Anato block II: Shoulder Flashcards
1
Q
segments of upper limb:
A
- Shoulder
- Arm
- Forearm
- Hand
2
Q
What does the shoulder connect to?
A
Connects the upper limb to the trunk
3
Q
What are the bones of the shoulder?
A
Scapula, clavicle, proximal end of the humerus
4
Q
What bones does the arm include?
A
humerus
5
Q
What bones does the fore arm include?
A
Ulna, radius
6
Q
What bones does the hand include?
A
Carpals, metacarpals, phalanges
7
Q
What is the major function of the upper limb?
A
position the hand in space for use as mechanical and sensory tool.
Designed to be flexible
8
Q
By what is the shoulder predominantly suspended to the trunk?
A
by muscles
9
Q
The bone framework of the shoulder consists of:
A
Clavicle
Scapula
[manubrium of sternum]
Proximal end of the humerus
10
Q
What bones form the pectoral girdle [shoulder girdle]
A
-Clavicle
-Scapula
-manubrium of sternum [completes anteriorly the shoulder girdle]
11
Q
Which is the only bone attached between the trunk and the upper limb?
A
Clavicle (s- shaped)
12
Q
Describe the acromial end of the clavicle
A
-lateral end
-flat
-articulates with acromion
13
Q
Describe the sternal end of the clavicle
A
-medial end
-robust and quadrangular or triangular
-articulates with the manubrium of sternum
14
Q
What is the cervico-axillary canal?
A
-passageway between the neck and arm
-clavicle forms part of it
15
Q
What are the three angles of the scapula?
A
lateral
superior
inferior
16
Q
What are the three borders of the scapula?
A
superior
lateral
medial
17
Q
What are the 2 surfaces of the scapula?
A
costal
posterior
18
Q
What are the three processes of the scapula?
A
Acromion
Spine
Coracoid process
19
Q
Which muscles participate in the elevation of the scapula?
A
Trapezius
Levator scapulae
Rhomboids
20
Q
Which muscles participate in the depression of the scapula?
A
Pectoralis major, inferior sternocostal head
Latissimus dorsi
Trapezius, ascending part
Serratus anterior
Pectoralis minor
21
Q
Which muscles participate in the protraction of the scapula?
A
Serratus anterior
pectoralis major
Pectoralis minor
22
Q
Which muscles participate in the retraction of the scapula?
A
Trapezius, middle part
Rhomboids
Latissimus dorsi
23
Q
Which muscles participate in the upward rotation of the scapula?
A
Trapezius, descending part
Trapezius, ascending part
Serratus anterior, inferior part
24
Q
Which muscles participate in the downward rotation of the scapula?
A
Levator scapulae
Rhomboids
Latissimus dorsi
Pectoralis minor
Pectoralis major, inferior sternocostal head
25
What nerve is affected if humeral inferior dislocation?
axillary nerve
26
identify
Postero-inferior humeral dislocation
27
identify
Anteroinferior humeral dislocation
28
How does humeral surgical neck fracture occur?
It normally occurs with the anterior and
posterior dislocation of the shoulder
(Humerus).
29
Which structures regarding irrigation and innervation, does surgical neck fractures affect?
axillary nerve and humeral circumflex arteries
30
What happens when the circumflex arteries are affected?
Avascular necrosis
31
The surgical neck of the humerus is in contact with what structures?
axillary nerve and circumflex axillary arteries
32
The radial groove of the humerus is in contact with what structures?
radial nerve
33
The distal end of humerus is in contact with what structures?
median nerve and humeral circumflex artery
34
The medial epicondyle of the humerus is in contact with what structures?
ulnar nerve
35
Fractures of the body of the humerus can damage which structure?
radial nerve
36
identify
fracture of body of humerus
37
Fractures in the medial supracondylar region can damage which structure?
ulnar nerve
38
identify
supracondylar facture
39
identify
40
What are the joints of the 3 bones of the shoulder?
Acromioclavicular joint
Sternoclavicular joint (medial)
Glenohumeral joint
41
Which is the "real" shoulder joint?
