Dr Beaver's tute - shoulders Flashcards
what is the most lateral point of the normal anatomical shoulder
greater tuberosity
squared off shoulder clinical appearance
the acromion points out as the most lateral point instead of the greater tuberosity of the humeral head\indicates the shoulder is dislocated
light bulb sign
if the shoulder is internally rotated you can’t see the greater tuberosity anymore
so the humeral head looks like a light bulb (perfectly round top)
humorous is fully internally rotated so the humorous dislocated posteriorly
indicates posterior dislocation of the shoulder
frequently missed
who gets posterior dislocation of the shoulder
electricians falling off ladders after getting electric shocks
may hace bilateral posterior dislocations
also lighting strikes or epilepsy
why do people getting electric shocks get dislocated shoulders
electric shock causes sudden muscle contraction
pecs are strongest muscle effected by this
pecs contract and pull the shoulders into internal rotation and dislocates the shoulders
how to reduce a dislocated shoulder
aneasthesia
don’t need much force
make sure you exclude fractures and damaged brachial plexus
sedation not always necessary
don’t use brute force as this will produce fractures and damage nerves
the hanging arm technique
good one
hang arm off a gurney with or without a weight attached to the arm
leave them and let them fall asleep
tie them to the gurney so they don’t fall off
usually you wake them up and their shoulder is reduced
who gets dislocations of the shoulder
young people and athletes
do old people get dislocations
no
they may have a dislocation but they always always absolutely have a fracture as well
do not attempt to reduce the dislocation as there is probably a fracture
another good method to reduce a dislocated shoulder
what x-ray view to ask for
Y view, AP, lateral
