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Movement and Musculoskeletal Biology Emily > 002 The shoulder > Flashcards

002 The shoulder Flashcards

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1
Q

what are the 4 parts of the upper limb?

A
  • shoulder
  • arm (between shoulder and elbow)
  • forearm ( between elbow and wrist)
  • hand
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2
Q

what is the pectoral girdle?

A
  • the clavicle and the scapula
  • connects upper limbs to the axial skeleton
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3
Q

what is the evolutionary benefit of the pectoral girdle?

A
  • cushions head from inpacts from limbs when running/jumping
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4
Q

what 2 bones does the clavicle attach to?

A
  • acromion of the scapula
  • manubrium of the sternum
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5
Q

describe the structure of the clavicle

A
  • only bony attachment between the trunk and upper limbs
  • from the above view, it has a bend
    -acromion process on the outer end which joins to the acromion, part of the scapula (shoulder blade)
  • process on the inner end to join with the manubrium of the sternum and first costal cartilage
  • conoid tubercle on lateral 1/3 (towards the arm) where the coracoclavicular ligament attaches
  • trapezoid line, lateral from conoid tubercle, where the trapezoid ligament attaches
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6
Q

what is the common name for the scapula?

A

shoulder blade

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7
Q

describe the bone structure of the scapula

A
  • main wing part = subscapular fossa (anterior side) and infraspinous fossa (posterior side)
  • glenoid is lateral and is the socket part of the glenohumeral joint
  • the spine is posterior and connects to the acromion
  • the spine also separates the supraspinous fossa and infraspinous fossa on the posterior
  • the coracoid process is anterior and lateral, can palpate beneath clavicle
  • supraglenoid tubercle (notch above glenoid) attaches to bicep
  • infraglenoid tubercle (a notch below glenoid) attaches to tricep
  • suprascapular notch between the supraspinous fossa and the coracoid process where he suprascapular nerve runs and then down into the greater scapular notch posteriorly
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8
Q

what muscle attaches to the supraglenoid tubercle?

A

bicep

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9
Q

what muscle attaches to the infraglenoid tubercle

A

tricep

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10
Q

describe the structure of the proximal humerus

A
  • at the top there is the head which is half a sphere and is the ‘ball’ in the ball and socket joint
  • anterior and neck to head = greater tubercle, points laterally = attachment of: ( superior = supraspinatus, middle = infraspinatus, inferior = teres minor
  • anterior and below head = bicipital groove/intertubercular sulcus (where the bicep tendon is)
  • medial to groove = lesser tubercle = attachment of subscapularis muscle
  • anterior, lateral and middle of bone length = deltoid tuberosity = where the deltoid attaches
  • posterior, where the head attches to the main bone at the top = anatomical neck (rarely fractures)
  • below anatomical neck = surgical neck (fractures a lot)
  • below the head posteriorly = tricep attachment and radial groove for radial nerve and artery
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11
Q

what is the top of the humerus called?

A

head

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12
Q

what does the greater tubercle attach to?

A
  • superior facet = supraspinatus
  • middle facet = infraspinatus
  • inferior facet = teres minor
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13
Q

what muscle tendon is in the bicipital groove/intertubercular sulcus?

A

bicep tendon

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14
Q

what attaches to the lesser tubercle?

A

subscapularis muscle

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15
Q

what attaches to the deltoid tuberosity?

A

the deltoid

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16
Q

which fractures very often - anatomical or surgical neck of the humerus?

A

surgical neck fractures a lot

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17
Q

what attachments/ grooves are posterior on the humerus?

A
  • tricep attachment
  • radial groove for the radial nerve and artery
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18
Q

what are the 3 joints in the shoulder?

