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Year 2 Limbs > 2 - Shoulder and Arm > Flashcards

2 - Shoulder and Arm Flashcards

1
Q

What are the two main processes coming off the scapula?

A

Coracoid process

Acromion process

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2
Q

How can you differentiate between the 2 ends of the clavicle?

A

sternal end = round

acromial end = flattened

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3
Q

How can you differentiate between the anterior and posterior surface of the clavicle?

A 
anterior = smooth
posterior = roughened
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4
Q

Why is the sternoclavicular joint described as being the pivot point of the limb?

A

joint between the trunk and the clavicle - the ONLY bony attachment between the upper limb and the trunk:

  • shoulder joint (gleno-humeral) is between the humerus and the scapula
  • the scapula does not have a bony joint with the trunk (it is a virtual joint)
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5
Q

Name the muscles of the scapula

A

deltoid
trapezius
subclavius

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6
Q

What are the differences between the anatomical and surgical necks of the humerus?

A

Anatomical – between the head of the humerus and everything else
Surgical – the main narrowing of the distal humerus – it is the most common site for fractures of the humerus

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7
Q

Which part of the scapula articulates with the humerus?

A

Glenoid cavity

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8
Q

What are the three fossae of the scapula?

A

Supraspinous
Infraspinous
Subscapular

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9
Q

On which bones are deltoid tubercles found?

A

Spine of the scapula

Humerus

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10
Q

What is the name given to the distinctive notch on the scapula?

A

Suprascapular notch

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11
Q

What is the name given to the groove between the greater and lesser tubercles of the humerus?

A

Intertubercular (bicipital) groove

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12
Q

What are the two distinctive protrusions on the lateral third of the clavicle and what are their roles?

A

Conoid tubercle
Trapezoid line
They are the point of attachment of the conoid ligament and trapezoid ligament (both part of the coracoclavicular ligament)

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13
Q

What are the names of the three fossae at the distal end of the humerus?

A

Anterior – coronoid and radial fossae

Posterior – olecranon fossa

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14
Q

Name the condyles, describe their shape and name the bone that they attach

NOTE: these are important for articulation at the elbow joint

A

capitulum - round - radius attaches

trochlea - cylindrical - ulner attaches

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15
Q

What are the five muscle compartments of the region?

A 
Anterior pectoral 
Posterior pectoral
Intrinsic shoulder 
Anterior compartment of arm 
Posterior compartment of arm
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16
Q

Which muscles make up the anterior pectoral compartment?

A

Pectoralis major
Pectoralis minor
Serratus anterior
Subclavius

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17
Q

What are the attachments of pectoralis major?

A

Medial 1/3 of the clavicle + sternum + costal cartilages

Lateral lip of intertubercular sulcus

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18
Q

What are the actions of pectoralis major?

A

Adducts and medially rotates the shoulder

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19
Q

What are the attachments of pectoralis minor?

A

Ribs 2-5

Coracoid process of scapula

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20
Q

What is the function of the pectoralis minor?

A

pulls the scapula forward to the back of the thoracic wall

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21
Q

What are the attachments of subclavius?

A

1st costochondral joint

Clavicle

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22
Q

What function does the subclavius perform?

A

anchors the clavicle

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23
Q

What are the attachments of serratus anterior?

A

Medial border of the costal surface of the scapula

Anteriorly attaches to the ribs (1-9)

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24
Q

Which nerve innervates serratus anterior?

A

Long-thoracic nerve

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25
Q

Which muscles make up the posterior pectoral compartment?

A

Trapezius
Latissimus dorsi
Levator scapulae
Rhomboids (minor and major)

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26
Q

What is the motor supply to trapezius?

A

Accessory nerve (CN XI)

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27
Q

Other than the trapezius, what else does the accessory nerve innervate?

A

the sternocleidomastoid

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28
Q

Describe the attachments of latissimus dorsi.

A

Thoracolumbar fascia and posterior 1/3 of the iliac crest

Floor of the intertubercular sulcus

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29
Q

What movement is latissimus dorsi responsible for?

