Anatomy clinical correlates: Clavicle and shoulder
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Anatomy clinical correlates: Clavicle and shoulder
Prerequisite basic sciences
Prerequisite basic sciences
Anatomy clinical correlates: Anterior and posterior abdominal wall
Anatomy clinical correlates: Inguinal region
Anatomy clinical correlates: Peritoneum and diaphragm
Anatomy clinical correlates: Viscera of the gastrointestinal tract
Anatomy clinical correlates: Other abdominal organs
Appendicitis: Pathology review
Complications during pregnancy: Pathology review
Diverticular disease: Pathology review
Gallbladder disorders: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Mood disorders: Pathology review
Pancreatitis: Pathology review
Anatomy clinical correlates: Female pelvis and perineum
Cervical cancer: Pathology review
Complications during pregnancy: Pathology review
Uterine disorders: Pathology review
Anatomy clinical correlates: Heart
Anatomy clinical correlates: Mediastinum
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Thoracic wall
Aortic dissections and aneurysms: Pathology review
Coronary artery disease: Pathology review
Deep vein thrombosis and pulmonary embolism: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review
ECG cardiac infarction and ischemia
Pigmentation skin disorders: Pathology review
Skin cancer: Pathology review
Papulosquamous and inflammatory skin disorders: Pathology review
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Thoracic wall
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Lung cancer and mesothelioma: Pathology review
Nasal, oral and pharyngeal diseases: Pathology review
Obstructive lung diseases: Pathology review
Pneumonia: Pathology review
Tuberculosis: Pathology review
Chest X-ray interpretation: Clinical sciences
Amnesia, dissociative disorders and delirium: Pathology review
Cerebral vascular disease: Pathology review
Dementia: Pathology review
Electrolyte disturbances: Pathology review
Mood disorders: Pathology review
Hypothyroidism: Pathology review
Mood disorders: Pathology review
Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves
Cardiomyopathies: Pathology review
Cerebral vascular disease: Pathology review
Heart blocks: Pathology review
Supraventricular arrhythmias: Pathology review
Valvular heart disease: Pathology review
Ventricular arrhythmias: Pathology review
Vertigo: Pathology review
ECG axis
ECG cardiac hypertrophy and enlargement
ECG intervals
ECG normal sinus rhythm
ECG QRS transition
ECG rate and rhythm
Kidney stones: Pathology review
Sexually transmitted infections: Vaginitis and cervicitis: Pathology review
Sexually transmitted infections: Warts and ulcers: Pathology review
Urinary tract infections: Pathology review
Central nervous system infections: Pathology review
Nasal, oral and pharyngeal diseases: Pathology review
Pneumonia: Pathology review
Shock: Pathology review
Urinary tract infections: Pathology review
Anatomy clinical correlates: Anterior blood supply to the brain
Anatomy clinical correlates: Temporal regions, oral cavity and nose
Central nervous system infections: Pathology review
Cerebral vascular disease: Pathology review
Headaches: Pathology review
Traumatic brain injury: Pathology review
Vasculitis: Pathology review
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Axilla
Anatomy clinical correlates: Bones, fascia and muscles of the neck
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Foot
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Wrist and hand
Seronegative and septic arthritis: Pathology review
Apnea, hypoventilation and pulmonary hypertension: Pathology review
Deep vein thrombosis and pulmonary embolism: Pathology review
Heart failure: Pathology review
Nephrotic syndromes: Pathology review
Renal failure: Pathology review
Anatomy clinical correlates: Anterior and posterior abdominal wall
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Vertebral canal
Aortic dissections and aneurysms: Pathology review
Back pain: Pathology review
Anatomy clinical correlates: Inguinal region
Anatomy clinical correlates: Male pelvis and perineum
Penile conditions: Pathology review
Prostate disorders and cancer: Pathology review
Testicular and scrotal conditions: Pathology review
Testicular tumors: Pathology review
Anatomy clinical correlates: Pleura and lungs
Coronary artery disease: Pathology review
Obstructive lung diseases: Pathology review
Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Anatomy clinical correlates: Ear
