Shoulder Ouchies Flashcards by Callum Donoher

What are the 3 bones that make up the shoulder joint?

Clavicle
Scapula
Humerus

How well did you know this?

Not at all

Perfectly

What are the 4 shoulder joints?

Sternoclavicular
Acromioclavicular
Glenohumeral
Scapulothoracic

How well did you know this?

Not at all

Perfectly

What is the significance of the glenoid fossa of the scapula?

Articulating surface with the humeral head

How well did you know this?

Not at all

Perfectly

What is the significance of the coracoid process of the scapula?

Anchor point of tendinous and ligamentous attachments

How well did you know this?

Not at all

Perfectly

What helps stabilise the highly mobile Glenohumeral joint?

Glenoid labrum
Rotator cuff muscles

How well did you know this?

Not at all

Perfectly

Which direction is the most common way to dislocate the shoulder?

Anteriorly

How well did you know this?

Not at all

Perfectly

How does an anterior shoulder dislocation appear?

Squaring of the shoulder

How well did you know this?

Not at all

Perfectly

How does a posteriorly dislocated shoulder appear on an xray?

Humerus looks like a light bulb
It internally rotates so you see the back of it

How well did you know this?

Not at all

Perfectly

Which way does the sternocleidomastoid muscle pull the clavicle?

Pulls up the medial side

How well did you know this?

Not at all

Perfectly

Which way does the Pectoralis major muscle pull the clavicle?

Inwards

How well did you know this?

Not at all

Perfectly

Which way does the Trapezius muscle pull the clavicle?

Upwards

How well did you know this?

Not at all

Perfectly

Which way does the weight of the arm pull the clavicle?

Downwards with gravity

How well did you know this?

Not at all

Perfectly

When the clavicle fractures the medial and lateral segments move differently, which way does the medial side move and what way does the lateral segment move?

Medial pulled superiorly

Lateral moved inferomedially

How well did you know this?

Not at all

Perfectly

What causes the medial segment of fractured clavicle to move superiorly?

Sternocleidomastoid muscles pulls superiorly

How well did you know this?

Not at all

Perfectly

What causes the lateral segment of fractured clavicle to move inferomedially?

Weight of arm drags it down
Pectoralis major pulls inwards

How well did you know this?

Not at all

Perfectly

What is the function of infraspinatus?

External rotation

How well did you know this?

Not at all

Perfectly

What is the function of subscapularis?

Internal rotation

How well did you know this?

Not at all

Perfectly

How do you test for the function of subscapularis?

Put hand behind back and push against doctors

How well did you know this?

Not at all

Perfectly

What is the function of Supraspinatus?

Initiates first bit of abduction

How well did you know this?

Not at all

Perfectly

What are the muscles of the rotator cuff?

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

How well did you know this?

Not at all

Perfectly

Where does Supraspinatus, Infraspinatus and Teres minor insert?

Greater tubercle of Humerus

How well did you know this?

Not at all

Perfectly

Where does subscapularis originate and insert?

Origin = Subcapular fossa of scapula

Insert = Lesser tubercle of Humerus

How well did you know this?

Not at all

Perfectly

What nerve supplies both Supraspinatus and Infraspinatus?

Suprascapular nerve

How well did you know this?

Not at all

Perfectly

What are the nerve roots of the Suprascapular nerve?

C5 and C6

How well did you know this?

Not at all

Perfectly

What is the innervation of Teres minor?

Axillary nerve

What is the innervation of subscapularis?

Subscapularis nerve

What is impingement syndrome?

Narrowing of the subacromial space When the Supraspinatus tendon impinges/rubs on the coraco-acromial arch leading to irritation and inflammation

What can lead to narrowing of the subacromial space leading to impingement syndrome?

Tendinitis Bursitis Osteophytes

What is the normal cause of tendinitis that leads to impingement syndrome?

Over use and weakening of Supraspinatus tendon leads to it becoming inflamed narrowing the space of the joint

What bursa usually leads to the bursitis that is responsible for impingement syndrome?

Subacromial bursa

The thickening of what ligament can cause impingement syndrome?

Coracoacromial ligament

Where do osteophytes form to cause impingement syndrome?

Subacromial space

In impingement of the Supraspinatus tendon, what is the presentation?

Painful arc Pain between 60º and 120º

What is Calcific Supraspinatus tendinopathy?

Deposits of hydroxyapatite (Calcium phosphate) in the tendon of Supraspinatus

What aggravates the pain in calcific supraspinatus tendinopathy?

ABducting or flexing arm above shoulder Lying on shoulder

How is Calcific supraspinatus tendinopathy treated?

Rest Analgesia Surgery for persistent symptoms

What is Adhesive Capsulitis (Frozen shoulder)?

When Glenohumeral joint (Whole shoulder capsule thickens) becomes stiff thick and inflamed which restricts movement You run out of synovial fluid

What are the 3 time periods for Adhesive Capsulitis?

Freezing (6-9 weeks) Frozen (4-6 months) Thawing (6 months - 2years)

What are some risk factors to developing Adhesive Capsulitis?

Diabetes Female Hyper and Hypothyroidism Connective tissue disease

What is the treatment for Adhesive Capsulitis (Frozen Shoulder)?

Physiotherapy Analgesia Anti inflammatory drugs Manipulation under anaesthesia to break adhesions

What are the 4 signs on an x-ray that indicate osteoarthritis?

Loss of joint space Osteophytes Subchondral sclerosis Subchondral cysts

How is Osteoarthritis of the shoulder treated?

Analgesia NSAIDs Steroid injections for swelling Surgery as last resort

What are some risk factors of osteoarthritis?

Age (Over 50yrs) Female Obesity

What is Hemiarthroplasty

Where half of the shoulder joint is replaced to treat Shoulder Osteoarthritis

What is a reverse total shoulder replacement?

Where the ball part of humeral head would be put in the normal place of the glenoid fossa, they are the other way around

Why may a reverse total shoulder replacement may be done?

In old age the rotator cuff muscles are lost so by moving the joint out the Deltoid takes over

If someone has pain on abduction between 60º to 120º of their shoulder, what are they likely suffering with?

Impingement syndrome This is the painful arc

What is a Bankart lesion?

The Glenoid labrum tears in the anterior joint capsule allowing humeral head to move aroun

What is a Hilsack legion?

Deformity of humeral head caused by recurrent dislocations (dent)

Where is the main point that the clavicle fractures?

Fractures in the middle third

Which way does the shoulder dislocate?

Anteriorly

What is general impingement syndrome?

Compression of rotator cuff in the subacromial space

What nerve can be damaged if the clavicle is fractured and the medial segment is pulled up?

Suprascapular nerve

What are the nerve roots of the subscapular nerve?

C3 and C4

What movement cannot happen to the arm if the subscapular nerve is damaged?

Cannot internally rotate

What blood vessels can be damaged from a clavicular fracture?

Subclavian artery Subclavian vein

What is it called when a fractured clavicle punctures the lungs?

Pneumothorax

What nerve is most at risk of being damaged during dislocation of the humeral head?

Axillary nerve

What sensory region is lost when the Axillary nerve is damaged?

Regimental badge region

Why do humeral neck fractures likely lead to Axillary nerve damage?

Axillary wraps around the surgical neck of the humerus

If somebody has a posterior shoulder dislocation, what do you need to consider as potential causes?

If they’ve had seizures or an electric shock (Lightbulb sign)