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Year 2 Medicine > Anatomy of the Shoulder Region > Flashcards

Anatomy of the Shoulder Region Flashcards

1
Q

Skeletal components of the Shoulder Region

  • C..
  • S…
    • Both referred to as the … …
  • H…
  • 2 joints:
    • … joint
    • … joint
A
  • Clavicle
  • Scapula
    • Both referred to as the Pectoral Girdle
  • Humerus
  • 2 joints:
    • Glenohumeral joint
    • Acromioclavicular joint
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2
Q

The humerus has 2 tubercles- - what are they?

  • What sits between these tubercle?
A
  • The Greater tubercle and the Lesser tubercle
  • The intertubercular sulcus/bicipital groove sits between them
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3
Q

Where is the intertubercular sulcus/bicipital groove?

A

Sits between greater and lesser tubercle of the humerus

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4
Q

Necks of the Humerus

  • What are the necks called?
A
  • Anatomical neck
  • Surgical neck - more prone to fracture
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5
Q

Distal Region of the Humerus

  • At the distal end, we have the medial and lateral …
  • The … is the larger of the two and extends more distally.
  • The ulnar nerve passes in a groove on the posterior aspect of the … …where it is palpable.
A
  • At the distal end, we have the medial and lateral epicondyles
  • The medial is the larger of the two and extends more distally. The ulnar nerve passes in a groove on the posterior aspect of the medial epicondyle where it is palpable.
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6
Q

The Glenohumeral joint is a … type of joint - between the … and …

A

The Glenohumeral joint is a ball and socket type of joint - between the head of humerus and the glenoid fossa

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7
Q

The Acromioclavicular joint is a … type of joint - between the … and …

A

The Acromioclavicular joint is a synovial plane type of joint - between the acromion and clavicle

  • can become dislocated
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8
Q

Ligaments of the shoulder region

  • Stabilize/support the shoulder region - Very strong
  • Acromioclavicular, Coracoclavicular, Coracoacromial, Glenohumeral (superior, middle, inferior)
  • Attachments are in the name
A
  • Stabilize/support the shoulder region - Very strong
  • Acromioclavicular, Coracoclavicular, Coracoacromial, Glenohumeral (superior, middle, inferior)
  • Attachments are in the name
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9
Q

Coracoclavicular ligament

  • Two parts - composed of the … and … ligaments
  • Major … ligament
A
  • Two parts - composed of the trapezoid and conoid ligaments
  • Major stabilizing ligament
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10
Q

Coracoacromial ligament

  • Forms …
  • Provides support for … of …
  • Prevents superior …
A
  • Forms arch
  • Provides support for head of humerus
  • Prevents superior dislocation
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11
Q

The … ligament - Running between the acromion and coracoid process of the scapula it forms the coraco-acromial arch. This structure overlies the shoulder joint, preventing superior … of the humeral head.

A

The Coracoacromial ligament - Running between the acromion and coracoid process of the scapula it forms the coraco-acromial arch. This structure overlies the shoulder joint, preventing superior dislocation of the humeral head.

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12
Q

Glenohumeral joint

  • Highly mobile … joint
  • Articulation between head of humerus and glenoid fossa
  • Allows for:
    • A…/…
    • F…/…
    • C…
    • L../… rotation
A
  • Highly mobile ball and socket joint
  • Articulation between head of humerus and glenoid fossa
  • Allows for:
    • Abduction/Adduction
    • Flexion/Extension
    • Circumduction
    • Lateral/Medial rotation
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13
Q

Abduction of the arm

  • Performed by … muscle
    • Origin: Spine of … + a.. + c..
    • Insert: … tuberosity
  • Supplied by … nerve
  • … fibres:
    • Extension + lateral rotation
  • … fibres:
    • Flexion + medial rotation
A
  • Performed by deltoid muscle
    • Origin: Spine of scapula + acromion + clavicle
    • Insert: Deltoid tuberosity
  • Supplied by axillary nerve
  • Posterior fibres:
    • Extension + lateral rotation
  • Anterior fibres:
    • Flexion + medial rotation
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14
Q

Adduction of the arm

  • Performed by what 2 muscles?
A
  • Performed by latissimus dorsi, pectoralis major
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15
Q

What muscle is this?

A

Latissimus dorsi

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16
Q

What muscle is this?

