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BSMS204 Theme 2 Musculoskeletal > 3. Anatomy of the shoulder region > Flashcards

3. Anatomy of the shoulder region Flashcards

1
Q

Skeletal components of shoulder region

A

Pectoral girdle - clavicle and scapula
humerus

Two joints: glenohumeral joint and acromioclavicular joint

Important aspects: acromion, coricoid, greater tubercle of humerus, lesser tubercle of humerus, bicepital groove

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2
Q

ligaments of shoulder

A

stabilise/support shoulder region

coracoclavicular

acromioclavicular

coracoacromial

glenohumeral (superior, middle, inferior)

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3
Q

Coracoclavicular ligament

A

two parts

major stabilising ligament

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4
Q

Coracoacromial ligament

A
  • Forms arch
  • Provides support for head of humerus
  • Prevents superior dislocation
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5
Q

Glenohumeral joint

A

Highly mobile ball and socket joint

  • Abduction/adduction
  • Flexion/extension
  • Lateral/medial rotation
  • Circumduction

between head of humerus and glenoid fossa

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6
Q

Abduction of arm

A

Performed by deltoid
Origin: spine of scapula & acromion & clavicle

Insert: deltoid tuberosity

Innervation: axillary nerve (from posterior chord of brachial plexus)

Posterior fibres: extension and lateral rotation
Anterior fibres: flexion and medial rotation

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7
Q

Adduction of arm

A

lattisimus dorsi

  • origin spinal processes of T6-T12
  • inserts into bicepital groove

pectoralis major

  • origin sternum, clavicle, costal cartilages
  • inserts into bicepital groove’s lateral lip
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8
Q

What components accommodate abduction/adduction of arm

A

Glenohumeral joint accommodates parts of movement

Rotation of scapula increases range of movement

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9
Q

Which muscles move the scapula during abduction of the arm and in what direction?

A

Upper fibres of trapezius moves acromion medially superiorly
lower fibres of trapezius moves spine inferiomedially
serratus anterior moves lower angle superiorly distally

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10
Q

Which muscle(s) move the scapula during adduction of the arm and in what direction?

A

levator scapular moves top of scapula medially and upright

Rhomboids move medial border medially and upright

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11
Q

Flexion of the arm

A

Short head of biceps, long head of biceps, coracobrachialis

also anterior fibres of deltoid

Brachialis flexes forearm

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12
Q

Extension of arm

A

Long head of triceps

Posterior fibres of deltoid
Lattisimus dorsi

Lateral head of triceps and medial head of triceps extend forearm

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13
Q

Forearm flexion

A

Brachialis

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14
Q

Forearm extension

A

lateral head of triceps and medial head of triceps

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15
Q

Glenohumeral joint stability

A

Between large humeral head and shallow glenoid fossa

unstable structure

most frequently dislocated joint - anterior dislocation common (humeral head descends inferiorly and ends up anterior

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16
Q

Factors increasing glenohumeral joint stability

A
  1. Coracoacromial arch
  2. Glenohumeral ligaments
  3. Deepening of glenoid fossa by glenoid labrum
  4. Long heads of biceps (above) and triceps (below)
  5. Tendons of rotator cuff muscles
17
Q

Glenohumeral arch

A

prevents superior dislocation of joint

18
Q

Glenohumeral ligaments

A

Supports anterior of joint

19
Q

Glenoid labrum

A

Deepens the glenoid fossa

20
Q

Long head of biceps and triceps

A

Splint joint - prevent movement of head of humerus out of glenoid fossa
Long head of biceps origin in supraglenoid tubercle, passes through joint capsule
Origin of long head of triceps in infraglenoid tubercle

21
Q

Tendons of rotator cuff muscles

A

Four muscles

Insert on humerus close to joint

Fuse with the joint capsule

Forms cuff around joint

22
Q

Rotator cuff muscles origin

A

supraspinatus - origin from supraspinous fossa

Intraspinatus - origin from infraspinatus fossa

Teres minor - posterior of scapula near lateral border

23
Q

Rotator cuff muscles - insertion

A

Supraspinatus, infraspinatus and teres minor insert into the greater tubercle

SIT - upper, middle and lower facets of greater tubercle

24
Q

Subscapularis

A

Originates from subscapular fossa, forms a tendon, passes across anterior of joint to insert into lesser tubercle

25
Q

Rotator cuff function

A

Supraspinatus - initiate abduction
Infraspinatus - lateral rotation
Teres minor - lateral rotation
Subscapularis - medial rotation

26
Q

Teres major

A

Should also be considered with the rotator cuff muscles

Performs medial rotation

Stabilises the humerus during abduction - Eccentric contraction

Originates: inferior angle of scapula
Insertion: medial lip of bicepital groove

27
Q

Rotator cuff injuries

A

Supraspinatus impingement:
Supraspinatus most commonly injured
Limited space for tendon under coracoacromial arch

  • Impingement due to repetitive overhead activities
  • Common in athletes (throwers)
28
Q

Blood supply

A

Rich blood supply

Scapula anastomosis

Allows continuous supply of blood to shoulder region during movement

From subclavian and axillary arteries

29
Q

Scapula anastomosis

A

From subclavian and axillary

Subclavian -> thyrocervical trunk -> suprascapular -> subscapular subscapula -> dorsal scapula -> subclavian

30
Q

Nerve supply to the shoulder

A

From brachial plexus

Suprascapular nerve -> supraspinatus and infraspinatus

from posterior cord

31
Q

Cords of brachial plexus

A

Within axilla

below pectoralis major

32
Q

Posterior cord

A

Deltoid and teres minor - axillary

triceps brachii - radial

subscapularis, teres major - upper/lower subscapular nerves

Thoracodorsal nerve - lattisimus dorsi

33
Q

Quadrangular space

A

Formed by teres minor (superior), humerus (lateral), teres major (inferior), long head of triceps (medial)

34
Q

What is found in the quadrangular space?

A

Nerve supply to :
deltoid
teres minor
badge area

Axillary nerve and posterior circumflex humeral artery

35
Q

Clinical significance of quadrangular space

A

Fracture of surgical neck can damage axillary nerve and posterior circumflex humeral artery

36
Q

Lateral cord

A

lateral pectoral nerve -> pectoralis major

Musculocutaneous - arm flexors

37
Q

Medial cord

A

Medial pectoral nerve - Pectoralis major/minor

Medial cutaneous nerves to arm and forearm

BSMS204 Theme 2 Musculoskeletal (22 decks)

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