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SHB > 9.22.16 Shoulder, Breast, and Pectoral Region > Flashcards

9.22.16 Shoulder, Breast, and Pectoral Region Flashcards

1
Q

What are the fascial compartments of the shoulder/pectoral region?

A
  1. Pectoral fascia
  2. Axillary fascia
  3. Clavipectoral fascia
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2
Q

What covers the pectoralis major muscle?

A

Pectoral fascia

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3
Q

What is a continuation of the pectoral fascia laterally?

A

Axillary fascia

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4
Q

What is found deep to the pectoralis major and encloses the subclavius muscle and pectoralis minor muscle?

A

Clavipectoral fascia

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5
Q

What part of the body is aligned with the following dermatomes - C5, T4, T10?

A

C5: Clavicles
T4: Level of nipples
T10: Level of umbilicus

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6
Q

Identify the following parts of the scapula:

  1. Scapular spine
  2. Acromion
  3. Coracoid process
  4. Supraspinous fossa
  5. Infraspinous fossa
  6. Subscapular fossa
  7. Glenoid cavity
  8. Supraglenoid tubercle
  9. Infraglenoid tubercle
  10. Medial border
  11. Superior angle
  12. Inferior angle
A

Refer to Powerpoint

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7
Q

Identify the clavicle.

A

Refer to Powerpoint

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8
Q

What is the large, fan-shaped muscle covering most of the anterior thoracic wall?

A

Pectoralis major

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9
Q

What innervates the pectoralis major?

A

Medial and lateral pectoral nerves

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10
Q

What is the origin and insertion of the pectoralis major?

A

Origin: sternal half of clavicle, sternum to 7th rib
Insertion: humerus

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11
Q

What is the function of the pectoralis major?

A

Flexes and adducts arm, rotates arm medially

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12
Q

What supplies the pectoralis major?

A

Pectoral branch of the thoraco-acromial artery, perforating branches of internal thoracic artery

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13
Q

What is the origin and insertion of the pectoralis minor?

A

Origin: Ribs 3-5
Insertion: Coracoid process of scapula

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14
Q

What is the function of the pectoralis minor?

A

Lowers lateral angle of scapula and protracts scapula

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15
Q

What innervates the pectoralis minor?

A

Medial pectoral nerve

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16
Q

What supplies the pectoralis minor?

A

Pectoral branch of thoraco-acromial and intercostal lateral thoracic arteries

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17
Q

What is useful as a landmark for axillary structures such as the axillary artery?

A

Pectoralis minor

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18
Q

What is the sawtoothed muscle that helps stabilize the scapula?

A

Serratus anterior

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19
Q

What innervates the serratus anterior?

A

Long thoracic nerve

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20
Q

What is the origin and insertion of serratus anterior?

A

Origin: Lateral surfaces of upper 8-9 ribs
Insertion: Costal surface of medial border of scapula

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21
Q

What supplies the serratus anterior?

A

Lateral thoracic artery

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22
Q

What is the function of the serratus anterior?

A

Protracts and rotates the scapula and holds it against the thoracic wall

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23
Q

What is the origin and insertion of the deltoid?

A

Origin: lateral third of anterior clavicle, lateral acromion, inferior edge of spine of scapula
Insertion: Deltoid tuberosity of humerus

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24
Q

What innervates the deltoid?

A

Axillary nerve

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25
Q

What are the functions of the deltoid?

A

Simply put, the deltoid abducts the humerus to 90 degrees;

Clavicular part: Flexes and medially rotates arm
Acromial part: Abducts arm beyond initial 15 degrees done by supraspinatus
Spinal part: Extends and laterally rotates arm

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26
Q

What are the rotator cuff muscles?

A

Supraspinatus, infraspinatus, teres minor, and subscapularis (SitS)

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27
Q

What is the origin and insertion of supraspinatus?

A

Origin: Supraspinous fossa of scapula and deep fascia
Insertion: Superior facet of greater tubercle of humerus

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28
Q

What innervates supraspinatus?

A

Suprascapular nerve

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29
Q

What is the function of the supraspinatus?

