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Diagnostic Imaging II Exam Two > AC joint to Elbow > Flashcards

AC joint to Elbow Flashcards

1
Q

What are the 3 grades for an AC joint injury?

A

Grade I = mild sprain
Grade II = moderate sprain
Grade III = severe sprain

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2
Q

What is the most common mechanism of injury for an AC joint injury?

A

Landing on top of shoulder

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3
Q

Which AC joint sprain grade appears radiographically normal?

A

Grade I

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4
Q

A Grade III AC joint sprain involves the tearing of which two ligaments?

A

Acromioclavicular and coracoclavicular ligaments

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5
Q

A Grade II AC joint sprain involves the tearing of which ligament?

A

Acromioclavicular

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6
Q

What is the normal range for the space at the distal end of the clavicle (AC joint)?

A

0-5mm

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7
Q

What is the normal range of the space between the clavicle and coracoid process?

A

0-11mm

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8
Q

What special X-ray view of the shoulder can help assess AC join separation?

A

Y-view

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9
Q

How is a severe AC joint sprain treated?

A

Screw through clavicle into coracoid process with resection of clavicle

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10
Q

What is the most common fracture in infants/kids?

A

Middle third clavicle

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11
Q

Which third of the clavicle is least likely to fracture?

A

Medial third

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12
Q

Posterior dislocation of which clavicular joint can be potentially life threatening and why?

A

Sternoclavicular; compression of great vessels

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13
Q

What anatomical structure is pulled up and which is pulled down following a clavicle fracture?

A

SCM pulled up, shoulder droops

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14
Q

How can callus formation following a clavicular fracture lead to a complication?

A

Neurovascular ocmpromise

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15
Q

Which artery is especially at risk of complication following a clavicle fracture?

A

Subclavian (also brachial plexus)

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16
Q

What is the name of the classifications system for humeral fractures?

A

Neer Classification

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17
Q

What is the most common direction for a shoulder dislocation?

A

Anterior (97%)

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18
Q

What is the most common type of anterior shoulder dislocation?

A

Subcoracoid

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19
Q

What are the three subcategories of anterior shoulder dislocations?

A

Subcoracoid, subglenoid, intrathoracic

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20
Q

The type of anterior shoulder dislocation is assessed relative to the position of which bone?

A

Resting place of humerus after dislocation

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21
Q

Does the humeral head usually move inferior or superior with an anterior shoulder dislocation?

A

Inferior

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22
Q

In which direction does the humeral head usually move with a posterior shoulder dislocation?

A

Either stays the same or superiorly

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23
Q

A Bankart lesion is associated with what injury?

A

Anterior shoulder dislocation

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24
Q

Where does the Bankart lesion occur?

A

Inferior aspect of the labrum (avulsion fracture)

