Shoulder Flashcards
What are the 5 boarders of the axilla?
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.
What are the 5 main structures that run through the axilla?
Axillary lymph nodes. Brachial plexus. Axillary artery. Axillary vein. Axillary sheath.
What is anterior dislocation of the shoulder usually caused by?
Extension/lateral rotation force.
What is posterior shoulder dislocation usually caused by?
Significant forces eg electrocution
What structures is the shoulder joint stabilised by?
Rotator cuff muscles.
Glenoid labrum.
Ligaments.
What are the 4 rotator cuff muscles from anterior to posterior?
Subscapularis.
Supraspinatus.
Infraspinatus.
Teres minor.
What are the 3 main ligaments that stabilise the shoulder joint?
Coracohumeral ligament.
Coracoacromial ligament.
Glenohumeral ligaments.
What treatment is used for a dislocated shoulder joint?
Reduction.
Supportive measures.
Follow up.
What artery can be damaged in a shoulder dislocation?
Axillary artery
What nerves can be damaged in a shoulder dislocation?
Brachial plexus, radial, axillary, musculocutaneous.
When is axillary nerve damage more likely in a shoulder dislocation? What can been seen clinically with it?
If brachial plexus injury is present.
Axillary haematoma, cool limb, absent or reduced pulses.
What is a bankart lesion?
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.
What is a Hill-Sachs lesion?
A posterolateral humeral head indentation fracture occurs at the soft base of the humeral head and impacts against the relatively hard anterior glenoid.
When does a Hill-Sachs lesion occur most?
Occurs very often in recurrent dislocations.
Where is the surgical neck of the humerus located?
Below the tubercles.
Where is the anatomical neck of the humerus located?
Area where the capsule attaches and epiphyseal growth plate.
What can be damaged and therefore seen in a humeral neck fracture?
Axillary nerve damage - paralysis to deltoid and teres minor, so difficult abduction of limb and regimental badge sign.
Posterior circumflex artery damage.
What is damaged in a mid shaft humeral fracture?
Radial nerve and profounda brachii artery.
What is humeral impingement?
Pain often attributed to the subacromial space when the humerus is elevated or internally rotated.
What usually causes impingement at the glenohumeral joint?
Supraspinatus tendon and bursae impinging on the acromion. Can be due to tendinitis of the rotator cuff tendons.
What is often a pre-requisite to rotator cuff injury?
Impingement of the glenohumeral joint.
What are the 5 features of osteoarthritis at the glenohumeral joint that can be seen on a radiograph?
Joint space narrowing. Sclerosis. Osteophytes. Erosions. Subchondral cysts.
What 3 muscles are found in the anterior compartment of the upper arm? What are they innervated by?
Biceps brachii - musculocutaneous.
Coracobrachialis - musculocutaneous.
Brachialis - musculocutaneous (some contributions from radial nerve).
What muscle makes up the posterior compartment of the upper arm? What is it innervated by?
Triceps brachii - radial nerve.