A

Pectoralis major

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17
Q

Abduction/adduction of the arm

  • … joint accommodates parts of movement
  • Rotation of … increases range of movement
A
  • Glenohumeral joint accommodates parts of movement
  • Rotation of scapula increases range of movement
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18
Q

Rotation of scapula increases range of movement - means i can lift arm above head - what muscles allow rotation of scapula?

A
  • Trapezius (upper fibres and middle fibres) and Serratus anterior
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19
Q

Adduction of arm (from above head down to side of body) is mainly about gravity - however … scapulae and … contract which brings the scapula back towards the midline

A

Adduction of arm (from above head down to side of body) is mainly about gravity - however levator scapulae and rhomboids contract which brings the scapula back towards the midline

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20
Q

Overview of Abduction/Adduction of Arm

  • Abduction of arm (to 90 degrees - horizontal) - … muscle
  • Abduction of arm (above head) - … of scapula via upper / lower fibres trapezius and serratus anterior
  • Adduction (arm back down from above head) - gravity and levator … and … contracting to bring scapula back to midline
A
  • Abduction of arm (to 90 degrees - horizontal) - deltoid muscle
  • Abduction of arm (above head) - rotation of scapula via upper / lower fibres trapezius and serratus anterior
  • Adduction (arm back down from above head) - gravity and levator scapulae and rhomboids contracting to bring scapula back to midline
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21
Q

Flexion of the arm (upper)

  • At … joint
    • … brachii, c… and … fibres of … flex the upper arm
A
  • At glenohumeral joint
    • Biceps brachii, coracobrachialis and anterior fibres of deltoid flex the upper arm
      • note - brachialis flexes the forearm
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22
Q

Biceps brachii

  • Biceps brachii is one of the three muscles found in the … compartment of the arm.
  • It gets its name from its two heads, each of which has a separate origin.
  • The long head originates from the … tubercle of scapula, while the short head shares its origin with the coracobrachialis muscle at the coracoid process of …
A
  • Biceps brachii is one of the three muscles found in the anterior compartment of the arm.
  • It gets its name from its two heads, each of which has a separate origin.
  • The long head originates from the supraglenoid tubercle of scapula, while the short head shares its origin with the coracobrachialis muscle at the coracoid process of scapula.
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23
Q

Coracobrachialis

  • Coracobrachialis is the most medial muscle in the … compartment of the arm.
  • Its attachments at the … process of the scapula and the anterior surface of the shaft of humerus make coracobrachialis a strong adductor of the arm.
  • Additionally, this muscle is also a weak … of the arm at the shoulder joint.
A
  • Coracobrachialis is the most medial muscle in the anterior compartment of the arm.
  • Its attachments at the coracoid process of the scapula and the anterior surface of the shaft of humerus make coracobrachialis a strong adductor of the arm.
  • Additionally, this muscle is also a weak flexor of the arm at the shoulder joint.
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24
Q

