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NYCC Bone & Joint > (1,3) Rib, Sternum & Shoulder Injuries > Flashcards

(1,3) Rib, Sternum & Shoulder Injuries Flashcards

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1
Q

What populations more commonly experience rib fractures?

A

adult & geriatric

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2
Q

Which ribs most commonly fracture?

A

4-9
(1-3 rarely Fx)

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3
Q

What rib is most commonly fractured in benchpressers?

A

rib 2

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4
Q

What may cause a fracture of rib 1?

A

throwing athletes, asthmatics, heavy backpacks resulting in fatigue Fx

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5
Q

What imaging should not be relied on for rib fractures?

A
  • thoracic w/ open collimation
  • chest x-ray
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6
Q

What radiographic views are best for rib fractures?

A
  • 1 frontal (AP or PA) and 1 oblique (30 deg)
  • hemithorax imaging must visualize either rib 1 or 12
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7
Q

What are the imaging findings of rib fractures?

A
  • often radiographically occult
  • radiolucent Fx line
  • cortical offset of sup. margin
  • altered rib orientation (angulation)
  • extrapleural sign (swelling displaces lung)
  • callus
  • diaphragm elevation (splinting)
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8
Q

Name 4 types of rib fractures.

A
  • flail chest
  • golfer Fx
  • passion (bear hug) Fx
  • child abuse
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9
Q

What is meant by flail chest?

A

1 rib broken in 2 places resulting in compromised respiratory function

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10
Q

What ribs are involved in a golfer fracture?

A

upper ribs

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11
Q

What is the mechanism of a sternal fracture?

A

blunt trauma
- steering wheel
- shoulder belt

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12
Q

What is the most common orientation of a sternal fracture?

A

transverse

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13
Q

What is the best radiographic view for sternal fractures?

A

lateral sternum

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14
Q

What are the possible complications of thorax trauma?

A
  • pneumothorax
  • hemothorax
  • chylothorax
  • lung contusion
  • diaphragmatic rupture
  • aortic rupture
  • tracheal deviation
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15
Q

What is considered a red flag following a rib fracture?

A

shortness of breath

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16
Q

What imaging modalities are more sensitive for rib fractures?

A

bone scan & Diagnostic ultrasound (DxUS)

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17
Q

What is the most common location of clavicle fracture?

A

middle clavicle Fx
(usually complete Fx)

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18
Q

What imaging modality is best for medial clavicle fractures?

A

CT scan

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19
Q

What is the mechanism of a middle clavicle fracture?

A
  • FOOSH
  • shoulder pointer
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20
Q

What is the common appearance of a middle clavicle fracture?

Study These Flashcards
A

Bayonet apposition
(shoulder pulls lat. end down, proximal end lifts up)

21
Q

What are the potential complications of clavicle fractures?

Study These Flashcards
A
  • post-traumatic osteolysis (PTOC)
  • AC & SC joint degeneration
  • neurovascular damage
  • nonunion
  • malunion
22
Q

What complication of clavicle fractures is common in bench press & power lifting?

23
Q

What scapular fracture is associated with anterior GH dislocation?

24
Q

What is a Bankart fracture?

Study These Flashcards
A

Fx of anterior inferior glenoid rim

25
What is a reverse Bankart fracture?
Fx of posterior inferior glenoid rim
26
What is another name for a Hill-Sach fracture?
hatchet Fx (d/t V-shaped groove)
27
What is the mechanism of a Hill-Sach fracture?
anterior shoulder dislocation resulting in post/lat compression of humeral head on ant/inf glenoid
28
What radiographic view is best for a Hill-Sach fracture?
internal rotation
29
What is the term for a greater tuberosity avulsion fracture?
flap fracture
30
What is the mechanism of a flap fracture?
anterior shoulder dislocation
31
What is the most common direction of glenohumeral dislocation?
anterior
32
What is your next step for a patient with an anterior glenohumeral dislocation?
immobilize and send to ER
33
What are the 4 subtypes of anterior glenohumeral dislocation?
- subcoracoid - infraglenoid - subclavicular - intrathoracic
34
What is the most common subtype of anterior GH dislocation?
subcoracoid (humerus hits coracoid and drops inferiorly)
35
Name 3 lesions associated with anterior GH dislocation.
- Hill-Sach Fx - flap Fx - Bankart lesion
36
What are the mechanisms of posterior GH dislocations?
- seizures - electric shock - FOOSH w/ arm across body
37
What is the clinical finding of a posterior GH dislocation?
arm stuck in internal rotation
38
What is the best radiographic view for posterior GH dislocations?
axillary view or scapular Y view
39
What are the radiographic findings of a posterior GH dislocation?
- lightbulb sign (head in int rot.) - Trough sign (Reverse Hill-Sach Fx) - Reverse Bankart
40
What structure(s) is/are involved in a type 1 AC dislocation?
AC ligament sprain (mild)
41
What is the MOI of an AC dislocation?
FOOSH
42
What are the radiographic findings of a type 1 AC dislocation?
normal
43
What structure(s) is/are involved in a type 2 AC dislocation?
- AC lig tear - CC lig sprain (mild)
44
What are the radiographic findings of a type 2 AC dislocation?
- wide AC jt space - mild clavicular elevation
45
What structure(s) is/are involved in a type 3 AC dislocation?
AC + CC lig. tear
46
What are the radiographic findings of a type 3 AC dislocation?
- clavicle elevation >5mm from opposite side, or 100% elevation above acromion - wide AC jt space
47
Which type(s) of AC dislocation may require surgery?
type 3
48
What soft tissue injuries are associated with AC dislocations?
- rotator cuff tear - long head biceps tear - glenoid labrum tear
49
What landmarks are used to determine the type of AC dislocation?
- inf clavicle border - bottom & top edges of acromion

NYCC Bone & Joint (71 decks)

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