterior SC dislocation

Answer 18

 Emergency
 Can lead to airway and vascular compromise
 Traction with concurrent clavicle manipulation

Question 19

Classification of AC separation

Answer 19

Type 1-2
 Minimal deformity and swelling
Types 3-5
 Severe pain and held in tight adduction

Question 20

MGMT of AC separation

Answer 20

1-2
	sling for comfort with CP FU
3
	variable, with most non-op
4+
	need OR

Question 21

4 types of anterior GHJ dislocations

Answer 21

1. Subcoracoid
2. Subglenoid
3. Subclavicular
4. Intrathoracic

Question 22

Radiographic sign of posteriro GHJ dicslocation

Answer 22

lightbulb sign

Question 23

2 methods for reduction of posterior shoulder

Answer 23

1. internal rotations and lateral traction

2. Stimson - weights

Question 24

Reduction of inferior shoulder

Answer 24

traction/counter traction

Question 25

Signs of impingement

Answer 25

Painful arc at 60-120

Question 26

test for shoulder impingement

Answer 26

Hawkin’s Kennedy

Question 27

2 tests for rotator cuff tear

Answer 27

1. Drop arm

2. Cannot initiate shoulder abduction

Question 28

2 tests for biceps tendonitis

Answer 28

1. Yergason

2. Speeds

Question 29

MGMT of biceps tendon rupture

Answer 29

Sling with 90 degrees flexion