Brachialis does not act at the glenohumeral joint, it is a flexor of the …

A

forearm

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25
_Extension of arm - (upper)_ * Muscles which extend the upper arm - ... brachii, ... fibres of deltoid and ... dorsi
* **Triceps brachii, posterior fibres of deltoid and latissimus dorsi**
26
_Triceps brachii_ * Triceps brachii is a large muscle found in the posterior (...) compartment of the arm. * It consists of three distinct muscle bellies (heads) each of which has a different origin but share the same insertion point. * The long head arises from the ... tubercle of scapula * The ... head from the posterior surface of the humerus (inferior to radial groove) * The ... head originates from the posterior surface of the humerus (superior to radial groove). * All three heads join to form a single tendon, which inserts onto the ... of ulna and fascia of the forearm.
* Triceps brachii is a large muscle found in the posterior (**extensor**) compartment of the arm. * It consists of three distinct muscle bellies (heads) each of which has a different origin but share the same insertion point. * The long head arises from the **infraglenoid** tubercle of scapula * The **medial** head from the posterior surface of the humerus (inferior to radial groove) - extend the forearm * The **lateral** head originates from the posterior surface of the humerus (superior to radial groove). - extend the forearm * All three heads join to form a single tendon, which inserts onto the **olecranon** of ulna and fascia of the forearm.
27
What head of the triceps brachii extends the arm? (upper arm - not forearm)
Long head of triceps (lateral and medial head extend the forearm)
28
Which heads of the triceps brachii extend the forearm? (not the upper arm)
Medial and lateral head of triceps extend forearm (long head = upper arm)
29
All three heads of the triceps brachii muscle join to form a single tendon, which inserts onto the ... of ulna and fascia of the forearm.
All three heads of the triceps brachii muscle join to form a single tendon, which inserts onto the **olecranon** of ulna and fascia of the forearm.
30
_Glenohumeral joint stability_ * ... humeral head * ... glenoid fossa * ... structure * Most frequently ... joint * Anterior ... common * (Humeral head descends inferiorly and ends up anterior)
* **Large** humeral head * **Shallow** glenoid fossa * **Unstable** structure * Most frequently **dislocated** joint * Anterior **dislocation** common * (Humeral head descends inferiorly and ends up anterior)
31
Is the Glenohumeral joint stable?
no - unstable structure (large humeral head, shallow glenoid fossa - most frequently dislocated joint
32
What is the most frequently dislocated joint?
Glenohumeral joint
33
_Factors increasing stability of the Glenohumeral joint_ * Coracoacromial ... * Glenohumeral ... * Deepening of glenoid fossa by glenoid ... * ... heads of biceps (above) and triceps (below) * Tendons of ... cuff muscles
* Coracoacromial **arch** * Glenohumeral **ligaments** * Deepening of glenoid fossa by glenoid **labrum** * **Long** heads of biceps (above) and triceps (below) * Tendons of **rotator** cuff muscles
34
_Factors increasing stability of the Glenohumeral joint_ * ... arch * Glenohumeral ligaments * ... of glenoid fossa by glenoid labrum * Long heads of ... (above) and ... (below) * ... of rotator cuff muscles
* **Coracoacromial** arch * Glenohumeral ligaments * **Deepening** of glenoid fossa by glenoid labrum * Long heads of **biceps** (above) and **triceps** (below) * **Tendons** of rotator cuff muscles
35
_Coracoacromial arch_ * The acromion, together with the coracoacromial ... and the coracoid process, form the coracoacromial arch * Prevents superior ... of the humerus
* The acromion, together with the coracoacromial **ligament** and the coracoid process, form the coracoacromial arch * Prevents superior **dislocation** of the humerus
36
_Glenohumeral ligaments_ * In human anatomy, the glenohumeral ligaments (GHL) are three ligaments on the ... side of the glenohumeral joint * Glenohumeral ligaments (..., ... and ...) – the joint capsule is formed by this group of ligaments connecting the humerus to the glenoid ... * They are the main source of stability for the shoulder, holding it in place and preventing it from ... ..iorly
* In human anatomy, the glenohumeral ligaments (GHL) are three ligaments on the **anterior** side of the glenohumeral joint * Glenohumeral ligaments (**superior, middle and inferior**) – the joint capsule is formed by this group of ligaments connecting the humerus to the glenoid **fossa**. * They are the main source of stability for the shoulder, holding it in place and preventing it from **dislocating anteriorly.**
37
Label the diagram
* Top - coracoid * Three arrows = glenohumeral ligeaments (superior, middle, inferior)
38
_Glenoid labrum_ * ... glenoid fossa * ... rim attached around the margin of the glenoid fossa in the shoulder blade.