Glenohumeral joint (because is responsible of movement)
42
Where is the sternoclavicular joint located?
Occurs between the proximal end of the clavicle and the clavicular notch of the
sternum.
43
What structure gives stability to the sternoclavicular joint?
costoclavicular ligament, maintains cinturon pegado
44
Where is the costoclavicular ligament located?
between rib 1 and clavicle
45
What does the capsular ligament do?
covers the capsule, located in the external head of clavicle with sternum
46
What type of joint is the acromioclavicular joint?
small synovial joint between an oval facet on the medial surface of the acromion and a similar facet on the acromial end of
the clavicle
47
What gives stability to the acromioclavicular joint?
coracoclavicular and acromiocalvicular ligaments;
sustain the clavicle in its anatomical position
48
where do clavicle fractures happen?
Normally the clavicle fractures medial to the coracoclavicular ligament
49
identify
fracture fo clavicle
50
identify
Dislocation of the Acromeoclavicular Joint causes acromioclavicular separation
51
identify
Dislocation of acromioclavicular joint without ligament rupture
52
identify
Dislocation of acromioclavicular joint with rupture of coracoclavicular ligament
53
identify
Dislocation of the Acromeoclavicular Joint
54
What type of joint is glenohumeral joint?
Is a synovial ball and socket joint between the head of the humerus and the glenoid
cavity of the scapula
55
How much is the head of humerus in contact with glenoid cavity?
round 1/3;
This small contact is one of the things that permits free movement of the joint.
Because of this is also considered unstable.
56
What gives stability to the glenohumeral joint?
glenoid Labrum
57
by what id the glenoid cavity deepened and expanded peripherally?
fibrocartilaginous collar (the glenoid labrum) which attaches to the margin of the fossa and makes it deeper
58
What are the extrinsic muscles of the pectoral region?
1. Pectoralis major
2. pectoralis minor
3. Subclavius
59
Which are the anterior extrinsic muscles?
1. Pectoralis major
2. pectoralis minor
3. Subclavius
4. Serratus anterior
60
How many heads does the pectoralis major had and which are those?
1. Clavicular
2. Sternocostal
3. Abdominal
61
By what is the pectoralis major innervated?
lateral and medial pectoral nerves {most imp]
clavicular head: C5, C6
Sternocostal head: C7, C8, T1
62
What is the function of the pectoralis major?
-Adduction and medial rotation of the arm when acting together with other muscles
-individually:
clavicular head: flex humerus
sternocostal head: extend it back from flexed position
63
identify
64
What to do to test the clavicular head of pectoralis major?
– the arm is abducted 90°; the individual then moves the arm anteriorly against resistance.
– If acting normally, the clavicular head can be seen and palpated.
65
What to do to test the sternocostal head of pectoralis major?
– the arm is abducted 60° and then adducted against resistance.
– If acting normally, the sternocostal head can be seen and palpated.
66
What makes up most of the anterior wall of the axilla?
pectoralis major
67
What is the pectoralis minor attached to?
attached to the anterior ends of the 3rd–5th ribs near their costal cartilages
68
By what is the pectoralis minor innervated?
medial pectoral nerve
69
What is the function of the pectoralis minor
stabilizes the scapula by drawing it inferiorly and anteriorly against the thoracic wall
used when stretching the upper limb
forward to touch an object that is just
out of reach
70
What is the subclavius muscle?
Protects the subclavian vessels and brachial plexus
71
By what is the subclavius inneervated?
Nerve to the subclavius
72
What is the function of the subclavius?
Supports and maintain the sternal end of the clavicle in its place while we move the
shoulder.
73
Where does the serratus anterior lies?
Overlies the lateral part of the thorax and forms the medial wall of the axilla
74
What is the innervation of the serratus anterior?
long thoracic nerve
75
What is the function of the serratus anterior?
Protracts the scapula and hold it
against the thoracic wall
-the inferior part of the serratus anterior:
1.Anterior rotates the scapula, elevating its glenoid cavity so the arm can be raised above the shoulder
2. Participates in the abduction of the shoulder after 90 degrees
76
What are the posterior extrinsic muscles?