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25
What is the name of the injury that results from an anterior shoulder dislocation that is a cortical depression in the posterolateral head of the humerus results from forceful impaction of the head against the anterioinferior glenoid rim?
Hill-Sachs lesion (appears as "V" shape depression)
26
What is a flap fracture (type 4 Neer)?
Avulsion of the greater tuberosity by retraction of the rotate cuff
27
What are the 3 possible mechanisms of injury for a posterior shoulder dislocation?
1 direct blow to arm 2 electrical shock 3 convulsive seizures
28
What is the name of the sign that appears with a posterior shoulder dislocation that is analogous to the Hill-Sachs lesion of an anterior dislocation?
Trough sign
29
What is the different of location between the trough sign and Hill-Sachs lesion?
Trough sign = anterior medial surface | Hill-Sachs = posterolateral head
30
What is the name of the shoulder dislocation where the humerus is dislocated anteriorly and inferiorly with the arm hyperabducted and locked above the head?
Luxatio erecta
31
Why is a luxatio erecta dislocation particularly serious?
Increased potential for neurovascular issues
32
What four muscles make up the rotator cuff?
Supraspinatus, infraspinatus, teres minor, and subscapularis
33
Which muscle is most commonly injured in a rotator cuff injury?
Supraspinatus
34
What is unique about the anatomy of the subscapularis compared to the other rotator cuff muscles?
Subscapularis inserts on the lesser tuberosity instead
35
What is the location of the "critical zone" in reference to a rotator cuff injury?
1 cm proximal to supraspinatus insertion at greater tuberosity
36
Why is the critical zone called that?
Area of least vascularization aka most susceptible to tear
37
The acromiohumeral joint space is narrowed to how many millimeters with a rotator cuff tear seen on X-ray?
Less than 6mm
38
How does a rotator cuff injury change the acromion process?
Erosion of the inferior aspect
39
How does a rotator cuff injury change the greater tuberosity?
Flattening and atrophy
40
What is the best imaging procedure to asses for a rotator cuff tear?
MRI (soft tissues)
41
How does a rotator cuff tear appear on MRI?
Area of increased signal intensity (white) between the tendon (aka fluid disrupting continuity)
42
What is the name for a rotator cuff tear that doesn't go completely through the tendon but is still visible upon MRI?
Intrasubstance tear
43
What is usually the cause of a scapular fracture?
Direct trauma from a fall (also MVA...hard to break scapulas)
44
When a scapular fracture is known, what other anatomy should be assessed for fracture?
Ribs (located just anterior to the scapula)
45
What type of fracture is usually seen at either the medial or lateral condyle of the distal humerus in children?
Avulsion
46
What kind of fracture usually causes Volkman's ischemic contracture?
Midshaft humeral fractures due to callus formation leading to neuromuscular issues
47
What are the usual signs and symptoms of Volkman's ischemic contracture?
Cold hands or altered sensation
48
What is the most common elbow injury in children?
Supracondylar
49
What is the most common elbow injury in adults?
Radial head fracture
50
What is the second most common elbow injury in adults?
Olecranon process
51
Why don't olecranon process fractures occur in children?
Aren't present until teenage years
52
Which elbow fracture sign is only present in adults?
Sail sign
53
Which elbow fracture signs/tools can be used in kids?
Positive fat pad sign, radio-capitellar line, anterior humeral line, hockey stick appearance
54
The tools to find elbow fractures are visualized on which X-ray view?
Lateral (90 degrees)
55
Which fat pat about the elbow should be able to be seen normal and without fracture?
Anterior
56
How sensitive is a posterior fat pad sign to an elbow fracture?
95%
57
The anterior humeral line and radio-capitellar lines should intersect what piece of anatomy?
Middle 1/3 of the capitellum
58
What is the sail sign?
Anterior and posterior fat pad signs visible in elbow region
59
When the radio-capitellar line is projecting into the shaft of the humerus, what is the overall injury?
Anterior radial dislocation
60
What is the most common kind of radial head fracture?
Vertical fracture without displacement (type 1)
61
What are the types of radial head fractures?
``` 1 = vertical fracture without displacement 2 = vertical fracture with displacement 3 = comminuted fracture 4 = fracture and dislocation ```
62
What is another name for a radial head fracture?
Chisel fracture
63
Olecranon fractures are usually what kind of fracture due to the mechanism of injury being a fall to the elbow?
Comminuted
64
What is the acronym to remember the order in which the parts of the elbow ossify?
CRI TOE
65
What is the easiest way to tell if an ossification center is displaced?
One part of every growth center MUST be touching the parent bone - if not, then displaced
66
Nursemaid's elbow usually affects what age group?
Toddlers ages 2-5
67
What is the mechanism of injury for a nursemaid's elbow?
Sudden jerk or pull on the hand resulting gin entrapment of the annular ligament by the radial head
68
In which direction is the forearm held in with a nursemaid's elbow injury?
Pronation
69
How is reduction accomplished for a nursemaid's elbow?
Supinating the forearm
70
How does the radiograph appear for a nursemaid's elbow?
Normal (reduction is usually the quick fix)
71
What are the 3 most common areas of dislocation in adults?
1 shoulder MC 2 interphalangeal 3 elbow
72
What is the most common area of dislocation in children?
Elbow
73
What is the most common direction for an elbow dislocation?
Posterior (90%)
74
What is the most common injury to the forearm?
Fracture of both radius and ulna
75
What is a Galeazzi injury?
Distal radial fracture with distal radioulnar joint dislocation (ulna remains intact)
76
What is a parry fracture?
Ulna fracture (usually in self defense)
77
What is a Monteggia fracture?
Fracture of proximal third of the ulna with dislocation of the head of the radius
78
What is usually the mechanism of injury for a Monteggia fracture?
FOOSH with forearm in excessive pronation
79
In which direction does the radius usually dislocate?
Anteriorly
80
What type of injury is also considered the adult version of Nursemaid's elbow?
Monteggia fracture
81
Greenstick fractures usually occur in what age group?
Less than 10 years of age
82
Which has a greater force involved: torus or greenstick fracture?
Greenstick
83
Does the concave or the convex side of the bone usually result in the greenstick fracture?
Convex (concave is maintained)
84
What is the term for the combination of a greenstick and torus fracture?
Lead pipe fracture
85
What is the most common forearm fracture in a child?
Torus (6-10 years of age)
86
What is the most common location for a torus fracture of the forearm?
Posterior surface of radius
87
What is the "trick" to guessing a child's age based on presence of carpals on X-ray?
Number of carpals minus 1
88
What type of fracture is also known as a reverse Colle's?
Smith's fracture
89
Which involves the hand extending outward: Colle's or Smith's?
Colle's
90
Which involves the hand flexing inward: Colle's or Smith's?
Smith's
91
Which fracture is also known as the dinnerfork deformity?
Colle's
92
What is the most common mechanism of injury for a Colle's fracture and which population does it most commonly affect?
FOOSH; elderly
93
What is a Colle's fracture?
Fracture of the distal radius about an inch and a half above the carpals with posterior displacement of the distal fragment
94
What other fracture is often associated with a Colle's fracture?
Ulnar styloid fracture
95
What is the normal degree of palmar angulation seen that is disrupted with a Colle's fracture?
10-15 degrees
96
What is another name for the dinnerfork deformity?
Garden spade deformity
97
Which X-ray view is most definitive for a Colle's fracture?
Lateral (view of posterior dislocation)
98
What is a Smith's fracture?
Fracture of the radius one and a half inches from the carpals with volar angulation of the distal fragment (toward the palm)
99
Which involves the hand being displaced anteriorly: Colle's or Smith's fracture?
Smith's
100
Which is more common: Colle's or Smith's?
Colle's
101
What is the mechanism of injury for a Smith's fracture?
Fall onto back of the hand
102
What type of fracture is one of the anterior or posterior rim of the radius with accompanying carpal dislocation?
Barton's fracture
103
What is the mechanism of injury for a Barton's fracture?
FOOSH in the elderly
104
What usually causes a Barton's fracture in the younger population?
Motorcycle accidents
105
Barton's fractures are best depicted on what X-ray view?
Lateral
106
What is the location of a Hutchinson's or Chauffer's fracture?
Radial styloid process
107
On which X-ray view is a Chauffer's fracture best seen?
PA view

Diagnostic Imaging II Exam Two (4 decks)

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