Anatomy Of Shoulder and Brachial Plexus Flashcards

1
Q

What is the functional consideration of the upper limb and how does this affect the bone structure?

A
  • Mobility and ability to perform fine motor skills and grasp.
  • Weight bearing is not a consideration
  • Allows bones to be lighter and less robust
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2
Q

What 4 regions can the upper limb be separated into?

A
  • Shoulder
  • Arm
  • Forearm
  • Hand
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3
Q

What does the emphasis on mobility of the UL compromise and how?

A
  • Stability compromised

- Limited fixation to axial skeleton

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4
Q

How is the UL fixated to the axial skeleton?

A
  • Ant. = sternoclavicular joint

- Post = muscles to vertebral column

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5
Q

What does the clavicle connect?

A

-Upper limb to trunk

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6
Q

What do the sternal and acromial ends of the clavicle articulate with?

A
  • Sternal: with manubrium at the sternoclavicular joint (SC)

- Acromial: with the acromion of the scapula at the acromioclavicular joint (AC).

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7
Q

What are the shapes of the parts of the clavicle?

A
  • Medial 2/3rds concave ant.

- Lateral 1/3rd flattened and concave ant.

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8
Q

What function can the clavicle act out?

A

Acts as a strut

Can transmit weight

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9
Q

What is the internal structure of the clavicle?

A

No medullary cavity, trabecular with a shell of compact bone.

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10
Q

What shape is the scapula?

A

Large flat triangular bone

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11
Q

Where around would you find the scapula in terms of ribs?

A

Overlaps ribs 2-7

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12
Q

Name the different parts of the scapula?

A
  • Acromion
  • Coracoid
  • Glenoid
  • Medial border
  • Spine
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13
Q

What is the spine of the scapula?

A

Sharp ridge, divides bone into supraspinous and infraspinous fossa.

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14
Q

What and where are the acromion processes of scapula?

A

Are lateral and high point

Articulate with clavicle

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15
Q

What and where is the glenoid cavity of scapula?

A

Lateral, inferior to acromion

Articulates with humerus

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16
Q

What and where are the coracoid processes of scapula?

A
  • Lateral and anterior

- Muscles attatch here

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17
Q

What is the medial border of the spine?

A

Place for attatchment of muscles

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18
Q

What joins the scapula with the axial skeleton?

A

No joint

So held in place by muscles

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19
Q

What muscles hold the scapula in place?

A
  • Trapezius
  • Rhomboids
  • Levator scapulae
  • Serratus anterior
  • Pectoralis minor
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20
Q

What movments may the muscles surrounding the scapula generate?

A
  • Protraction/retraction
  • Lat rotation/ med rotation
  • Elevation/ depression
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21
Q

What are the joints of the pectoral girdle?

A
  • Sternoclavicular

- Acromioclavicular

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22
Q

What type of joint is the sternoclavicular joint?

A

Synovial, acts as ball and socket joint

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23
Q

What makes up the sternoclavicular joint?

A

-Notch of manubrium and medial clavicle

24
Q

What strengthens the SC joint to prevent dislocation, name and explain what they do/where they are?

A

Ligaments
Sternoclavicular ligament = capsule thicked ant. and post.
Interclavicular ligament = at med. end of clavicle
Costoclavicular ligament = from 1st rib to clavicle

25
Q

What type of joint is the AC joint?

A

Gliding, synovial

26
Q

Where is the AC joint?

A

Lateral clavicle -acromion

27
Q

What ligaments strengthen the AC joint?

A
  • Coracoclavicular
  • Acromioclavicular
  • Coracoacromial
28
Q

What is the shoulder joint?

A

Glenohumeral joint

29
Q

What does the glenohumeral joint join?

A

Head of humerus and glenoid cavity of scapula.

30
Q

What type of joint is the glenohumeral joint?

A

Synovial, multiaxial ball and socket

31
Q

Why does the shoulder joint have limited stability and what can help provide this?

A
  • Poor bony fit, loose capsule and ligaments.

- Stability can be provided by rotator cuff muscles

32
Q

What is the axilla and what does it do and how?

A

Is a pyrmaidal space that helps communicate between UL and neck.
It does this through, BP, lymph nodes and axillary vessels.

33
Q

What are the landmarks of the axilla and how and where do they appear?

