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Anatomy > 7: Musculo-neuro-vascular systems of arm and glenohumeral joint > Flashcards

7: Musculo-neuro-vascular systems of arm and glenohumeral joint Flashcards

1
Q

Anterior axio-appendicular muscles

A

1) pectoralis major
2) pectoralis minor
3) subclavius
4) serratus anterior

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2
Q

Posterior axio-appendicular muscles

A

1) Trapezius
2) latissimus dorsi
3) levator scapulae
4) rhomboid minor and major

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3
Q

Scapulohumeral muscles

A

Rotator cuff
Deltoid
Teres major

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4
Q

Rotator cuff muscles are______ stabilizers of the glenohumeral joint

A

Active

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5
Q

Origin of supraspinatus

A

Supraspinous fossa of scapula

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6
Q

Insertion of supraspinatus

A

Greater tubercle of humerus (superior facet)

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7
Q

Innervation of supraspinatus

A

Suprascapular nerve (C5,6) from superior trunk

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8
Q

Actions of supraspinatus (2)

A

Abducts arm 0-15 degrees
Assists deltoid with abduction from 15-90 degrees

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9
Q

Rotator cuff tear typically affects____ muscle

A

Supraspinatus

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10
Q

Origin of infraspinatus

A

Infraspinous fossa of scapula

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11
Q

Insertion of infraspinatus

A

Greater tubercle of humerus (middle facet)

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12
Q

Innervation of infraspinatus

A

Suprascapular nerve (C5,6) from superior trunk

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13
Q

Actions of intraspinatus (1)

A

Externally rotates arm at GH joint

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14
Q

Origin of suprascapular nerve

A

C5, C6

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15
Q

Course of suprascapular nerve

A

Arises from superior trunk of brachial plexus
Passes inferiorly through the scapular notch into the supraspinous fossa
Curves around the spine of the scapula entering the infraspinous fossa

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16
Q

Structures innervated by suprascapular nerve

A

Supraspinatus
Infraspinatus
Glenohumeral joint

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17
Q

Origin of teres minor

A

Infraspinous fossa

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18
Q

Insertion of teres minor

A

Greater tubercle of humerus (inferior facet)

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19
Q

Innervation of teres minor

A

Axillary nerve C5

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20
Q

Actions of teres minor (2)

A

External rotation of humerus at GH joint
Adduction of the GH joint

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21
Q

Origin of axillary nerve

A

Terminal branch of posterior cord (C5, C6)

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22
Q

Course of axillary nerve

A

Passes laterally through quadrangular space reaching the posterior of the surgical neck

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23
Q

Quadrangular space borders

A

Teres minor
Teres major
Surgical neck of humerus
Long head of triceps

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24
Q

Structures innervated by axillary nerve

A

GH joint
Teres minor
Deltoid muscles
Skin of superolateralam

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25
Q

Origin of subscapularis

A

Subscapular fossa of scapula

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26
Q

Insertion of subscapularis

A

Lesser tubercle of humerus (anterior)

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27
Q

Innervation of subscapularis

A

Upper and lower subscapular nerves from posterior cord (C5,C6)

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28
Q

Actions of subscapularis (2)

A

Internal rotation of humerus at GH joint
Stabilizes GH joint

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29
Q

Subscapularis tendon tear results in…..

A

Weak internal rotation of the humerus

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30
Q

Origin of subscapular nerve

A

Posterior cord, upper: C5, lower: C6

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31
Q

Course of subscapular nerve

A

Upper: passes posteriorly to enter subscapularis directly
Lower: passes inferolaterally, deep to subscapular artery and vein

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32
Q

Structures innervated by subscapular nerve

A

Subscapularis (upper + lower)
Teres major (lower)

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33
Q

Acute tear
cause

A

Sudden powerful movement

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34
Q

Chronic tear cause

A

Tendon rubs against bone

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35
Q

Origin of deltoid (3)

A

Lateral 1/3 clavicle
Acromion
Lateral 1/3 spine of scapula

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36
Q

Insertion of deltoid

A

Deltoid tuberosity on humerus

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37
Q

Innervation of deltoid

A

Axillary nerve (C5,C6)

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38
Q

Actions of deltoid on glenohumeral joint

A

Anterior fibers: flexion
Middle fibers: abduction
Posterior fibers: extension

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39
Q

Origin of teres major

A

Inferior 1/3 of Medial border of scapula

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40
Q

Insertion of teres major

A

Medial lip of bicipital groove (intertuberclar sulcus)

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41
Q

Innervation of teres major

A

Lower subscapular nerve (C5,6)

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42
Q

Actions of teres major on glenohumeral joint

A

Internal rotation
Adduction
Extension

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43
Q

Causes of quadrangular space syndrome

A

Repeated injury and subsequent fibrosis can reduce the size of the quadrangular space
Leads to compression of the axillary nervev as it passes through the quadrangular space

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44
Q

Consequences of quadrangular space syndrome

A

Shoulder pain and paraesthesia in distribution of axillary nerve
Weakness of muscles innervated by axillary nerve

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45
Q

What is shoulder impingement?