A
  • sternoclavicular
  • acromioclavicular
  • glenohumeral
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19
Q

describe the sternoclavicular joint

A
  • synovial joint
  • between sternum (manubrium) and the clavicle
  • articular disc between them on the clavicle end
  • clavicular notch between them on the sternum end
  • costoclavicular ligament joining clavicle and rib 1 at the 1st costal cartilage
  • interclavicular ligament connecting the 2 clavicles
  • anterior and posterior sternoclavicular ligament attaching clavicle to sternum
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20
Q

describe the acromioclavicular joint

A
  • synovial joint
  • between the acromion and the clavicle
  • acromioclavicular ligament between the acromion and the clavicle
  • coracoclavicular ligaments join the clavicle to the coracoid process ( trapezoid ligament is lateral, conoid ligament is medial)
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21
Q

what is shoulder separation and what are the different types/degrees?

A
  • when the ligaments in the shoulder (acromioclavicular) joint tear
    -type 1 = slight tear
  • type 2 = one ligament completely torn
  • type 3 = most ligaments have torn
    there are types 4-6 but they are very extreme
    = dislocated shoulder
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22
Q

what are the 2 movements of the scapula?

A
  • around vertical axis = pointing arm forwards = glenoid faces more anteriorly
  • around horizontal axis = moving arm backward = glenoid faces more superiorly
    = motions are possible because the scapula can slide over the posterior rib cage
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23
Q

describe the glenohumeral joint

A
  • synovial joint
  • highly mobile but very unsteady
  • between the humerus head and the glenoid
  • glenohumeral ligaments ( superior, middle and inferior) 3 bands between humerus and glenoid fossa
  • coracohumeral ligament = attaches to the base of coracoid process to the greater tubercle of the humerus
  • transverse humeral ligament = between 2 tubercles of humerus, holds bicep tendon in intertubercular groove
  • coracoacromial ligament = between acromion and coracoid process of scapula creating arch preventing displacement
  • glenoid labrum = soft tissue that deepens the cup
    -bicep tendons = prevent upwards displacement
  • arch of coracoid and acromium = prevent upwards displacement
  • synovial and fibrous capsule membranes over the joint
  • membranes sag underneath to allow lots of movement
  • rotator cuff muscles
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24
Q

what are bursae?

A
  • small fluid-filled sacs that reduce friction between joints
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25
Q

what is bursitis?

A
  • inflammation of bursa, causing pain and restricting movement
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26
Q

what are the names of the bursae in the shoulder?

A
  • subacromial bursa
  • subdeltoid bursa
  • tendon sheath
  • subcoracoid bursa
  • subsacpular bursa
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27
Q

what is the rotator cuff

A

group of muscles and tendons that surround the shoulder joint, keeping the head of the upper arm bone firmly within the shallow socket of the shoulder

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28
Q

what are the muscles of the rotator cuff and their location?

A
  • Teres minor = inferior, lateral
  • infraspinatus = above teres minor, lateral
  • supraspinatus = superior (on top)
  • subscapularis = middle, medial
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29
Q

where in the rotator cuff is there no muscle?

A
  • in the armpit, to allow free movement
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30
Q

what are the different movements of the shoulder (5)?

A
  • flexion/extension
  • medial rotation/lateral rotation
  • adduction/abduction
  • circumduction
  • retraction/protraction
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31
Q

when a shoulder is dislocated, which joint is involved?

A
  • glenohumeral joint
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32
Q

what is the origin of the trapezius muscle?

A
  • midline of back
  • skull, occipital protuberance and spinous processes C7-T12
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33
Q

what is the insertion of the trapezius muscle?

A
  • lateral 1/3 of clavicle, acromion and scapula spine
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34
Q

what is the innervation of the trapezius muscle?

A
  • cranial nerve XI (accessory nerve) and C3,C4
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35
Q

what is the action of the trapezius muscle?

A
  • rotate and elevate scapula to raise arm
  • depresses and retracts scapula
  • extends and rotates head
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36
Q

what is the origin of the levator scapulae muscle?

A
  • transverse processes of C1-C4 vertebrate
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37
Q

what is the insertion of the levator scapulae muscle?

A
  • upper medial border of scapula
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38
Q

what is the innervation of the levator scapulae muscle?

A
  • C3,C4 and dorsal scapula nerve
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39
Q

what is the action of the levator scapulae muscle?

A
  • elevate the scapula
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40
Q

what are the origins of the rhomboid muscles?

