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Anatomy

Upper Limb

Question 85 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

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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