Anatomy of the Shoulder and Arm Flashcards
What 2 bones make up the shoulder/pectoral girdle?
1 - clavicle
2 - scapula
The shoulder/pectoral girdle is composed of the clavicle and scapula. In addition to the glenohumeral joint there are 3 other joints that move as a unit. Label them on the image below using the labels below:
- acromioclavicular
- sternoclavicular
- scapulothoracic
1 - sternoclavicular joint
2 - scapulothoracic joint
3 - acromioclavicular joint
What bones form the glenohumeral joint?
- head of humerus and glenoid fossa of scapula
The glenohumeral joint is composed of the head of humerus and glenoid fossa of scapula. What are the 4 main movements possible here?
1 - flexion/extension
2 - adduction/abduction
3 - lateral/medial rotation
4 - circumduction
Which muscle of the shoulder performed shoulder abduction?
- medial deltoid muscle
The medial deltoid muscle performs abduction at the shoulder. What are the origin and insertion of the deltoid muscle?
- origin is site that doesn’t really move
- insertion is site that moves
- origin = spine of scapula + acromion + clavicle
- insert = deltoid tuberosity
What movements does the posterior deltoid muscle perform?
- extension and lateral rotation
What movements does the anterior deltoid muscle perform?
- flexion and medial rotation
What is the main nerve supplying the anterior deltoid muscles?
- axillary nerve
What are the 2 key muscles that facilitate adduction of the shoulder?
1 - latissimus dorsi
2 - pectoralis major
Label the key muscles involved in flexion of the arm below using the labels:
anterior deltoid coracobrachialis short head of biceps long head of biceps brachialis
1 - short head of biceps 2 - long head of biceps 3 - brachialis 4 - coracobrachialis 5 - anterior deltoid
Label the key muscles involved in extension of the arm below using the labels, that are in addition to the posterior deltoid and latissimus dorsi:
long head of triceps
lateral head of triceps
medial head of triceps
1 - long head of triceps
2 - lateral head of triceps
3 - medial head of triceps
The nmemonic Lady between 2 Majors is used to identify the 3 muscles that insert at the intertubercular groove (bicipital groove) of the humerus, flanked on either side by the crest of the lesser (medially) and greater (laterally) tubercles. What are the 3 muscles that attach here?
- Major 1 = Teres Major (crest of lesser tubercle)
- Lady = latissimus dorsi
- Major 2 = Pectoralis Major (crest of greater tubercle)
There are 3 important muscular spaces of the shoulder. Using your fingers is an easy way to remember how this is organised. Using the labels below, label the 3 spaces and the important structures that make these spaces:
- long head of triceps
- humeral shaft
- teres minor
- teres major
- upper triangular space
- upper triangular space
- quadrangular space
1 - teres minor 2 - teres major 3 - upper triangular space 4 - long head of triceps 5 - quadrangular space 6 - humeral shaft 7 - lower triangular space
Where does the long head of the triceps originate from?
- infraglenoid tubercle
What is the most commonly dislocated joint in the body?
- glenohumeral joint
- most commonly anteriorly
Rotation of the scapula allows increased range of movement at the shoulder joint. Using the 3 muscles below, label the muscles involved in shoulder abduction:
Lower fibres trapezius
Serratus anterior
Upper fibres trapezius
1 = Upper fibres trapezius 2 = Lower fibres trapezius 3 = Serratus anterior
Rotation of the scapula allows increased range of movement at the shoulder joint. Using the 2 muscles below, label the muscles involved in shoulder adduction:
Rhomboids
Levator scapulae
1 = Levator scapulae 2 = Rhomboids
What tissue within the glenoid fossa is important for trying to deepen the glenoid fossa, and in doing so add stability to the glenohumeral joint, labelled with a question mark in the image below?
- glenoid labrum
- hyaline cartilage
What extrinsic ligament aims to prevent superior dislocation that is part of the arch formed between the acromion and coracoid processes called the coracoacromial arch?
