Anatomy of the shoulder Flashcards

1
Q
  1. which bones are involved in the movement of the shoulder [3]?
  2. movements of the shoulder include a combination of movements from which joints [4]?
A
  1. which bones are involved in the movement of the shoulder [3]?
    - clavicle
    - scapula
    - humerus
  2. movements of the shoulder include a combination of movements from which joints [4]?
    - sternoclavicular joint
    - acromiclavicular joint
    - glenohumeral joint
    - scapulothrocic joint
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2
Q

which of the following is the only articulation between upper limb and axial skeleton?

  • sternoclavicular joint
  • acromiclavicular joint
  • glenohumeral joint
  • scapulothrocic joint
A

ssternoclavicular joint

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3
Q

Sternoclavicular joint:

What is the type of joint? [1]
Which structure is present for shock absorption? [1]
Which type of movement does the joint permit? [1] ?

A

joint type: synovial, saddle joint

shock absoption: articular disc

movements: around 60 degrees when elevate scapula

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4
Q

is the sternoclavicular joint easy / hard to break? why [2]

A

is the sternoclavicular joint easy / hard to break? why [2]

  • hard to break [1]
  • ligaments arround sternoclavicular joint are extremely strong [1]

(is often alongside other fractures)

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5
Q

which structures would be affected by a posterior fractture to sternoclavicular joint? [5]

A
  • common carotid artery
  • vagus nerve
  • brachiocephalic vein
  • trachea
  • oesophagus

therefore v serious have posterior break !

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6
Q

what happens to your shoulder when your clavicle fractures? [1]

A

- shoulder will drop (bc wont act as a strut any more to keep shoulder in place)

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7
Q

If you break your clavicle, which structures act and cause different movements of the clavicle? [3]

What do u need to help bring bones back together to heal? [1]

A
  • Sternocleidomastoid muscle: pulls medial aspect of clavicle up
  • Pectoralis major muscle pulls arm and clavicle medially
  • Gravity will pull down
  • need an internal fixation
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8
Q

Acromioclavicular joint?

Which joint is present? [1]

What type of movement does this allow? [1]

which bones does this joint connection? [2]

A

what type of joint is the acromioclavicular joint? [2]

  • synovial [1]; plane joint [1]
  • gliding movement [1]

what is a connection between? [1]

  • acromonion of scapula
  • clavicle
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9
Q

what is a typical trauma mechanism on for breaking the acromioclavicular joint? [1]

A
  • force that depresses the pectoral girdle (e.g. falling off bike / contact sports)
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10
Q

label these xox

which of these labels are joining points for muscles? [3]

A

which of these labels are joining points for muscles? [3]

  • coracoid process
  • supraspinous fossa
  • infraspinous fossa
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11
Q

glenohumeral joint:

What is the type of joint? [2}

Which movements does this joint permit? [5]

A

Joint:
- synovial [1]; ball & socket [1]

Movements:
- flexion-extension
- abduction
- adduction
- rotation
- circumduction

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12
Q

what are two prominent structures / features of the the glenohumeral joint? [2]

Why is this clinically significant [1]

A

what are two prominent features of the glenohumeral joint? ​

glenoid cavity accomodates approx/ 1/3 of the humeral head: means that should can have wider range of movement

inferior joint capusule is lax. allows elevate above head. but means is much weaker than superior portion

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13
Q

what is most common type of dislocation of the glenohumeral joint? [1]

What type of movements cause ^ [3}

A

what is most common type of dislocation of the glenohumeral joint? [1]
- anterior dislocation

what type of movements cause ^ [3}

  • abduction
  • external rotation
  • external extension
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14
Q

which nerve can be effected glenohumeral dislocation? [1]

which muscle does this nerve particularly effect if damaged? [1]

A

axillary nerve

deltoid muscle

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15
Q

Which structures deepen the shallow glenoid fossa? [2]

A

what is the shallow glenoid fossa deepened by? [2]

  • glenoid labrum (fibrocart. ring that surrounds articular surface). helps deepen the socket and support the joint
  • long head of the biceps - attaches to superior aspect of labrum
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16
Q

whats a SLAP tear?

A

SLAP tear: when superior aspect of labrum pulls away from glenoid fossa

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17
Q

Scapulotharacic joint

What is the type of joint [1]?

Which movements does this joint allow? [3]

A

not a true joint articulation between scapula and thoracic wall

movements:
- elevation & depression
- protraction & retraction
- rotation - important in abduction

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18
Q

what is the scapula-humeral rthym?

A

First 30 degrees of shoulder elevation involves a “setting phase”:

  • the movement is largely glenohumeral.
  • scapulothoracic movement is small and inconsistent.

And after the first 30 degrees of shoulder elevation:

  • The glenohumeral and scapulothoracic joints move simultaneously.
  • Overall 2:1 ratio of glenohumeral to scapulothoracic movement.

(e.g. when the arm is abducted 180 degrees, 60 degrees by rotation of the scapula & 120 degrees occurs by rotation of the humerus at the glenohumeral joint)

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19
Q
A
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20
Q

which part of the humerus is most likely to break? [1]

A

surgical head !

21
Q

label A-E

A

A: acromioclavicular joint
B: corocoid process
C: clavicle
D: acromion
E: glenoid fossa

22
Q

trapezius - where found?

where does it run? [3]

what are the three different fibre parts? [3] what movements do they cause [3]

A

trapezius

runs from occipital bone to bottom of thoracic vertebral. attaches to spine of scapula and clavicle

three parts​

  • descending fibres / suprior fibres = elevate (shrug shoulders)
  • middle fibres = retract scapula
  • ascending / inferior fibres = depress scapula
23
Q

which nerve is the trapezuius innervated by? [1]

why is this special?