* **Deepens** glenoid fossa * **Fibrocartilaginous** rim attached around the margin of the glenoid fossa in the shoulder blade.
39
Label the diagram (blue circle)
Glenoid labrum - deepens glenoid fossa
40
_Long head of biceps and triceps_ * Help to ... joint (glenohumeral) * Long head biceps - origin is ... tubercle - tendon passes through joint capsule * Long head triceps - origin is ... tubercle
* Help to **splint** joint * Long head biceps - origin is **supraglenoid** tubercle - tendon passes through joint capsule * Long head triceps - origin is **infraglenoid** tubercle
41
_Tendons of the rotator cuff muscles_ * How many ? * Insert on humerus close to joint (... joint) * Fuse with the joint ... * Forms cuff around joint
* **Four** muscles * Insert on humerus close to joint **(Glenohumeral)** * Fuse with the joint **capsule** * Forms cuff around joint
42
_Mnemonic - Rotator cuff SITS on the shoulder_ * S = * I = * T = * S =
* **S = Supraspinatus** * **I = Infraspinatus** * **T = Teres minor** * **S = Subscapularis**
43
What are these muscles known as?
Rotator cuff muscles
44
The rotator cuff muscles surround the glenohumeral joint of all sides except ...
The rotator cuff muscles surround the glenohumeral joint of all sides except **inferiorly**
45
Label the Rotator Cuff muscles
* Top left - Supraspinatus * Middle left - Infraspinatus * Bottom left - Teres Minor * Right - Subscapularis
46
The subacromial bursa is lubricating movement of the ... tendon
The subacromial bursa is lubricating movement of the **supraspinatus** tendon
47
The ... bursa is an extension of the synovial membrane
The **subscapular** bursa is an extension of the synovial membrane
48
_Rotator Cuff Muscles - Origin_ * Supraspinatus - Origin: Supraspinatous ... of scapula * Infraspinatus - Origin: Infraspinatous ... of scapula * Teres minor - Origin: ... border of scapula * (Subscapularis - Origin: **Medial** **two**-third of the subscapular fossa - different card)
* Supraspinatus - Origin: Supraspinatous **fossa** of scapula * Infraspinatus - Origin: Infraspinatous **fossa** of scapula * Teres minor - Origin: **Lateral** border of scapula * (Subscapularis - Origin: **Medial** **two**-third of the subscapular fossa)
49
_Rotator Cuff Muscles - Insertion_ * Supraspinatus, infraspinatus and teres minor insert into the ... ... of humerus
* Supraspinatus, infraspinatus and teres minor insert into the **greater** tubercle of humerus
50
This diagram shows rotator cuff muscle insertion - label the rotator cuff muscles
* S = Supraspinatus * I = Infraspinatus * T = Teres minor
51
_Subscapularis (fourth rotator cuff)– Origin and Insertion_ * Origin - medial two-third of the subscapular ... * Inserts - ... tubercle of the humerus
* Origin - medial two-third of the subscapular **fossa** * Inserts - **lesser** tubercle of the humerus
52
_Rotator cuff function_ * Contract Together: ... humeral head on glenoid fossa * Supraspinatus - Initiates ... * Infraspinatus - ... rotation * Teres minor - ... rotation * (Anteriorly - Subscapularis - ... rotation)
* Contract Together: **Stabilize** humeral head on glenoid fossa * Supraspinatus - initiates **abduction** * Infraspinatus - **lateral** rotation * Teres minor - **lateral** rotation * (Anteriorly - Subscapularis - **medial** rotation)
53
The ... muscle initiates the abduction of the of the arm (deltoid muscle after)
The **supraspinatus** muscle initiates the abduction of the of the arm.
54
The teres minor muscle and the infraspinatus muscle ... rotate the arm at the glenohumeral joint
The teres minor muscle and the infraspinatus muscle **laterally** rotate the arm at the glenohumeral joint
55
Subscapularis - responsible for ... rotation of the arm
Subscapularis - responsible for **medial (internal)** rotation of the arm
56
Teres major should also be considered with the ... ... muscles
Teres major should also be considered with the **rotator cuff** muscles
57
_Teres Major_ * Not a rotator cuff - but should be considered with them * Performs ... rotation * ... the humerus during abduction
* Not a rotator cuff - but should be considered with them * Performs **medial** rotation (same as subscapularis) * **Stabilises** the humerus during abduction
58
What muscle is this?
Teres major
59
_Teres Major - Origin and Insertion_ * Origin - ... angle of ... * Insertion - ... lip of ... groove (intertubercular sulcus)
* Origin - **Inferior** angle of **scapula** * Insertion - **medial** lip of **bicipital** groove (intertubercular sulcus)
60
_Intertubercular sulcus / Bicipital groove_ * ... lip - Pectoralis major inserts here * ... lip - Teres major inserts here * Insert into groove itself - Latissimus ...
* **Lateral** lip - Pectoralis major inserts here * **Medial** lip - Teres major inserts here * Insert into groove itself - Latissimus **dorsi**
61
Unlike the teres ..., the teres ... muscle does not attach to the capsule of the glenohumeral joint. Thus it is not regarded as part of the rotator cuff muscles.
