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Shoulder dislocation quiz.pptx

A 20-year-old college football player presented with right shoulder pain after taking a blow to the arm during a game. On examination, the deltoid muscle was flattened and the overlying skin was insensitive to pinprick, while peripheral pulses were intact. This suggests an anterior dislocation of the humerus. The nerve most vulnerable to damage from anterior shoulder dislocation is the axillary nerve. Recurrent shoulder dislocation is associated with lesions like Bankart's and capsular lesions, but not usually supraspinatus tears.

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SHOULDER DISLOCATION QUIZ By Dr Ali Qasim & Dr Sunil Rajis
1. A 20 year old college football player is evaluated in emergency department for acute right shoulder pain.The patient sustained blow to the arm an hour ago while playing football.On physical examination,there is flattening of right deltoid muscle and insensitivity of overlying skin to pinprick.Peripheral pulses in the upper extremities are intact.Which of following injuries is most likely responsible for this patient’s findings? A) Acromioclavicular joint subluxation B) Anterior dislocation of the Humerus C) Clavicular Fracture D)Rotator cuff injury
2. Which nerve is most vulnerable to damage as a complication of anterior dislocation of shoulder joint? A) long Thoracic Nerve B) Axillary nerve C) Ulnar nerve D) Radial Nerve
3. The lesions associated with recurrent dislocation of shoulder joint include all, except A. Hillsac’s deformity B. Bankart’s lesion C. Capsular Lesion D. Supraspinatus tear
4. 35 years old male was working on an electric pole,he had a high voltage electric shock injury after which he presented to the emergency department .Initial resuscitation was done and now complains of severe pain in right shoulder joint. What could be the possible injury? A Lateral dislocation B Inferior dislocation C Posterior dislocation D Anterior dislocation
5. What is the possible presentation of a patient with posterior dislocation of shoulder joint? A Flexion, adduction with internal rotation B Flexion, adduction with internal rotation C Flexion, adduction with external rotation D Extension, abduction with internal rotation
Q6: The 'light bulb sign' observed on radiographs of posterior shoulder dislocations is due to... • A: fixed abduction of the humeral head • B: fixed adduction of the humeral head • C: fixed external rotation of the humeral head • D: fixed internal rotation of the humeral head
Q7: A 41-year-old man is brought into the ED after having a witnessed tonicclonic seizure. He is alert and oriented, and he states that he has not taken his seizure medication for the last week. His blood pressure (BP) is 140/75 mm Hg, heart rate (HR) is 88 beats/minute, respiratory rate (RR) is 16 breaths/minute, and temperature is 99.7°F. On examination, you notice that his arm is internally rotated and adducted. He cannot externally rotate the arm and any movement of his shoulder elicits pain. Which of the following is the most likely diagnosis? a. Humerus fracture b. Clavicle fracture c. Scapula fracture d. Posterior shoulder dislocation e. Anterior shoulder dislocation
The following scenario applies to questions 8 and 9 A 32-year-old construction worker reports standing on scaffolding before it suddenly gave way beneath him. In an attempt to catch his fall, he quickly grabbed and hung on to an overhead beam for approximately 30 seconds. Two hours later, he presents to the ED with left shoulder pain and decreased range of motion. Vital signs are within normal limits, except for the patient’s pain scale of 10/10. He is holding his left arm with the contralateral hand. On physical examination, the patient’s shoulder appears swollen with no skin breakage. The upper extremity is otherwise without obvious deformity. The patient has palpable brachial, radial, and ulnar pulses with capillary refill that is less than 2 seconds. He can wiggle his fingers but cannot internally rotate his shoulder or raise his left arm above his head. Pinprick testing reveals decreased sensation along the lateral deltoid of the affected arm
Q8 What is the most likely etiology of this patient’s symptoms? a. Acromioclavicular joint sprain b. Posterior shoulder dislocation with axillary nerve impingement c. Anterior shoulder dislocation with axillary nerve impingement d. Anterior shoulder dislocation with median nerve impingement e. Posterior shoulder dislocation with ulnar nerve impingement
Q9: A radiograph of the shoulder is obtained and is shown in the following figure. What is the most common lesion/fracture associated with the patient’s diagnosis? a. Bankart fracture b. Hill-Sachs deformity c. Clavicle fracture d. Coronoid process fracture e. Scapula fracture
Q10. Which of the following features is NOT a commonly associated injury in posterior shoulder dislocation? A: neurovascular damage B: posterior humeral avulsion of the glenohumeral ligament (HAGL) C: proximal humeral fractures D: reverse Bankart lesion E: reverse Hill-Sachs lesion
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KEY 1. B 2. B 3. D 4. C 5. B 6. D 7. D 8. C 9. B 10. A