A

Initiates arm abduction, acts with rotator cuff muscles

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30
Q

What supplies supraspinatus?

A

Suprascapular artery

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31
Q

True or false - supraspinatus rotates the humerus.

A

False

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32
Q

What is most frequently torn in rotator cuff injuries?

A

Supraspinatus

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33
Q

What is the origin and insertion of infraspinatus?

A

Origin: Infraspinous fossa of scapula and deep fascia
Insertion: Middle facet of greater tubercle of humerus

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34
Q

What innervates infraspinatus?

A

Suprascapular nerve

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35
Q

What is the function of infraspinatus?

A

Lateral rotation of arm (with teres minor)

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36
Q

What supplies infraspinatus?

A

Suprascapular artery

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37
Q

What is the origin and insertion of teres minor?

A

Origin: Upper 2/3 of posterior surface of lateral border of scapula
Insertion: Inferior facet of greater tubercle of humerus

38
Q

What innervates teres minor?

A

Axillary nerve

39
Q

What is the function of teres minor?

A

Laterally rotates arm

40
Q

What supplies teres minor?

A

Circumflex scapular artery

41
Q

What is the origin and insertion of subscapularis?

A

Origin: Subscapular fossa
Insertion: Lesser tubercle of humerus

42
Q

What innervates subscapularis?

A

Upper and lower subscapular nerves

43
Q

What is the function of subscapularis?

A

Medially rotates arm at shoulder and adducts, helps hold humeral head in glenoid cavity

44
Q

What supplies subscapularis?

A

Subscapular artery, lateral thoracic artery

45
Q

Rotator cuff muscles fix the head of the humerus in the ___ and during abduction and flexion of the arm.

A

Glenoid cavity

46
Q

What is the origin and insertion of teres major?

A

Origin: Posterior surface of inferior angle of scapula
Insertion: Medial lip of intertubercular sulcus of humerus

47
Q

What innervates teres major?

A

Lower subcapular nerve

48
Q

What is the function of teres major?

A

Adducts and medially rotates arm

49
Q

What supplies teres major?

A

Circumflex scapular artery

50
Q

Where does the axillary artery begin?

A

At the lateral border of the first rib; direct continuation of the subclavian artery

51
Q

What is the first part of the axillary artery and where is it located?

A

Superior thoracic artery; medial to the pectoralis minor muscle.

52
Q

What are the second parts of the axillary artery and where is it located?

A

Thoracoacromial trunk and lateral thoracic arteries; under the pectoralis minor muscle

53
Q

What are the third part of the axillary artery and where is it located?

A

Subscapular (circumflex scaupular and thoracodorsal), anterior and posterior circumflex humeral arteries; lateral to the pectoralis minor muscle

54
Q

Where does the axillary artery end?

A

The lower border of the teres major muscle where it becomes the brachial artery

55
Q

What are anastomoses?

A

Connections between two blood vessels, such as between arteries (arterio-arterial anastomosis), between veins (veno-venous anastomosis) or between an artery and a vein (arterio-venous anastomosis).

56
Q

What are the anastomotic branches around the shoulder?

A
  1. Subclavian branches (thyrocervical trunk, dorsal scapular)
  2. Axillary branches (thoracoacromial trunk, subscapular, humeral circumflex)
57
Q

What are the four unique spaces in the posterior shoulder?

A
  1. Suprascapular Notch
  2. Quadrangular space
  3. Triangular Space
  4. Triangular Interval
58
Q

Describe the suprascapular notch

A

Suprascapular nerve goes under the superior transverse scapular ligament. The suprascapular artery goes over the ligament (Army Over Navy)

59
Q

Describe the quadrangular space

A 
Superior: Teres minor
Inferior: Teres major
Medial: Long head of triceps
Lateral: Humerus
Includes the axillary nerve and the posterior circumflex humeral artery
60
Q

Describe the triangular space.

A

Superior: teres minor
Inferior: teres major
Lateral: long head of triceps
Includes the circumflex scapular artery

61
Q

Describe the triangular interval.