A
  • minor = spinous processes of C7-T1
  • major = spinous processes of T2-T5
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41
Q

what are the insertions of the rhomboid muscles?

A
  • minor = medial edge of the scapula at the level of scapula spine
  • major = medial edge of the scapula between the scapula spine and inferior angle
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42
Q

what is the innervation of the rhomboid muscles?

A
  • dorsal scapular nerve
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43
Q

what is the action of the rhomboid muscles?

A
  • elevate, retract and rotate the scapula
44
Q

what is the origin of the deltoid muscle?

A
  • clavicle and scapula
45
Q

what is the insertion of the deltoid?

A
  • deltoid tuberosity of humerus
46
Q

what is the innervation of the deltoid muscle?

A
  • axillary nerve (C5,C6)
47
Q

what is the action of the deltoid muscle?

A
  • abduction beyond 15 degrees upwards
48
Q

what myotome does abduction of the arm using deltoid muscle test for?

A
  • C5
49
Q

what is a myotome?

A
  • a region of skeletal muscle largely supplied by a single spinal cord level
50
Q

what are peripheral nerves?

A
  • contributions from multiple spinal levels that powers multiple muscles
51
Q

what is the origin of the latissimus dorsi muscle?

A
  • spinous processes of T6-L5, sacrum, iliac crest, ribs 10-12
52
Q

what is the insertion of the latissimus dorsi muscle?

A
  • floor of intertubercular sulcus
53
Q

what is the innervation of the latissimus dorsi muscle?

A
  • thoracodorsal nerve (C6,7,8)
54
Q

what is the action of the latissimus dorsi muscle?

A
  • powerful adduction, medial rotation and extension of the arm
55
Q

what is the origin of the pectoralis major muscle?

A
  • 2 heads:
    • medial half of the clavicle
    • anterior half of the sternum and first 7 costal cartilages
56
Q

what is the insertion of the pectoralis major muscle?

A
  • lateral lip of the intertubercular sulcus/bicipital groove
57
Q

what is the innervation of the pectoralis major?

A
  • medial and lateral pectoral nerves (C5-T1)
58
Q

what is the action of the pectoralis major muscle?

A
  • powerful adduction, flexion, extension, and medial rotation of the arm
59
Q

what is the origin of the pectoralis minor muscle?

A
  • anterior surfaces of ribs 3-5
60
Q

what is the insertion of the pectoralis minor muscle?

A
  • coracoid process
61
Q

what is the innervation of the pectoralis minor muscle?

A
  • medial pectoral nerve (C5-T1)
62
Q

what is the action of the pectoralis minor muscle?

A
  • rotates and protracts scapula
63
Q

what is the origin of the subclavius muscle?

A
  • first rib (at costal cartilage)
64
Q

what is the insertion of the subclavius muscle?

A
  • middle 1/3 of the clavicle
65
Q

what is the innervation of the subclavius muscle?

A
  • nerve to subclavius (C5,6)
66
Q

what is the action of the subclavius muscle?

A
  • depresses clavicle and stabilizes joint
67
Q

what is the origin of the coracobrachialis muscle?

A
  • corocoid process
68
Q

what is the insertion of the coracobrachialis muscle?

A
  • medial aspect of the humerus
69
Q

what is the innervation of the coracobrachialis muscle?

A
  • musculocutaneous nerve (C5-7)
70
Q

what is the action of the coracobrachialis muscle?

A
  • flexes arm
71
Q

what is the origin of the serratus anterior muscle?

A
  • lateral surface of ribs 1-8/9
72
Q

what is the insertion of the serratus anterior muscle?

A
  • medial border of scapula (costal surface)
73
Q

what is the innervation of the serratus anterior muscle?

A
  • long thoracic nerve (C5-7)
74
Q

what is the action of the serratus anterior muscle?

A
  • protracts and rotates scapula and prevents winging
  • use in press up position
75
Q

what is the origin of the supraspinatus of the rotator cuff?

A
  • supraspinous fossa of the scapula
76
Q

what is the insertion of the supraspinatus of the rotator cuff?