A

Extends, adducts and rotates the humerus

pulls the body up during climbing

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30
Q

Describe the attachments of the rhomboids.

A

Both attach distally to the medial border of the scapula
Rhomboid minor attaches proximally to the spinous processes of C7 and T1
Rhomboid major attaches proximally to the spinous processes of T2-T5

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31
Q

Which nerve supplies the rhomboids?

A

Dorsal scapular nerve

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32
Q

What movement are the rhomboids responsible for?

A

Retracts, rotates and fixes the scapula

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33
Q

Describe the attachments of levator scapulae.

A

Attaches proximally to the transverse processes of C1-C4

Attaches distally to the superior angle of the scapula

34
Q

What movements are levator scapulae responsible for?

A

Elevates and rotates the scapula

35
Q

Which muscles make up the intrinsic shoulder muscle compartment?

A

Rotator cuff muscles (supraspinatus, infraspinatus, teres minor and subscapularis)
Teres major
Deltoid

36
Q

Describe the attachments of deltoid.

A

Proximal – lateral 1/3 of the clavicle, acromion process and crest of the spine of the scapula
Distal – deltoid tuberosity of the humerus

37
Q

Which nerve supplies the deltoid?

A

Axillary nerve

38
Q

What movement is the deltoid responsible for?

A

abduction of the arm

39
Q

Describe the attachment of the rotator cuff muscles and state the nerves that innervate them.

A 
Supraspinatus
•	Suprascapular fossa to greater tubercle 
•	Innervated by suprascapular nerve 
Infraspinatus 
•	Infrascular fossa to greater tubercle 
•	Innervated by suprascapular nerve 
Teres minor 
•	Upper 2/3 of the lateral margin of the scapula to the greater tubercle 
•	Innervated by the axillary nerve 
Subscapularis 
•	Subscapular fossa to the lesser tubercle 
•	Innervated by the subscapular nerve
40
Q

Which rotator cuff muscle is important for abducting the arm?

A

Supraspinatus is important in the first 15 degree of abduction of the arm, then the deltoid takes over.

41
Q

Describe the attachments of teres major.

A

Inferior angle of the scapula to the floor and medial lip of the intertubercular sulcus of the humerus

42
Q

Which nerve innervates teres major?

A

Lower subscapular nerve

43
Q

Which muscles make up the anterior compartment of the arm?

A

Biceps brachii
Brachialis
Coracobrachialis

44
Q

Which nerve innervates the anterior compartment of the arm?

A

musculocutaneous nerve

45
Q

Describe the attachments of biceps brachii.

A

Long head – supraglenoid tubercle
Short head – coracoid process
Distal attachment – radial tuberosity

46
Q

Describe the attachments of coracobrachialis.

A

Proximal: coracoid process
Distal: front of the shaft of the humerus

47
Q

Describe the attachments of brachialis.

A

Proximal: shaft of the humerus
Distal: coronoid process of ulna

48
Q

Which muscles make up the posterior compartment of the arm?

A

Triceps

Anconeus

49
Q

What are the attachments of the triceps?

A

Long head – infraglenoid tubercle
Medial and lateral head – proximal part of the shaft of the humerus
Distal attachment: olecranon process of the ulna

50
Q

What are the attachments of anconeus?

A

Proximal: lateral epicondyle of the humerus
Distal: shaft of the ulna

51
Q

Which four joints make up the pectoral girdle?

A

Sternoclavicular
Acromioclavicular
Gleno-humeral
Scapulo-thoracic (physiologica/virtuall joint)

52
Q

Which two ligaments make up the coracoclavicular ligament?

A

Conoid ligament

Trapezoid ligament

53
Q

Which three ligaments surround the glenohumeral joint?

A

Glenohumeral ligament
Coracohumeral ligament
Transverse humeral ligament

54
Q

What is the ligament of the acromioclavicular joint?

A

Acromioclavicular ligament

55
Q

What type of joint is the glenohumeral joint?

