Shoulder dislocation

1. SHOULDER DISLOCATION
QUIZ
By
Dr Ali Qasim & Dr Sunil Rajis

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. THANK YOU!
NOW KINDLY SWAP YOUR PAPERS WITH EACH OTHER!

14. KEY
1. B
2. B
3. D
4. C
5. B
6. D
7. D
8. C
9. B
10. A