1 - trapezoid ligament
2 - conoid ligament
3 - coracoacromial ligament
4 - superior glenohumeral ligament
3 - coracoacromial ligament
There are 3 intrinsic ligaments that form the joint capsule of the glenouhumeral joint. These 3 ligaments lie within the glenohumeral joint and sit between the glenoid fossa of the scapula and the head of the humerus in an attempt to add stability to the glenohumeral joint anteriorly. What are these 3 ligaments called?
Use the mnemonic Sell More Insects.
- Sell = superior glenohumeral ligaments
- More = middle glenohumeral ligaments
- Insects = inferior glenohumeral ligaments
Which ligament connects the coracoid process of the scapula and the clavicle supporting the shoulder joint?
- coracoclavicular ligament
The coracoclavicular ligament connects the coracoid process of the scapula and the clavicle supporting the shoulder joint. There are 2 ligaments together that make up the coracoclavicular ligament. Use the labels below to label the image:
- trapeziod ligament
- conoid ligament
1 = conoid ligament (coracoid process of the scapula to conoid tubercle of the clavicle) 2 = trapeziod ligament (coracoid process of the scapula to trapezoid line of the clavicle)
In addition to ligaments, muscles also support shoulder stability. The long head of which 2 muscles supports the glenohumeral joint?
- biceps = supraglenoid tubercle
- triceps = infraglenoid tubercle
In addition to ligaments, muscles also support shoulder stability. The long head of bicep and tricep muscles supports the glenohumeral joint. Where does the long head of the biceps originate from?
- supraglenoid tubercle of the scapula
- passes through the joint capsule
In addition to ligaments, muscles also support shoulder stability. The long head of bicep and tricep muscles supports the glenohumeral joint. Where does the long head of the tricpes originate from?
- infraglenoid tubercle of the scapula
In addition to ligaments, muscles also support shoulder stability. The long head of bicep and tricep muscles supports the glenohumeral joint. The long head of the biceps originates from supraglenoid tubercle of the scapula. What ligament helps by holding the long head of the biceps in its position in the bicepital groove of the humerus?
1 - conoid ligament
2 - trapezoid ligament
3 - coracoacromial ligament
4 - transverse humeral ligament
4 - transverse humeral ligament
There are 4 muscles that surround the glenohumeral joint (except inferiorly), forming a cuff with their tendons and in doing so fusing with the joint capsule. Use the labels below to label these muscles:
Supraspinatus
Subscapularis
Infraspinatus
Teres Minor
1 - Supraspinatus
2 - Infraspinatus
3 - Teres Minor
4 - Subscapularis
Is the subscapularis on the anterior or posterior aspect of the scapula, and where does the subscapularis originate and insert?
- lies on anterior surface of the scapula
- origin = subscapula fossa of scapula
- insertion = lesser tubercle of the humerus
The subscapularis is located on the anterior aspect of the scapula, originating form the subscapula fossa of scapula and inserts on the lesser tuberosity of the humerus. What movement does this muscle assist with at the shoulder?
1 - lateral/medial rotation
2 - medial/internal rotation
3 - abduction
4 - adduction
1 - lateral/medial rotation (some adduction)
- humeral head rotates inwards (put hand behind back to test)
There are 2 fluid filled sacs called bursae in glenohumeral joint that helps cushion and glide surfaces to reduce friction between tissues of the body. Label the 2 bursae of the shoulder using the labels below:
subacromial bursae
subscapular bursae
1 = subacromial bursae 2 = subscapular bursae
There are 3 of the rotator cuff muscles that insert onto the greater tubercle of the humerus. The mnemonic SIT can be used to identify which muscles insert here. What are they?
- S = supraspinatus (supra = superior so at the top)
- I = infraspinatus (infra = inferior to supra)
- T = teres minor
The supraspinatus and infraspinatus insert onto the greater tubercle of the humerus. Where do these muscles originate, keeping in mind their names should help?