A

Ball-in-socket synovial joint

56
Q

What is the glenoid cavity deepened by?

A

Glenoid Labrum – fibrocartilaginous collar

57
Q

What structure is found between the superior surface of the humerus and the inferior surface of the acromion?

A

Subacromial bursa

58
Q

What does the rotator cuff do to the humeral head?

A

Depresses the humeral head and holds it within the glenoid cavity

59
Q

In which direction is dislocation of the shoulder most likely? Why?

A

downwards

the top and sides are covered in muscle, and there is a bone (acromium porocess) right above it

60
Q

What does the rotator cuff do to the humeral head?

A

Depresses the humeral head and holds it within the glenoid cavity

61
Q

What is the shape of the axilla?

A

Pyramid

62
Q

What does the axilla contain?

A

Nerves – the brachial plexus
Arteries – axillary artery and its branches
Veins – axillary vein and its branches
Lymphatic vessels and lymph nodes

63
Q

What are the four walls of the axilla?

A
  • Apex – between the first rib, clavicle and superior border of subscapularis
  • Floor – skin, subcutaneous tissue and fascia extending from the arm to the chest
  • Anterior wall – pectoralis major and pectoralis minor
  • Lateral wall – humerus
  • Medial wall – upper thoracic wall and serratus anterior
  • Posterior wall – scapula/subscapularis, teres minor and latissimus dorsi
64
Q

Describe the divisions of the subclavian artery as it passes into the axilla and down the arm.

A

As the subclavian artery passes over the first rib it becomes the axillary artery
The axillary artery then becomes the brachial artery as it passes the inferior border of teres major
The brachial artery has an important branch - profundi brachii
Brachial artery then divides into radial and ulnar arteries at the level of the elbow

65
Q

Which branch of the axillary artery goes around the humerus?

A

Circumflex humeral artery

66
Q

Describe the superficial venous anatomy of the arm.

A

There is are two main superficial veins: cephalic (lateral) and basilic (medial)
Above the elbow the basilic artery joins the venae comitantes of the brachial artery to form the axillary vein
The cephalic vein drains into the axillary vein more superiorly

67
Q

Which small vein joins the cephalic and basilic veins in the cubital fossa?

A

Median cubital vein

68
Q

What are the veins on the dorsal side of the hand called?

A

Dorsal venous network

69
Q

Describe the arrangement of the deep veins of the arm.

A

They follow the arteries back

70
Q

What are the groups of lymph nodes found in the shoulder and arm?

A

Cubital lymph nodes
Delto-pectoral lymph nodes
Axillary lymph nodes

71
Q

Which two nerves are found near the axillary lymph nodes?

A

Long thoracic nerve

Thoraco-dorsal nerve

72
Q

Why are the axillary lymph nodes clinically significant important?

A

they also drain the breast

removing them in great cancer treatment can lead to lymphedema of the arm, forearm and hand

73
Q

What are the five groups of axillary lymph nodes?

A 
Apical 
Central 
Pectoral 
Subscapular 
Humeral
74
Q

What are the five parts of the brachial plexus?

A 
Roots 
Trunks 
Divisions 
Cords 
Branches
75
Q

What are the five largest nerves of the brachial plexus?

A 
Musculocutaneous 
Axillary
Radial 
Median
Ulnar
76
Q

Which spinal nerves form the brachial plexus?

A

C5 - T1

77
Q

Which muscles attach to the scapular?

A 
Supraspinatus
Infraspinatus
Teres Major 
Teres minor 
Subscapularis
biceps (both heads)
coracobrachialis
pectoralis minor
triceps - long head
78
Q

What passes through the glenohumeral joint?

A

the tendon of the long head of the biceps

79
Q

What is the subacromial bursa?

A

The fibrous capsule holding the humerus in place in the glenohumeral joint extends above the humeral head to form a bursa

80
Q

What passes through the glen-humeral joint?

A

long head of the biceps

Year 2 Limbs (7 decks)

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