Shackles: Lecture Script: Upper Extremity: Exam 1

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What is the main advantage of using x-rays as a screening tool for upper extremity injuries?

Low cost and easy accessibility

Which imaging modality is typically used to identify common fracture patterns in the upper extremity?

X-rays

Why are CT scans and MRI sometimes preferred over x-rays for certain upper extremity injuries?

CT and MRI offer detailed soft tissue visualization

Why is CT recommended for significant injuries instead of just an x-ray?

CT provides a better 3D view of the bone and associated soft tissue injuries.

How does MRI differ from CT in evaluating bones?

MRI can see through cortical bone, while CT cannot penetrate it effectively.

In what way is the shoulder joint unique in terms of stability?

The knee joint is stabilized by ligaments, while the shoulder joint relies on muscles.

In an adult, what indicates that the physioplate is totally closed?

The acromium process

What anatomical landmark could indicate an anterior dislocation of the shoulder in an axillary view?

Humeral head sitting far anterior

What could be a sign of a separated shoulder when looking at the acromioclavicular joint?

Elevation of the acromial end of the clavicle

In reading radiographs, what does the acronym ABCs stand for?

Alignment, Bones, Cartilage, Soft tissues

What potential issue is indicated by 'loosen see through' on a radiograph according to Dr. Shackles?

Fracture

Why does an anterior dislocation of the shoulder occur frequently?

Because of the way the glenoid cavity is turned slightly anteriorly

Which muscle is labeled as the deltoid in the MRI?

Supraspinatus

What is the primary reason why the supraspinatus muscle is one of the first rotator cuff muscles injured over time?

It has a narrow space between the humeral head and acromion

In the context of MRI imaging, what does the 'whiter area' represent?

Fat

Which rotator cuff muscle is most commonly injured due to the formation of osteophytes grinding on the tendon?

Supraspinatus

In a coronal MRI view, where does the infraspinatus muscle insert?

Inferior and posterior to the supraspinatus

Which muscle comes from the medial aspect of the scapula and extends toward the humerus?

Teres major

Which bone feature thickens in response to muscle insertion, resulting in a more bulky attachment?

Deltoid tuberosity

Which bone structure prevents dislocation or subluxation of the humerus?

Coracoid process

What is the function of the coronoid process in the elbow joint?

Helps close the hinge joint

What is the significance of an elevated or obliterated anterior fat pad in the elbow?

Suggests a likely joint effusion or trauma-related damage

What does a dense effusion in the elbow joint likely indicate?

High probability of blood and potential fracture above the distal humeral condyles

What does an elevation of the anterior fat pad indicate after elbow relocation?

Previous or recent elbow subluxation or dislocation

What is the significance of fluid buildup in the posterior fat pad of the elbow?

Suggests a coronoid process subluxation

What anatomical structure is most likely to be affected by a coronoid process fracture?

Ulna styloid process

What does an empty electron faucet indicate in relation to the elbow joint?

Presence of a coronoid process fracture

Which structure helps form the electron faucet and hinge joints in the forearm?

Ulna proximal end

Why are styloid processes mentioned in the context of the ulna and radius?

'They are common sites for fractures.'

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