A

Superior: teres major
Medial: long head of triceps
Lateral: lateral head of triceps
Includes the profunda brachii artery and radial nerve

62
Q

What does the dorsal scapular nerve innervate?

A

Levator scapulae and rhomboids

63
Q

What does the suprascapular nerve innervate?

A

Supraspinatus and infraspinatus

64
Q

What does the long thoracic nerve innervate?

A

Serratus anterior

65
Q

What does the axillary nerve innervate?

A

Deltoid and teres minor

66
Q

What does the upper subscapular artery innervate?

A

Subcapularis

67
Q

What does the lower subscapular nerve innervate?

A

Subscapularis and teres major

68
Q

What does the thoracodorsal nerve innervate?

A

Latissimus dorsi

69
Q

What does the medial pectoral nerve innervate?

A

Pectoralis major and pectoralis minor

70
Q

What does the lateral pectoral nerve innervate?

A

Pectoralis major

71
Q

What is a pyramid-shaped space inferior to the glenohumeral joint and superior to the axillary fascia?

A

Axilla

72
Q

What does the axilla do?

A

Serves as a protected passageway for the neurovascular structures (axillary artery, brachial plexus, axillary vein) from the neck to the upper limb

73
Q

Describe the boundaries of the axilla.

A

Apex: 1st rib, clavicle, and superior edge of the scapula
Base: axillary fascia (armpit)
Anterior wall: pectoralis major and minor
Posterior wall: scapula and subscapularis
Medial wall: serratus anterior over 1st five ribs
Lateral wall: humerus and corocoid process

74
Q

Mammary glands are a modified and specialized type of __ gland.

A

Sweat

75
Q

The breast extends transversely from the lateral border of the ___ to the midaxillary line.

A

Sternum

76
Q

The breast also extends vertically from the ___ to ___ rib. A small part may extend toward the axilla. This is the axillary tail or the ___.

A

2nd; 6th; Tail of Sepnce

77
Q

2/3 of the breast rests on ___. 1/3 of the breast rests on fascia covering the ___.

A

Deep pectoral fascia; serratus anterior

78
Q

What makes up the bulk of the breast?

A

Tubuloalveolar glands and fat

79
Q

15-20 glands each form a lobe. 1 ___/lobe and sinus

A

Lactiferous duct

80
Q

What attach the lobes of the breast to skin and divide glandular tissues into lobes?

A

Suspensory ligaments (of Cooper)

81
Q

What arteries supply the breast?

A

Internal thoracic artery, pectoral branch of thoracoacromial trunk, lateral thoracic artery

82
Q

What are the major nodes that drain the breast towards the axilla?

A

Central, Lateral (humeral), Apical, Subscapular (posterior), Pectoral (anterior)

CLASP

83
Q

The highest frequency of breast cancer occurs in the ___ quadrant of the breast, which drains to the axillary nodes.

A

Superior-lateral

84
Q

What supplies deltoid?

A

Posterior circumflex humeral artery, deltoid branch of thoraco-acromial artery

85
Q

What is the origin and insertion of latissimus dorsi?

A

Origin: spinous processes of T7-L5 vetebrae, thoracolumbar fascia, iliac crest, last 3 ribs
Insertion: intertubercular sulcus of humerus

86
Q

What supplies latissimus dorsi?

A

Thoracodorsal nerve

87
Q

What is the function of latissimus dorsi?

A

Extends, adducts, and medially rotates humerus at shoulder

88
Q

What supplies latissimus dorsi?

A

Thoracodorsal artery, dorsal perforating branches of 9th, 10th, and 11th posterior intercostal, subcostal, and first three lumbar arteries

89
Q

What is the origin and insertion of subclavius?

A

Origin: upper border of 1st rib and its cartilage
Insertion: inferior surface of middle third of clavicle

90
Q

What innervates subclavius?

A

Nerve to subclavius

91
Q

What is the function of subclavius?

A

Anchors and depresses clavicle

92
Q

What supplies subclavius?

A

Clavicular branch of thoraco-acromial artery

SHB (36 decks)

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