A
  • superior facet of the greater tubercle of the humerus
77
Q

what is the innervation of the supraspinatus of the rotator cuff?

A
  • suprascapular nerve (C5,6)
78
Q

what is the action of the supraspinatus of the rotator cuff?

A
  • initiates abduction of the arm (first 15 degrees, higher = deltoid)
79
Q

what is the origin of the infraspinatus of the rotator cuff?

A
  • infraspinous fossa of scapula
80
Q

what is the insertion of the infraspinatus of the rotator cuff?

A
  • middle facet of the greater tubercle of humerus
81
Q

what is the innervation of the infraspinatus of the rotator cuff?

A
  • suprascapular nerve (C5,6)
82
Q

what is the action of the infraspinatus of the rotator cuff?

A
  • lateral rotation of the arm (elbow bent moving arms out)
83
Q

what is the origin of the subscapularis of the rotator cuff?

A
  • subscapular fossa
84
Q

what is the insertion of the subscapularis of the rotator cuff?

A
  • lesser tubercle of humerus
85
Q

what is the innervation of the subscapularis of the rotator cuff?

A

superior and inferior subscapular nerves (C5,6,7)

86
Q

what is the action of the subscapularis of the rotator cuff?

A
  • medial rotation of arm
87
Q

what is the origin of the teres minor of the rotator cuff?

A
  • origin = lateral infraspinous fossa
88
Q

what is the insertion of the teres minor of the rotator cuff?

A
  • inferior facet of the greater tubercle of humerus
89
Q

what is the innervation of the teres minor of the rotator cuff?

A
  • axillary nerve (C5,6)
90
Q

what is the action of the teres minor of the rotator cuff?

A
  • lateral rotation of arm
91
Q

what is the origin of the teres major muscle?

A
  • posterior surface of scapula near inferior angle
92
Q

what is the insertion of the teres major muscle?

A

medial lip of intertubercular sulcus/bicipital groove

93
Q

what is the innervation of the teres major muscle?

A
  • inferior subscapular nerve (C5,6)
94
Q

what is the action of the teres major muscle?

A
  • medially rotates and extends arm
95
Q

in an MRI, describe how the rotator cuff muscles are located ( side view/ sagittal / through scapula)

A
  • anterior = subscapularis
  • superior = supraspinatus
  • posterior below spine/acromion process = infraspinatus
  • posterior inferior = teres minor
96
Q

how many heads does the tricep have?

A

3

97
Q

how many heads does the bicep have?

A

2

98
Q

what is the action of the tricep?

A

extension

99
Q

what is the function of the bicep?

A

flexion

100
Q

what are the 2 main posterior nerves of the shoulder?

A
  • suprascapular nerve
  • axillary nerve
101
Q

describe the suprascapular nerve

A
  • from the brachial plexus (superior trunk)
  • travels through the suprascapular foramen between bone and supraspinatus muscle, through greater scapular notch to infraspinatus
102
Q

describe the axillary nerve

A
  • from brachial plexus ( posterior cord)
  • passes posterior to surgical neck of humerus = dangerous if fractured
  • innervates teres minor and deltoid, ( like an army base on outside of arm)
103
Q

what are anastomoses?

A

Anastomosis occurs naturally in the body, where veins and arteries connect to transport blood around the body
Anastomosis in the vascular system creates a backup pathway for blood flow if a blood vessel becomes blocked.

104
Q

describe the 2 pathways of the subclavian -> axillary anastomosis

A
  • subclavian artery -> thyrocervical trunk -> suprascapular artery -> circumflex scapular artery -> subscapular artery -> axillary artery
  • subclavian artery -> thyrocervical trunk -> transverse cervical artery -> deep branch/dorsal scapular artery -> circumflex scapular artery -> subscapular artery -> axillary artery
105
Q

describe the pathway of axillary -> subclavian anastomosis

A
  • axillary artery -> humeral circumflex artery (anterior and posterior) -> thoracoacromial trunk -> subclavian artery

Movement and Musculoskeletal Biology Emily (23 decks)

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