Shoulder Region

Question 1

2 prominent bursae

Answer 1

Subacromial bursa

Subscapular bursa

Question 2

Separates the tendon of Supraspinatus from the deltoid muscle

Answer 2

Subacromial bursa

Question 3

Separates the scapular fossa from the tendon of subscapularis muscle

Answer 3

Subscapular bursa

Question 4

Contributes to the stability of the glenohumeral joint along with the tendon of the long head of biceps brachii muscle

Supraspinatus muscle - subscapularis nerve

Infraspinatus muscle - suprascapular nerve

Teres minor muscle - Axillary nerve

Subscapularis muscle - suprascapular nerve

Answer 4

Rotator cuff

Question 5

Rotator cuff injury

Answer 5

MC: tendon of supraspinatus muscle & subscromial bursa

SSX: pain on lifting the arm above the head

Question 6

Anterior or inferior dislocation of the humerus

Answer 6

MC type of shoulder dislocation

Humeral head lies anterior & inferior to the coracoids process of scapula –> may damage the axillary nerve or artery

SSX: loss of normal round contour of the shoulder, palpable depression under the acromion, ability to palpate the head of the humerus in the axilla

Question 7

Articulation of the lateral end of clavicle with the acromion of the scapula

Stabilized by:

• coracoacromial ligament
• coracoclavicular ligament (coronoid & trapezoid)
• acromioclavicular ligament

Answer 7

Acromioclavicular joint

Question 8

Shoulder separation

Cause: downward blow at the tip of the shoulder

Answer 8

Acromioclavicular subluxation

Question 9

Ligament: no tear

Joint space: normal

Answer 9

Grade I subluxation (minor sprain)

Question 10

Ligament: + tear acromioclavicular ligaments

Joint space: 50% wider

Answer 10

Grade II subluxation

Question 11

Ligament: + tear in coracoclavicular & acromioclavicular ligaments

Joint space: 50% wider

SSX: injured arm is lower than the normal arm, bulge at the top of shoulder (upward displacement of clavicle)

Depressing and then releasing the lateral end of the clavicle causes a rebound (“piano key sign”)

X-ray with 10lbs weight on the injured side: marked separation of acromion from the clavicle

Answer 11

Grade III subluxation

Question 12

Fracture of the clavicle

Answer 12

MC: middle third of clavicle

Causes: upward displacement of proximal fragment as a result of pull of SCM muscle & downward displacement of distal fragment due to pull of deltoid muscle

Subclavian artery & vein are at risk for injury

Question 13

Articulation of the head of the humerus with the glenoid fossa of the scapula

Answer 13

Glenohumeral joint