- supraspinatus = supraspinous fossa
- infraspinatus = infraspinous fossa
The teres minor and infraspinatus perform the same movement, what is this?
- lateral/external rotation
What movement does the supraspinatus perform at the shoulder?
- initiates abduction
Where does the teres minor originate from?
1 - superior angle of scapula
2 - lateral border of the scapula
3 - medial border
4 - inferior angle of scapula
3 - lateral border of the scapula
The teres major, located below the teres minor is often included in the rotator cuff muscles. What are the origin and insertion of this muscle?
- origin = inferior angle of the scapula
- insertion = crest of lesser tubercle
The teres major, located below the teres minor is often included in the rotator cuff muscles. It originates at the inferior angle of the scapula and inserts at the medial lip of bicipital groove. What 2 actions is this muscle involved in at the shoulder?
- adduction
- internal/medial rotation
The axilla is the name given to an area that lies underneath the glenohumeral joint, at the junction of the upper limb and the thorax, essentially the arm pit. It is a passageway by which neurovascular and muscular structures can enter and leave the upper limb and should be viewed as a 3D object with a lateral, medial, posterior and anterior border. What muscles make up the anterior border?
- pectoralis major and minor
The axilla is the name given to an area that lies underneath the glenohumeral joint, at the junction of the upper limb and the thorax, essentially the arm pit. It is a passageway by which neurovascular and muscular structures can enter and leave the upper limb and should be viewed as a 3D object with a lateral, medial, posterior and anterior border. What 3 muscles make up the posterior border?
1 - teres minor, teres major, subscapularis
2 - latissimus dorsi, teres minor, subscapularis
3 - latissimus dorsi, teres major, infraspinatus
4 - latissimus dorsi, teres major, subscapularis
4 - latissimus dorsi, teres major, subscapularis
The axilla is the name given to an area that lies underneath the glenohumeral joint, at the junction of the upper limb and the thorax, essentially the arm pit. It is a passageway by which neurovascular and muscular structures can enter and leave the upper limb and should be viewed as a 3D object with a lateral, medial, posterior and anterior border. What muscle and bony part of the chest make up the medial border?
1 - serratus anterior and thoracic wall
2 - pectoralis minor and thoracic wall
3 - serratus posterior and thoracic wall
4 - serratus anterior and subscapularis
1 - serratus anterior and thoracic wall
The axilla is the name given to an area that lies underneath the glenohumeral joint, at the junction of the upper limb and the thorax, essentially the arm pit. It is a passageway by which neurovascular and muscular structures can enter and leave the upper limb and should be viewed as a 3D object with a lateral, medial, posterior and anterior border. What bone and landmark on the bone make up the lateral border?
1 - humerus and greater tubercle
2 - humerus and bicipital groove
3 - humerus and lesser tubercle
4 - humerus and humeral head
2 - humerus and bicipital groove
The axilla is the name given to an area that lies underneath the glenohumeral joint, at the junction of the upper limb and the thorax, essentially the arm pit. It is a passageway by which neurovascular and muscular structures can enter and leave the upper limb and should be viewed as a 3D object with a lateral, medial, posterior and anterior border. Which part of the axilla do nerves, lymphatics and blood vessels enter the axilla?
- apex
Bony landmarks that make up the apex, also known as the axillary inlet of the axilla including a lateral, superior and posterior border. What bones make up these apex of the axilla?
1 - 2nd and 3rd rib, scapula and clavicle
2 - first rib, scapula and clavicle
3 - first rib, glenoid joint and clavicle
4 - first rib, coronoid process and clavicle
2 - first rib, scapula and clavicle
- lateral border = first rib
- superior border = scapula
- posterior border = clavicle
What 2 key blood vessels that pass through the axilla?
1 - axillary artery and vein
2 - subclavian artery and vein
3 - brachiocephalic artery and vein
4 - brachial artery and vein
1 - axillary artery and vein
The mnemonic MARMU can be used to identify the 5 key terminal branches of the brachial plexus that pass through the axilla. What does MARMU stand for?
