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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
What are the functions of the deltoid?
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
26
What are the rotator cuff muscles?
Supraspinatus, infraspinatus, teres minor, and subscapularis (SitS)
27
What is the origin and insertion of supraspinatus?
Origin: Supraspinous fossa of scapula and deep fascia Insertion: Superior facet of greater tubercle of humerus
28
What innervates supraspinatus?
Suprascapular nerve
29
What is the function of the supraspinatus?
Initiates arm abduction, acts with rotator cuff muscles
30
What supplies supraspinatus?
Suprascapular artery
31
True or false - supraspinatus rotates the humerus.
False
32
What is most frequently torn in rotator cuff injuries?
Supraspinatus
33
What is the origin and insertion of infraspinatus?
Origin: Infraspinous fossa of scapula and deep fascia Insertion: Middle facet of greater tubercle of humerus
34
What innervates infraspinatus?
Suprascapular nerve
35
What is the function of infraspinatus?
Lateral rotation of arm (with teres minor)
36
What supplies infraspinatus?
Suprascapular artery
37
What is the origin and insertion of teres minor?
Origin: Upper 2/3 of posterior surface of lateral border of scapula Insertion: Inferior facet of greater tubercle of humerus
38
What innervates teres minor?
Axillary nerve
39
What is the function of teres minor?
Laterally rotates arm
40
What supplies teres minor?
Circumflex scapular artery
41
What is the origin and insertion of subscapularis?
Origin: Subscapular fossa Insertion: Lesser tubercle of humerus
42
What innervates subscapularis?
Upper and lower subscapular nerves
43
What is the function of subscapularis?
Medially rotates arm at shoulder and adducts, helps hold humeral head in glenoid cavity
44
What supplies subscapularis?
Subscapular artery, lateral thoracic artery
45
Rotator cuff muscles fix the head of the humerus in the ___ and during abduction and flexion of the arm.
Glenoid cavity
46
What is the origin and insertion of teres major?
Origin: Posterior surface of inferior angle of scapula Insertion: Medial lip of intertubercular sulcus of humerus
47
What innervates teres major?
Lower subcapular nerve
48
What is the function of teres major?
Adducts and medially rotates arm
49
What supplies teres major?
Circumflex scapular artery
50
Where does the axillary artery begin?
At the lateral border of the first rib; direct continuation of the subclavian artery
51
What is the first part of the axillary artery and where is it located?
Superior thoracic artery; medial to the pectoralis minor muscle.
52
What are the second parts of the axillary artery and where is it located?
Thoracoacromial trunk and lateral thoracic arteries; under the pectoralis minor muscle
53
What are the third part of the axillary artery and where is it located?
Subscapular (circumflex scaupular and thoracodorsal), anterior and posterior circumflex humeral arteries; lateral to the pectoralis minor muscle
54
Where does the axillary artery end?
The lower border of the teres major muscle where it becomes the brachial artery
55
What are anastomoses?
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
What are the anastomotic branches around the shoulder?
1. Subclavian branches (thyrocervical trunk, dorsal scapular) 2. Axillary branches (thoracoacromial trunk, subscapular, humeral circumflex)
57
What are the four unique spaces in the posterior shoulder?
1. Suprascapular Notch 2. Quadrangular space 3. Triangular Space 4. Triangular Interval
58
Describe the suprascapular notch
Suprascapular nerve goes under the superior transverse scapular ligament. The suprascapular artery goes over the ligament (Army Over Navy)
59
Describe the quadrangular space
``` Superior: Teres minor Inferior: Teres major Medial: Long head of triceps Lateral: Humerus Includes the axillary nerve and the posterior circumflex humeral artery ```
60
Describe the triangular space.
Superior: teres minor Inferior: teres major Lateral: long head of triceps Includes the circumflex scapular artery
61
Describe the triangular interval.
Superior: teres major Medial: long head of triceps Lateral: lateral head of triceps Includes the profunda brachii artery and radial nerve
62
What does the dorsal scapular nerve innervate?
Levator scapulae and rhomboids
63
What does the suprascapular nerve innervate?
Supraspinatus and infraspinatus
64
What does the long thoracic nerve innervate?
Serratus anterior
65
What does the axillary nerve innervate?
Deltoid and teres minor
66
What does the upper subscapular artery innervate?
Subcapularis
67
What does the lower subscapular nerve innervate?
Subscapularis and teres major
68
What does the thoracodorsal nerve innervate?
Latissimus dorsi
69
What does the medial pectoral nerve innervate?
Pectoralis major and pectoralis minor
70
What does the lateral pectoral nerve innervate?
Pectoralis major
71
What is a pyramid-shaped space inferior to the glenohumeral joint and superior to the axillary fascia?
Axilla
72
What does the axilla do?
Serves as a protected passageway for the neurovascular structures (axillary artery, brachial plexus, axillary vein) from the neck to the upper limb
73
Describe the boundaries of the axilla.
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
Mammary glands are a modified and specialized type of __ gland.
Sweat
75
The breast extends transversely from the lateral border of the ___ to the midaxillary line.
Sternum
76
The breast also extends vertically from the ___ to ___ rib. A small part may extend toward the axilla. This is the axillary tail or the ___.
2nd; 6th; Tail of Sepnce
77
2/3 of the breast rests on ___. 1/3 of the breast rests on fascia covering the ___.
Deep pectoral fascia; serratus anterior
78
What makes up the bulk of the breast?
Tubuloalveolar glands and fat
79
15-20 glands each form a lobe. 1 ___/lobe and sinus
Lactiferous duct
80
What attach the lobes of the breast to skin and divide glandular tissues into lobes?
Suspensory ligaments (of Cooper)
81
What arteries supply the breast?
Internal thoracic artery, pectoral branch of thoracoacromial trunk, lateral thoracic artery
82
What are the major nodes that drain the breast towards the axilla?
Central, Lateral (humeral), Apical, Subscapular (posterior), Pectoral (anterior) CLASP
83
The highest frequency of breast cancer occurs in the ___ quadrant of the breast, which drains to the axillary nodes.
Superior-lateral
84
What supplies deltoid?
Posterior circumflex humeral artery, deltoid branch of thoraco-acromial artery
85
What is the origin and insertion of latissimus dorsi?
Origin: spinous processes of T7-L5 vetebrae, thoracolumbar fascia, iliac crest, last 3 ribs Insertion: intertubercular sulcus of humerus
86
What supplies latissimus dorsi?
Thoracodorsal nerve
87
What is the function of latissimus dorsi?
Extends, adducts, and medially rotates humerus at shoulder
88
What supplies latissimus dorsi?
Thoracodorsal artery, dorsal perforating branches of 9th, 10th, and 11th posterior intercostal, subcostal, and first three lumbar arteries
89
What is the origin and insertion of subclavius?
Origin: upper border of 1st rib and its cartilage Insertion: inferior surface of middle third of clavicle
90
What innervates subclavius?
Nerve to subclavius
91
What is the function of subclavius?
Anchors and depresses clavicle
92
What supplies subclavius?
Clavicular branch of thoraco-acromial artery

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