Shoulder and Upper Arm Flashcards
What makes up the shoulder joint proper
Humerus and the gleaned part of the scapula
What is important in stabilising the shoulder and also in producing shoulder rotation
The rotator cuff muscles
What is the function of the deltoid
power of abduction
What is Sprengel’s shoulder
A congential condition in which the scapula is higher and small than usual and also rotated into adduction
What results in a fracture of the clavicle
All onto the shoulder or the outstretch hand
What is the treatment for a fractured clavicle
Supporting the weight of the arm in a broadarm sling
Occasionally internal fixation
How do fractures of the accordion and scapula occur
direct blow or fall and rarely displaced
What causes a subluxation or dislocation of the acromioclavicular joint
fall onto the shoulder often as a result of sport
What does a complete dislocation of the acromioclavicular joint involve
rupture of the superior and inferior acromioclavicular ligaments and the coracoclavicular ligament
What are the clinical features of a subluxed or dislocated acromioclavicular joint
Outer end of the clavicle is abnormally prominent and tender usually with some additional swelling
Restricted shoulder movements
What is the treatment for a subluxed or dislocated acromioclavicular joint
Broad sling
How do dislocations of the shoulder occur
following a fall on the arm or shoulder
What happens to the deltoid muscle in an anterior dislocation
it becomes flattened- loss in the curved contour of the shoulder and becomes squared off
What is the characteristic feature of a posterior shoulder dislocation
Light bulb appearance
What should be done if there is any doubt about a shoulder dislocation
CT scan
What are possible complications of a shoulder dislocation
axillary nerve is damaged - paralysis of the deltoid
What are some methods of reducing a shoulder dislocation
Hippocratic method
Kocher’s method
Patient lies face down with the arm hanging over the side of a cough and operator can slip the humeral head back in when the patient is given analgesic injection
How is the Hippocratic method of reduction performed
Pain relief and encouraged to relax
Patient supine, surgeon pulls downwards on the arm whilst applying counter-traction in the axilla with his or her foot
How is the Kocher’s method of reduction performed
The elbow is flexed and traction applied tot eh arm
Arm is then externally rotated, adducted across the chest and flexed at the shoulder and then internally rotated until the forearm touches the chest
How long is a patients arm immobilised for in a sling
3 weeks
What is the treatment for recurrent dislocations of the shoulder
surgical treatment to stabilise the shoulder or to repair the damaged capsule and labrum to the gleaned
Describe the type of fracture that normally occurs in a humeral neck
comminuted fracture
What might an impacted humeral neck fracture result in
damage to the brachial plexus or axillary artery
What is the prognosis for a humeral neck fracture
Reduced normal range of movement after
What is capsulitis
A very common condition - the shoulder is prone to stiffness following immobilisation in a sling
What is the commonest biceps injury
rupture of the long head of biceps from its insertion to the gleaned tubercle
Popeye appearance
What type of biceps injury requires surgery
When the distal biceps pulls away from its attachments to the radial tubercle