- M = musculocutanoeus nerve
- A = axillary nerve
- R = radial nerve
- M = median nerve
- U = ulnar nerve
There are 3 key arteries that supply the scapular and form a scapula anastomosis. Label them in the image below and where they originate from:
suprascapular artery = subclavian artery
subscapular artery = axillary artery
dorsal scapular artery = subclavian artery
1 = dorsal scapular artery = subclavian artery 2 = suprascapular artery = subclavian artery 3 = subscapular artery = axillary artery
Anastomosis are connection of blood vessels in the body to transport blood effectively around the body. Why are they important in the body, specifically in the shoulder?
- creates a backup pathway for blood flow if a blood vessel becomes blocked
- if shoulder is dislocated or blocked the scapula anatomises ensures blood flow continues
There are 3 main muscles located anteriorly on the upper arm involved in flexion of the arm, using the labels below, label the image:
Biceps brachii
Brachialis
Coracobrachialis
1 = Coracobrachialis 2 = Biceps brachii 3 = Brachialis
There is 1 main muscle located posteriorly on the upper arm involved in extension of the arm, what is this muscle called?
- triceps brachii
MAMRU is the mnemonic that is used to remember the terminal brachial plexus branches, which stands for:
- M = musculocutaneous
- A = axillary
- M = median
- R = radial
- U = ulnar
What nerve root supplies the musculocutaneous nerve?
- C5 to C7
MAMRU is the mnemonic that is used to remember the terminal brachial plexus branches, which stands for:
- M = musculocutaneous
- A = axillary
- M = median
- R = radial
- U = ulnar
What nerve root supplies the axially nerve?
- C5 and C6
MAMRU is the mnemonic that is used to remember the terminal brachial plexus branches, which stands for:
- M = musculocutaneous
- A = axillary
- M = median
- R = radial
- U = ulnar
What nerve root supplies the median nerve?
- C5 to C8 and T1
MAMRU is the mnemonic that is used to remember the terminal brachial plexus branches, which stands for:
- M = musculocutaneous
- A = axillary
- M = median
- R = radial
- U = ulnar
What nerve root supplies the radial nerve?
- C5 to C8 and T1
MAMRU is the mnemonic that is used to remember the terminal brachial plexus branches, which stands for:
- M = musculocutaneous
- A = axillary
- M = median
- R = radial
- U = ulnar
What nerve root supplies the ulnar nerve?
- C7, C8 and T1
Number your fingers as in the picture below including the 5 nerve rami from C5-C8 and T1. The remember the following saying:
3 Musketeers 2 were Assassinated 5 Men 5 Rats 2 Unicorns
Using this saying and our fingers we can then remember the terminal branches of the brachial plexus and the nerve rami that supply them. So what does the 3 musketeers relate to?
- 3 = 3 nerve rami = C5, C6 and C7
- Musketeers = Musculocutaneous nerve
Number your fingers as in the picture below including the 5 nerve rami from C5-C8 and T1. The remember the following saying:
3 Musketeers 2 were Assassinated 5 Men 5 Rats 2 Unicorns
Using this saying and our fingers we can then remember the terminal branches of the brachial plexus and the nerve rami that supply them. So what does the 2 were Assassinated relate to?
- 2 = 2 rami - C5 and C6
- Assassinated = Axillary Nerve (and fingers look like a gun)
Number your fingers as in the picture below including the 5 nerve rami from C5-C8 and T1. The remember the following saying:
3 Musketeers 2 were Assassinated 5 Men 5 Rats 2 Unicorns
Using this saying and our fingers we can then remember the terminal branches of the brachial plexus and the nerve rami that supply them. So what does the 4 Men relate to?