Anatomy clinical correlates: Temporal regions, oral cavity and nose
Nasal, oral and pharyngeal diseases: Pathology review
Sexually transmitted infections: Vaginitis and cervicitis: Pathology review
Prerequisite basic sciences
Anxiety disorders, phobias and stress-related disorders: Pathology Review
Atherosclerosis and arteriosclerosis: Pathology review
Back pain: Pathology review
Bone disorders: Pathology review
Coronary artery disease: Pathology review
Diabetes mellitus: Pathology review
Drug misuse, intoxication and withdrawal: Alcohol: Pathology review
Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review
Drug misuse, intoxication and withdrawal: Other depressants: Pathology review
Drug misuse, intoxication and withdrawal: Stimulants: Pathology review
Dyslipidemias: Pathology review
Heart failure: Pathology review
Hypertension: Pathology review
Mood disorders: Pathology review
Obstructive lung diseases: Pathology review
Peripheral artery disease: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Assessments
Anatomy clinical correlates: Clavicle and shoulder
USMLE® Step 1 questions
0 / 8 complete
USMLE® Step 2 questions
0 / 9 complete
Questions
USMLE® Step 1 style questions USMLE
of complete
USMLE® Step 2 style questions USMLE
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Image reproduced from Radiopedia
Which of the following physical examination maneuvers is most likely to yield a positive test, given this patient’s clinical findings?
Transcript
Our upper limbs are complex structures. They’ve got bones, muscles, fascia, nerves and blood vessels, and everything in between. Our upper limbs are prone to injury however, and oftentimes, even a small injury can have a huge functional deficit as we are so reliant on our upper limbs in everyday life. One of these commonly injured areas is the shoulder region.
Ok, so let’s start by taking a look at the injuries of the clavicle. Because of its subcutaneous position, the clavicle is prone to fractures, which are usually the result of direct or indirect trauma. An example of direct trauma is falling directly on the shoulder. Indirect trauma, however, may occur when falling on an outstretched hand, and the force of impact is transmitted through the bones of the forearm and the arm to the shoulder, which can result in a clavicle fracture. Most of these fractures occur in the middle third of the clavicle, particularly where the middle third meets the lateral third, which is the weakest point of the clavicle.
So with clavicular fractures, the medial fragment is usually pulled up by the sternocleidomastoid muscles, which can be apparent to the naked eye and palpable. At the same time, the trapezius muscle is having trouble holding the lateral fragment up, because of the weight of the limb, so the shoulder drops. And since the two fragments may glide under each other, the clavicle is also shortened. Additional features may signal complications of a clavicle fracture. For example, if the skin above the fracture seems to be tenting, meaning it looks like a tent, that suggests the fracture may become an open fracture in the future, and warrants surgical stabilization.
Alright, now, another thing that can happen in this region is an acromioclavicular dislocation, also called a “shoulder separation”. Just like the name says, the clavicle and acromion process separate, usually because of a direct blow to the shoulder, or a fall landing directly on the shoulder joint. And this may be seen in contact sports, like football, soccer or hockey.
Sources
- "Clavicle fractures" Orthopaedics & Traumatology: Surgery & Research (2017)
- "Bedside Ultrasound Diagnosis of Clavicle Fractures in the Pediatric Emergency Department" Academic Emergency Medicine (2010)
- "Treatment of Acute Midshaft Clavicle Fractures: Systematic Review of 2144 Fractures" Journal of Orthopaedic Trauma (2005)
- "Acute rotator cuff tears" BMJ (2017)
- "Surgery for rotator cuff tears" Cochrane Database of Systematic Reviews (2019)
- "DeLee & Drez's Orthopaedic Sports Medicine" W B Saunders Company (2015)
- "Treatment of Adhesive Capsulitis of the Shoulder" Journal of the American Academy of Orthopaedic Surgeons (2019)
- "Shoulder Pain and Mobility Deficits: Adhesive Capsulitis" Journal of Orthopaedic & Sports Physical Therapy (2013)
- "Clavicle fractures" Am Fam Physician (2008)
- "Treatment of clavicle fractures" Transl Med UniSa (2012)
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