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Final Score 46%
12
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Anatomy
Upper Limb
Question 151 of 180
You are asked to review a 34 year old rugby player who has presented with shoulder pain following a tackle. X-ray reveals an acromioclavicular dislocation. Which of the following ligaments is the most important in stabilising the acromioclavicular joint:
Answer:
The strong coracoclavicular ligament (made up of two ligaments, the conoid and trapezoid ligament) is the main stabilising force at the acromioclavicular joint.Acromioclavicular Joint
Anatomy / Upper Limb / Pectoral Region
Last Updated: 8th April 2019
Table: Anatomical Overview of the Acromioclavicular Joint
| Joint | Acromioclavicular |
|---|---|
| Type | Plane type synovial joint |
| Articulations | Lateral end of clavicle and acromion of scapula |
| Main stabilising factors | Acromioclavicular ligament and coracoclavicular ligament |
Joint Articulations
The acromioclavicular joint is a plane type synovial joint, occurring between the lateral end of the clavicle and the acromion of the scapula.
Joint Ligaments
The acromioclavicular joint is reinforced by two main ligaments; a small acromioclavicular ligament and a much larger coracoclavicular ligament.
The strong coracoclavicular ligament (made up of two ligaments, the conoid and trapezoid ligament) is the main stabilising force, and essentially suspends the weight of the upper limb from the clavicle.
![By Henry Vandyke Carter [Public domain], via Wikimedia Commons](https://mrcemsuccess.com/wp-content/uploads/2016/12/Acromioclavicular-Joint.png)
Acromioclavicular Joint. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)
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- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
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