Shoulder

Question 1

What are the 5 boarders of the axilla?

Answer 1

Anterior - pectoralis major and minor.
Medial - serratus anterior and thoracic wall.
Posterior - scapularis, teres major, latissimus dorsi.
Lateral border - intertubecular sulcus.
Apex - lateral border of first rib, superior border of scapula, posterior border of clavicle.

Question 2

What are the 5 main structures that run through the axilla?

Answer 2

Axillary lymph nodes.
Brachial plexus.
Axillary artery.
Axillary vein.
Axillary sheath.

Question 3

What is anterior dislocation of the shoulder usually caused by?

Answer 3

Extension/lateral rotation force.

Question 4

What is posterior shoulder dislocation usually caused by?

Answer 4

Significant forces eg electrocution

Question 5

What structures is the shoulder joint stabilised by?

Answer 5

Rotator cuff muscles.
Glenoid labrum.
Ligaments.

Question 6

What are the 4 rotator cuff muscles from anterior to posterior?

Answer 6

Subscapularis.
Supraspinatus.
Infraspinatus.
Teres minor.

Question 7

What are the 3 main ligaments that stabilise the shoulder joint?

Answer 7

Coracohumeral ligament.
Coracoacromial ligament.
Glenohumeral ligaments.

Question 8

What treatment is used for a dislocated shoulder joint?

Answer 8

Reduction.
Supportive measures.
Follow up.

Question 9

What artery can be damaged in a shoulder dislocation?

Answer 9

Axillary artery

Question 10

What nerves can be damaged in a shoulder dislocation?

Answer 10

Brachial plexus, radial, axillary, musculocutaneous.

Question 11

When is axillary nerve damage more likely in a shoulder dislocation? What can been seen clinically with it?

Answer 11

If brachial plexus injury is present.

Axillary haematoma, cool limb, absent or reduced pulses.

Question 12

What is a bankart lesion?

Answer 12

Avulsion of the anterior-inferior glenoid labrum at its attachment to the anterior-inferior glenohumeral ligament complex. There is a rupture of the joint capsule and inferior glenohumeral ligament injury.

Question 13

What is a Hill-Sachs lesion?

Answer 13

A posterolateral humeral head indentation fracture occurs at the soft base of the humeral head and impacts against the relatively hard anterior glenoid.

Question 14

When does a Hill-Sachs lesion occur most?

Answer 14

Occurs very often in recurrent dislocations.

Question 15

Where is the surgical neck of the humerus located?

Answer 15

Below the tubercles.

Question 16

Where is the anatomical neck of the humerus located?

Answer 16

Area where the capsule attaches and epiphyseal growth plate.

Question 17

What can be damaged and therefore seen in a humeral neck fracture?

Answer 17

Axillary nerve damage - paralysis to deltoid and teres minor, so difficult abduction of limb and regimental badge sign.
Posterior circumflex artery damage.

Question 18

What is damaged in a mid shaft humeral fracture?

Answer 18

Radial nerve and profounda brachii artery.

Question 19

What is humeral impingement?

Answer 19

Pain often attributed to the subacromial space when the humerus is elevated or internally rotated.

Question 20

What usually causes impingement at the glenohumeral joint?

Answer 20

Supraspinatus tendon and bursae impinging on the acromion. Can be due to tendinitis of the rotator cuff tendons.

Question 21

What is often a pre-requisite to rotator cuff injury?

Answer 21

Impingement of the glenohumeral joint.

Question 22

What are the 5 features of osteoarthritis at the glenohumeral joint that can be seen on a radiograph?

Answer 22

Joint space narrowing.
Sclerosis.
Osteophytes.
Erosions.
Subchondral cysts.

Question 23

What 3 muscles are found in the anterior compartment of the upper arm? What are they innervated by?

Answer 23

Biceps brachii - musculocutaneous.
Coracobrachialis - musculocutaneous.
Brachialis - musculocutaneous (some contributions from radial nerve).

Question 24

What muscle makes up the posterior compartment of the upper arm? What is it innervated by?

Answer 24

Triceps brachii - radial nerve.