50.Scapula Flashcards Preview

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Flashcards in 50.Scapula Deck (21):
1

what muscles insert on the acromion and the supraglenoid tubercle respectively

acromion--acromion head of the deltoid musclesupreglenoid tubercle--origin of biceps brachia muscle

2

nerve present in cranial scapular notch

suprascapular nerve emerges cranial to notch and travels caudally

3

where is the axillary nerve found in respect to the scapula

axillary nerve emerges from the caudal border of the subscapularis muscle and crosses the caudal aspect of the scapulohumeral joint

4

radiographic view of scapular to assess for scapular fractures

Roush et aldistoproximal or axial view of the scapula

5

type I, II and III fractures of scapula

I. body and spine (includes acromion)II. neckIII. glenoid (includes supraglenoid)other classification: stable extraarticular, unstable extraarticular, articular

6

surgical stabilization for scapular body fractures`

bone plates (locking, inverted tubular plates)interfragmentary wireplates + wiretotal scapulectomypartial scapulectomy+/- Velpeau

7

screw purchase and bone depth for plating the scapula

bone depth greater cranially in the ventral halfbone depth greater caudally in the dorsal halfangle screws 45 degrees to spine to increase bone purchase

8

T/Fno significant difference in cyclic testing of plated scapular fracture with single vs double plate

TRUEno sign difference in cyclic testing

9

T/Fcase series with 60% scapulectomy had an excellent recovery

TRUE

10

ideal repair for acromion fractures

under tensile strength of acromion head of deltoid musclefix with pins/wires and tension band

11

T/Finjury to the supra scapular nerve will result in decreased sensation to the affected limb

FALSEinjury to the supra scapular nerve will NOT affect distal limb function or cutaneous sensationwill cause atrophy of supra and infraspinatus muscles

12

approaches to the neck of the scapula

cranial or craniolateral or intermuscular approachavoid supra scapular nerve+/- osteotomy of acromion+/- tenotomy of acromion head of the deltoid muscle

13

additional exposure to lateral scapular neck fractures can be achieved with...

osteotomy of greater tubercletenotomy of infraspinatus and/or teres minor muscles

14

repair methods of the scapular neck

1. cross pin fixation (excessive exposure needed to see glenoid and supraglenoid tubercle)2. divergent pin fixation (pins originate at supraglenoid tubercle3. plate fixation (small, T plate) placed cranially to scapular spine on ventral scapula--slide plate under supra scapular nerve

15

at what age should the supraglenoid tubercle fuse

5 months

16

most common intra articular scapular fracture

CRANIAL glenoid fractures (including the supraglenoid tubercle)

17

approaches to scapula for repair of a glenoid fracture

1. cranial with osteotomy of greater tubercle 2. cranial with longitudinal myotomy of supraspinatus3. Cranial with tenotomy of infraspinatus and/or teres minor

18

stabilization of the supraglenoid tubercle

1. lag screw and antirotational pin2. two K wires and figure eight3. excision of supraglenoid tubercle with biceps brachia tenodesis

19

scapular luxation/avulsions occur due to rupture of what muscle

serratus ventralis+/- rhombodeius and trapezius

20

treatment or stabilization recommendation for scapular avulsion

20-22 gauge cerclage passed around 5, 6, or 7 rib and holes drilled in caudal dorsal border of scapulareconstruct serratus ventralis +/- Velpeau

21

incidental findings of the caudal glenoid

ununited accessory caudal glenoid ossification centercheck bilaterallyoften incidentalcan deride if needed

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