- 4 = 5 rami - C5, C6, C7, C8 and T1 using the 5 fingers
- Men = Median Nerve
Number your fingers as in the picture below including the 5 nerve rami from C5-C8 and T1. The remember the following saying:
3 Musketeers 2 were Assassinated 5 MEn 5 RAts 2 UNicorns
Using this saying and our fingers we can then remember the terminal branches of the brachial plexus and the nerve rami that supply them. So what does the 5 RAts relate to?
- 5 = 5 rami - C5-C8 and T1
- RAts = RAdial Nerve
Number your fingers as in the picture below including the 5 nerve rami from C5-C8 and T1. The remember the following saying:
3 Musketeers 2 were Assassinated 5 MEn 5 RAts 2 Unicorns
Using this saying and our fingers we can then remember the terminal branches of the brachial plexus and the nerve rami that supply them. So what does the 2 UNicorns relate to?
- 2 = 2 rami -
- UNicorns = Ulnar Nerve
The quadrangular space is an anatomical space that allows neovascular structures to pass through. What are the 4 borders of this space?
1 - humerus, teres minor, teres major, long head of triceps brachii
2 - femur, teres minor, teres major, long head of triceps brachii
3 - humerus, teres minor, teres major, long head of biceps brachii
4 - humerus, subscapularis, teres major, long head of triceps brachii
1 - humerus, teres minor, teres major, long head of triceps brachii
The quadrangular space is an anatomical space that allows neovascular structures to pass through, which has 4 borders, the humerus (lateral), teres minor (superior), teres major (inferior), long head of triceps brachii (medial). What nerve and blood vessels runs through this space?
1 - median nerve and posterior circumflex humeral artery/vein
2 - axillary nerve and posterior circumflex humeral artery/vein
3 - radial nerve and posterior circumflex humeral artery/vein
4 - ulnar nerve and posterior circumflex humeral artery/vein
2 - axillary nerve and posterior circumflex humeral artery/vein
The quadrangular space is an anatomical space that allows neovascular structures to pass through, which has 4 borders, the humerus (lateral), teres minor (superior), teres major (inferior), long head of triceps brachii (medial). This space allows the axillary nerve and posterior circumflex humeral artery/vein to pass through. What fracture could damage these structures?
1 - fractured clavicle
2 - fractured surgical neck of humerus
3 - fractured anatomical neck of humerus
4 - fractured humeral shaft
2 - fractured surgical neck of humerus
The triangular space is medial to the quadrangular space. It an anatomical space that allows neovascular structures to pass through. What are the 3 borders of this space?
1 - pectoralis minor, teres major, long head of the triceps brachii
2 - teres minor, teres major, long head of the triceps brachii
3 - teres minor, subscapularis long head of the triceps brachii
4 - subscapularis, teres major, long head of the triceps brachii
2 - teres minor, teres major, long head of the triceps brachii
- teres minor = superior border
- teres major = inferior border
- long head of the triceps brachii = medial border
The triangular space is medial to the quadrangular space. It an anatomical space that allows neovascular structures to pass through. It has 3 borders teres minor, teres major, long head of the triceps brachii. What blood vessel passes through this space?
1 - circumflex clavicular artery
2 - circumflex sternal artery
3 - circumflex scapular artery
4 - circumflex humeral artery
3 - circumflex scapular artery
The triangular interval is inferior to the quadrangular space. It an anatomical space that allows neovascular structures to pass through. It has 3 borders, what are they?
1 - triceps brachii long and medial head, teres major
2 - biceps brachii long and medial head, teres major
3 - triceps brachii long and medial head, teres minor
4 - humerus, teres major
1 - triceps brachii long and medial head, teres major
The triangular interval is inferior to the quadrangular space. It an anatomical space that allows neovascular structures to pass through. It has 3 borders, triceps brachii longus (medial) and medial head (lateral), teres major (superior). What passes through this space?
1 - ulnar nerve and profundus brachial artery
2 - median nerve and profundus brachial artery
3 - radial nerve and profundus brachial artery
4 - radial nerve and radial artery
3 - radial nerve and profundus brachial artery