Trapezius
Latissimus dorsi
Rhomboid minor and major
Levator scapulae
77
What does the trapezius attaches?
Provides a direct attachment of the pectoral girdle to the trunk
78
What are the functions of the trapezius?
descending part:
-elevate the tip of the shoulder (scapula)
middle part:
-retract the scapula
Ascending part:
-depress the scapula and lower the shoulder
79
What si the innervation of the trapezius
Spinal accessory nerve
80
What does the serratus anterior with the trapezium do?
laterally rotate the scapula
81
Where does the latissimus dorsi pass and acts?
Fan-shaped muscle passes from the
trunk to the humerus and acts directly
on the glenohumeral joint and indirectly
on the pectoral girdle
82
What is the innervation of the latissimus dorsi?
Thoracodorsal nerve
83
Function of the latissimus dorsi
Extends, adducts and medially rotates the humerus
84
What is the attachment of the latissimus dorsi in humerus?
floor of intertubercular groove of humerus
85
What to do to test the latissimus dorsi?
* the arm is abducted 90°and then adducted against resistance provided by the examiner.
* If the muscle is normal, the anterior border of the muscle can be seen and easily palpated in the posterior axillary fold
[while applying resistance, ask the patient to extend and medially rotate the arm]
86
Explain the work of the latissimus dorsi and pectoralis major together
* These two muscles work together to produce adduction and depression of the shoulder.
* In conjunction with the pectoralis major, the latissimus dorsi raises the trunk to the arm
* These two actions allow us to bear the body's weight with the upper extremity
87
What is the innervation of the rhomboids?
Dorsal scapular nerve
88
What is the function of the rhomboids?
1. Retract scapula and rotates the glenoid cavity inferiorly.
2. Fix the scapula to the thoracic wall
3. assist the serratus anterior in holding the scapula against the thoracic wall and fixing the scapula during movements of the upper limb
89
What is the innervation and function of the levator scapulae?
-Dorsal scapular and cervical nerves (C3,C4)
-Elevates de scapula and rotates the glenoid cavity inferiorly
-In combination with the acts with the descending part of the trapezius to elevate the scapula or fix it
90
What is the attachment of the deltoid?
attaches the clavicle and the scapula to
the humerus. (intrinsic muscle of shoulder)
91
What are the heads of the deltoid?
* Clavicular (Anterior)
* Acromial (Middle)
* Spinal (Posterior)
92
WHta is the innervation of the deltoid?
axillary nerve
93
Principal function of the deltoid?
Major abductor of the arm 15°-90° (abducts the arm beyond the initial 15°done by supraspinatus)
94
What to do to test the deltoid?
To test the deltoid (or the function of the axillary nerve that supplies it), the
arm is abducted, starting from approximately 15°, against resistance
95
Why is the teres major important?
important stabilizer of the humeral head in the glenoid cavity [posterior intrinsic muscle of the shoulder]
96
What is the innervation of the teres major?
Lower subscapular nerve
97
What is the function of the teres major?
adducts and medially rotates the arm
98
What is the rotator cuff?
Posterior intrinsic muscles of shoulder
SITS (Supraspinatus, infraspinatus, teres minor: posterior. subscapularis: anterior)
Provide stability of the glenohumeral joint
99
Describe the subscapularis, its function and innervation
– forms part of the posterior wall of the axilla
– Its tendon forms the anterior part of the rotator cuff
– Function:
* Primary medial rotator of the shoulder
– Innervation:
* Upper and lower subscapular nerves
100
Function and innervation of the supraspinatus
– Function:
» Assist the deltoid in the initial 15°of abduction of the shoulder
– Innervation:
» Suprascapular nerve
101
Function and innervation of the infraspinatus
– Function:
» Lateral rotation of the humerus
– Innervation:
» Suprascapular nerve
102
Function and innervation of the teres major
– Function:
» works with the infraspinatus to rotate the arm laterally and assist in its adduction
– Innervation:
» Axillary nerve
103