A

During glenohumeral abduction, the supraspinatus tendon or its overlying subacromial bursa can be impinged between the head of the humerus and the inferior surface of the acromion.

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46
Q

Repeated shoulder impingement can lead to….

A

tendonitis or subacromial bursitis

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47
Q

What is painful arc syndrome?

A

Pain during shoulder abduction, within the 60-120° range. Usually follows shoulder impingement

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48
Q

Arterial blood supply to the glenohumeral joint

A

Anterior and posterior circumflex humeral arteries from the axillary artery
Suprascapular artery ( branch of thyrocervical trunk from subclavian)

49
Q

Arterial blood supply to acromioclavicular joint

A

Suprascapular artery
Acromial branch of thoracoacromial artery, axillary artery

50
Q

Arterial blood supply to supraspinous fossa

A

Suprascapular artery

51
Q

Arterial blood supply to infraspinous fossa

A

Dorsal scapular, thoracodorsal and circumflex scapular arteries

52
Q

Arterial blood supply to subscapular fossa (4)

A

Anastomosis between subscapular and thoracodorsal arteries with transverse cervical and dorsal scapular arteries

53
Q

3 divisions of axillary vein

A

1) proximal to pectoralis minor
2) deep to pectoralis minor
3) distal, between lower border of pectoralis minor and lower border of teres major

54
Q

Axillary vein is formed by union of…

A

Basilic vein and the brachial reins

55
Q

Proximally the axillary vein receives….

A

The cephalic vein

56
Q

Anterior compartment of arm

A

Biceps brachii
Brachialis
Coracobrachialis

57
Q

Posterior compartment of arm

A

Triceps brachii
Anconeus

58
Q

The two compartments of the arm are separated by..

A

Intermuscular septa

59
Q

Origin of long head of biceps brachii

A

Supraglenoid tubercle

60
Q

Origin of short head of biceps brachii

A

Coracoid process of scapula

61
Q

Insertion of biceps brachii

A

Radial tuberosity
Bicipital adoneurosis and fascia of forearm

62
Q

Innervation of biceps brachii

A

Musculocutaneous nerve (C5 -7)

63
Q

Actions of biceps brachii (3 joints)

A

Flexes elbow joint
Supinates forearm via radioulnar joint
Weak GH flexor
Long head is a weak GH abductor when arm is externally rotated
Short head is a weak GH adductor

64
Q

Long head of bicep passes…

A

Superiorly through bicipital groove

65
Q

____ ligament forms a roof over the bicipital groove

A

Transverse humeral ligament

66
Q

Long head of biceps inserts onto….

A

The supraglenoid tubercle

67
Q

Origin of brachialis

A

Distal 1/2 of anterior surface of humerus

68
Q

Insertion of brachialis

A

Ulnar tuberosity

69
Q

Innervation of brachialis

A

Musculocutaneous nerve (C5-C7)

70
Q

In 20% of people the brachialis recieves input from…

A

The radial nerve (C5, C6)

71
Q

Brachialis lies deep to…

A

Biceps

72
Q

Action of brachialis

A

Flexes elbow joint

73
Q

Origin of coracobrachialis

A

Coracoid process of scapula

74
Q

Insertion of coracobrachialis

A

Antero-medial aspect of humeral midshaft

75
Q

Innervation of coracobrachialis

A

Musculocutaneous nerve (C5 -7)

76
Q

Actions of coracobrachialis

A

Flexes arm at GH joint
Adducts arm at GH joint
Weak internal rotator of arm

77
Q

Origin of musculocutaneous nerve

A

Lateral cord of brachial plexus (roots C5-7)

78
Q

Course of musculocutaneous nerve

A

*Lies lateral to axillary artery
*Pierces and passes through coracobrachialis
*Descends between biceps and brachialis
* Emerges inferolateral at elbow and supplies elbow joint

79
Q

What does the musculocutaneous nerve continue as

A

The lateral cutaneous nerve of the forearm

80
Q

Structures innervated by musculocutaneous nerve

A
  • muscles of anterior compartment of arm
  • skin of lateral aspect of forearm
81
Q

Origin of long head of triceps brachii

A

Infraglenoid tubercle

82
Q

Origin of lateral head of triceps brachii

A

Posterior humerus (superior to radial groove)