A
  • Apex; passageway between neck and axilla, points up and medially
  • Floor; upward arching skin sheet
  • Ant. wall; pectoral muscles
  • Post. wall; subscapularis, teres major and lat. dorsi
  • Med. wall; chest wall and serratus ant.
  • Lat. wall; humerus and muscles
34
Q

What is the brachial plexus?

A

A major network of nerves supplying upper limb.

35
Q

What nerves make up the brachial plexus?

A

-Ventral Rami of C5-T1 spinal nerve roots.

Minor contribution from C4 and T2.

36
Q

What does the brachial plexus do?

A

Provides sensory, motor and sympathetic nerve supply to pectoral girdle and upper limb (except trapezius).

37
Q

Where does the brachial plexus extend?

A

-Extends inferiorly and laterally through neck/axilla into arm.

38
Q

Why does the brachial plexus have a complex re-routing system?

A

-Provides a back up mechanism

39
Q

Describe the organisation of the brachial plexus?

A
  • Roots (5)
  • Trunks (3)
  • Divisions (6)
  • Cords (3)
  • Branches
40
Q

What are the 5 BP roots, where do they emerge and then unite to form?

A
  • Ventral rami of C5-T1
  • Emerge between scalene anterior and medial muscles.
  • Unite to form 3 trunks
41
Q

How can the 3 trunks of BP be named, where are they located and what do they divide into?

A
  • Upper - C5 + C6
  • Middle C7
  • Lower C8 + T1
  • Located in neck, each trunk divides into divisions.
42
Q

How can the divisions of the BP be categorised and what areas do they supply, what do they then form and how?

A
  • Can be anterior or posterior
  • Anterior = supply flexor muscles and skin of front of UL.
  • Posterior supply the extensors and skin on back of UL.
  • Pass deep to middle 1/3 clavicle into apex of axilla and regroup to form cords.
43
Q

What are the cords of the BP, how are they named, and what makes each of them up?

A
  • Names according to position to axillary artery.
  • Lat. cord= ant. divisions of sup. and middle trunks
  • Med. Cord= ant. division of inf. trunk
  • Post. cord= uniting post. divisions of all 3 trunks.
44
Q

What are the terminal branches coming from each of the Cords of the BP?

A
  • Lat cord = musculocutaneous, median
  • Med. cord = median, ulnar
  • Post cord = radial, axillary
45
Q

What are the other main supraclavicular branches of the BP?

A
  • Dorsal scapular
  • Long thoracic
  • Suprascapular
46
Q

What are the other main infraclavicular branches of BP?

A
  • Medial and lateral pectoral
  • Upper and lower subscapular
  • Thoracodorsal
47
Q

What may happen as a result of injury to BP?

A
  • Affect movement and sensory.

- Paralysis and anaesthesia

48
Q

What may cause injury to BP?

A
  • Disease
  • Stretching
  • Compression damage
49
Q

Describe crutch palsy and potential effects?

A
  • After prolonged use of crutches

- Commonly affects radial nerve

50
Q

What may happen as a result of radial nerve damage and what may be another cause of it?

A
  • Drop wrist
  • cant extend hand
  • May be caused by intramuscular deltoid injections
51
Q

What happens in carpal tunnel syndrome?

A
  • Median nerve damage

- Numbness, tingling and pain in palm and fingers.

52
Q

What parts can the humerus be put into (shoulder part)?

A
  • Head
  • Neck
  • Greater tubercule
  • Deltoid tuberosity
  • Lesser tubercule
  • Intertubercule groove
53
Q

What parts can humerus be put into (elbow part)?

A
  • Areas that articulate with forearm :
  • Laterally, radius joins with capitolum
  • Medially, ulna joins with trochlea
  • Med and lateral epicondyles are sites for muscle attatchment
54
Q

What do the rotator cuff muscles do and what are they?

A
  • Join scapula to humerus
  • Teres minor
  • Infraspinatus
  • Supraspinatus
  • Subscapularis
55
Q

What do muscles lying closer to shoulder do and name them?

A
  • Smaller mechanical effect
  • Stabilise joints
  • Act as ligaments
  • Long head biceps
  • Triceps brachi
  • Rotator cuff
56
Q

What do muscles attatching a distance from the shoulder do and name them?

A
  • Have considerable mechanical effect
  • Deltoid
  • Teres major
  • Short head biceps brachi