A
accessry nerve (CNXI) 
special bc all other muscles are innervated from brachial plexus
24
Q

latissimus dorsi

Movements of the latissimus dorsi? [3]

A

runs from lower thoracic vertebra onto the lumbar vertebra & iliac crest. runs from iliac crest to anterior aspect of the humerus

movements:
- extend, adduct and medially rotate the shoulder

25
Q

teres major

Movements of the teres major? [3]

A

runs from:
- inferior angle of scapula to anterior aspect of humerus

movements:
- extend, adduct and medially rotate the shoulder

26
Q

where do the the rhomboids and levator scapulae run from?

which movements do they cause?

A

rhomboids
medial aspect of scapula to upper thoracic vertebra. muscle fibres cause retraction of scapula

  • *levator scapulae:**
  • neck to superior aspect of scapular
  • elevates scapula
27
Q

Serratus anterior

Where is the serratus anterior found? [1]

What movement does the serratus anterior permit? [1]

Which nerve supplies the serratus anterior? [1]

A

originates from medial border of the scapula, wraps around thorax to insert on the ribs

Movement:
* protraction of scapula when throwing a punch boxers muscle

Nerve:
long thoracic nerve

28
Q

Why is the long thoracic nerve easy to damage? [1]

A

Runs anterior to the muscle [1]

29
Q

pectoralis major and minor:

where do they run?

movements?

innervation?

A

pectoralis major:

most superficial: runs from humerus to medial aspect of clavicle, sternum and ribs
two heads: clavicular head & sternocostal head
movment: adduct, flex and medial rotates the shoulder (hugging muscle!)

  • *pectoralis minor:**
  • corocoid process to upper ribs
  • not much movement - stabilises the stable joint

both innervated by pectoral nerves

30
Q

fyi pec major

A
31
Q

deltoid muscle

What are the three heads of the deltoid muscle? [3]

What movements do each head permit? [3]

Which nerve innervates the deltoid muscle? [1]

A

Heads:
* anterior : flexion of arm
* posterior: extension of arm
* middle abduction of arm: major one

Innervation
* axillary nerve

32
Q

Rotator cuff musles

What are names of the different rotator cuff muscles [4]

What rotator cuff muscles are located posterioly? [3]

Which rotator cuff is found anteriorly? [1]

A
  • surround the glenohumeral joint and stabilise the joint
  • deep !

Posterior:
* supraspinatus muscle: superior to scapula spine
* infraspinatus muscle: inferior to scapula spine
* teres minor: inferior to infraspinatus

Anterior:
subscapualris muscle

33
Q

What are the movements that each of the following permit?

supraspinatus muscle [1]
infraspinatus muscle [1]
teres minor [1]
subscapularis muscle [1]

A

Supraspinatus muscle: first 10 degrees of abduction

Infraspinatus muscle: external rotation

Teres minor: external rotation

Subscapularis muscle: internal rotation

34
Q

rotator cuff muscles:

which muscles attach to greater tubercle?
which muscles attach to lesser tubercle?

A
  • *greater tubercle:**
  • teres minor
  • supraspinatus muscle
  • ​infraspinatus muscle:
  • *lesser tubercle**
  • subscapularis
35
Q

Which muscle initates the first 10 degrees of abduction? [1]

A

supraspinatus

36
Q

what does rotator cuff tear occur from ?

what can it cause?

A

tearing of the supraspinatous tendon - causes the los of initial 10 degrees od abduction

37
Q

muscles of the arm:

anterior compartment is innervated by?
posterior compartment is innervated by?

A

muscles of the arm:

anterior compartment is innervated by musculocutaneous nerve = flexion
posterior compartment is innervated by radial nerve = extension

38
Q

what are the three muscles found in anterior compartment of upper arm? what do they do?where do they run to?

A

biceps brachii - two heads:
i) one from corocoid process, distally to elbow (short head)
ii) superior border of glenoid fossa, superiorly to elbow
flex shoulder

  • *coracobrachialis**: corocoid process to humerus
  • flex shoulder

brachialis: mid shaft of humerus to elbow

39
Q

which is the main muscle of posterior compartment of upper arm?

  • what movement does it cause to shoulder?
  • what are the three different heads?
A

posteior compartment extends the shoulder

triceps brachii:

three heads:

  • *-medial head & lateral head:** humerus to elbow (olecranon process)
  • *-long head**: inferior head of glenoid fossa - olecranon. this is the main one that causes extension of should
40
Q
A
41
Q

Which of the following is the glenoid labrum?

A
B
C
D
E

A

Which of the following is the glenoid labrum?

A
B
C
D
E

42
Q

Which of the following is the acromion?

A
B
C
D
E

A

Which of the following is the acromion?

A
B
C
D
E

43
Q

Which of the following is the scapula?

A
B
C
D
E

A

Which of the following is the scapula?

A
B
C
D
E

44
Q

Which of the following is the supraspinatus muscle?

A
B
C
D
E

A

Which of the following is the supraspinatus muscle?

A
B
C
D
E

45
Q

Which of the following is the glenoid labrum

A
B
C
D
E

A

Which of the following is the glenoid labrum

A
B
C
D
E

46
Q

Which of the following is the glenoid cavity

A
B
C
D
E

A

Which of the following is the glenoid cavity

A
B
C
D
E

47
Q

What is muscle D? [1]

What is bone E? [1]

A

D: supraspinatus

E: Acromion

48
Q

Which of the following is the articular capsule

A
B
C
D
E

A

Which of the following is the articular capsule

A
B
C
D
E

49
Q

Which of the following is the articular capsule

A
B
C
D
E

A

Which of the following is the articular capsule

A
B
C
D
E