83
Q

Origin of medial head of triceps brachii

A

Posterior humerus (inferior to radial groove)

84
Q

Insertion of triceps brachii

A

Olecranon process of ulna and fascia of forearm

85
Q

Innervation of triceps brachii

A

Radial nerve (C6-C8)

86
Q

Action of triceps brachii

A

Extends elbow joint
Long head is weak adductor and extensor of GH joint

87
Q

Origin of anconeus

A

Lateral epicondyle of humerus

88
Q

Insertion of anconeus

A

Lateral part of olecranon process of ulna Elbow joint capsule

89
Q

Innervation of anconeus

A

Radial nerve (C7-T1)

90
Q

Actions of anconeus

A

Extends elbow joint
Tenses elbow joint capsule so that it is not pinched by olecranon in olecranon fossa during elbow extension

91
Q

Origin of radial nerve

A

Larger terminal branch of posterior cord form C5-T1

92
Q

Course of radial nerve

A

*Lies posterior to axillary artery
* Passes through triangular interval and descends inferolaterally within the radial groove of the humerus
* Gives branches that supply triceps
* In ~20% of people it gives a branch to brachialis

93
Q

What does the radial nerve continue as?

A

Posterior cutaneous nerve

94
Q

Borders of triangular interval

A

Humeral shaft
Teres major
Long head of triceps

95
Q

Contents of triangular interval

A

Radial nerve
Profunda brachii

96
Q

Triangular interval syndrome

A

Weakness in muscles innervated by radial nerve and paraesthesia in sensory distribution of radial nerve

97
Q

Radial nerve injury at axilla consequences (3)

A

Triceps denervated, weak or absent elbow extension
Wrist drop due to denervated wrist extensors
Loss of cutaneous sensation in the areas that the radial nerve normally supplies

98
Q

Radial nerve injury at humeral mid shaft

A

Triceps still mostly functions
Wrist drop due to denervated wrist extensors
Loss of cutaneous sensation in the areas that the nerve normally supplies

99
Q

Origin of lateral root of median nerve

A

Terminal branch of lateral cord (C6,C7)

100
Q

Origin of medial root of median nerve

A

Terminal branch of medial cord ( C8,T1)

101
Q

Course of median nerve

A

Lateral to axillary artery
Descends through arm adjacent to brachial artery
Crosses brachial artery from lateral to medial and lies medial to artery in cubital fossa

102
Q

Structures innervated by median nerve

A

Muscles of anterior forearm compartment
Thenar half of palm of hand
Palmar skin

103
Q

Origin of ulnar nerve

A

Larger terminal branch of medial cord (C8-T1)

104
Q

Course of ulnar nerve

A

Descends medial arm
Passes posterior to medial epicondyle of humerus
Descends ulnar aspect of forearm to hand

105
Q

Structures innervated by ulnar nerve (4)

A

Flexor carpi ulnaris
Ulnar half of flexor digitorum profundus
Intrinsic muscles of hand
Skin of hand medial to axial line of digit 4

106
Q

What is the brachial artery?

A

The continuation of axillary artery past lower border of teres major

107
Q

Position of brachial artery

A

Relatively superficial
Medial to biceps
Superficial to coracobrachialis/ brachialis
At elbow runs deep to biceps aponeurosis and divides into radial and ulnar arteries

108
Q

Relations of brachial artery

A

Median nerve crosses anteriorly over artery
Ulnar nerve is posteromedial to artery

109
Q

Branches of brachial artery (3)

A

Profunda brachii
Superior and inferior ulnar collateral arteries
Radial and ulnar arteries

110
Q

Profunda

A

Deep

111
Q

What does the profunda brachii supply?

A

Triceps and humerus

112
Q

Course of profunda brachii

A

Profunda brachii passes between long and medial heads of triceps then courses inferolaterally through radial groove then terminates by dividing into radial and ulnar arteries

113
Q

What does brachial vein do

A

Drains deoxygenated blood back towards the heart

114
Q

Small veins around brachial artery

A

Venae comitantes

115
Q

Course of basilic vein

A

Courses proximally along medial surface of superficial arm
About 1/2 way along arm, dives deep, piercing the brachial fascia
Basilic vein unites with brachial vein
At lower border of teres major vein becomes axillary vein

116
Q

What region does cephalic vein drain?

A

Lateral superficial region of arm

117
Q

Deltopectoral groove

A

Groove between deltoid anterior fibers and pectoralis major

118
Q

Course of cephalic vein

A

At proximal deltopectoral groove, cephalic vein pierces through clave pectoral fascia and drains into axillary artery

Anatomy (17 decks)

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