Unlike the teres **minor**, the teres **major** muscle does not attach to the capsule of the glenohumeral joint. Thus it is not regarded as part of the rotator cuff muscles.
62
The teres major stablises the humerus onto the glenoid fossa during abduction - it contracts (... contraction)
The teres major stablises the humerus onto the glenoid fossa during abduction - it contracts (**eccentric** contraction)
63
_Rotator cuff injuries_ * ... most commonly injured * ... impingement * Limited space for tendon under ... arch
* **Supraspinatus** most commonly injured * **Supraspinatus** impingement * Limited space for tendon under **coracoacromial** arch
64
Which rotator cuff is most commonly injured?
Supraspinatus - impingement (due to repetitive overhead activities - common in athletes - throwers)
65
Supraspinatus impingement happens to ... particularly ...
Supraspinatus impingement happens to **athletes** particularly **throwers (**Impingement due to repetitive overhead activities)
66
If you injure your supraspinatus tendon, (tear or impingment), clinician is likely to take an ... of it
ultrasound
67
_Blood supply to the Shoulder Region_ * ... blood supply * Scapula ... * Allows continuous supply of blood to shoulder region during movement * From ... and ... arteries
* **Rich** blood supply * Scapula **anastomosis** * Allows continuous supply of blood to shoulder region during movement * From **subclavian** and **axillary** arteries
68
_Scapula Anastomosis_ * The branches of the scapular anastomoses come from the subclavian artery and the axillary artery * Subclavian artery - Each divided into 3 parts by ... ... muscle: * The **... artery** branches off from the thyrocervical trunk (from 1st part of subclavian artery), which in turn arises from the first part of the subclavian artery - eventually anastomose with branches of axillary artery * The transverse cervical artery (3rd part of subclavian artery) gives off a branch, the **... ... artery**. Anastomoses with branches from axillary artery * Axillary Artery - also divided into three parts by ... ...: * First part medial * Second part posterior * Third part lateral - ... **artery** comes from this - branches from here anastomose with both branches of suprascapualr and branches from dorsal scapular
* The branches of the scapular anastomoses come from the subclavian artery and the axillary artery * Subclavian artery - Each divided into 3 parts by **scalenus anterior** muscle: * The **suprascapular artery** branches off from the thyrocervical trunk (from 1st part of subclavian artery), which in turn arises from the first part of the subclavian artery - eventually anastomose with branches of axillary artery * The transverse cervical artery (3rd part of subclavian artery) gives off a branch, the **dorsal scapular artery**. Anastomoses with branches from axillary artery * Axillary Artery - also divided into three parts by **pectoralis minor**: * First part medial * Second part posterior * Third part lateral - **subscapular** artery comes from this - branches from here anastomose with both branches of suprascapualr and branches from dorsal scapular
69
_Scapula Anastomosis_ * The branches of the scapular anastomoses come from the subclavian artery and the axillary artery * Subclavian artery - Each divided into 3 parts by ... ... muscle: * The **... artery** branches off from the thyrocervical trunk (from 1st part of subclavian artery), which in turn arises from the first part of the subclavian artery - eventually anastomose with branches of axillary artery * The transverse cervical artery (3rd part of subclavian artery) gives off a branch, the **... ... artery**. Anastomoses with branches from axillary artery * Axillary Artery - also divided into three parts by ... ...: * First part medial * Second part posterior * Third part lateral - ... **artery** comes from this - branches from here anastomose with both branches of suprascapualr and branches from dorsal scapular
* The branches of the scapular anastomoses come from the subclavian artery and the axillary artery * Subclavian artery - Each divided into 3 parts by **scalenus anterior** muscle: * The **suprascapular artery** branches off from the thyrocervical trunk (from 1st part of subclavian artery), which in turn arises from the first part of the subclavian artery - eventually anastomose with branches of axillary artery * The transverse cervical artery (3rd part of subclavian artery) gives off a branch, the **dorsal scapular artery**. Anastomoses with branches from axillary artery * Axillary Artery - also divided into three parts by **pectoralis minor**: * First part medial * Second part posterior * Third part lateral - **subscapular** artery comes from this - branches from here anastomose with both branches of suprascapualr and branches from dorsal scapular
70
_Scapula Anastomosis_ * The branches of the scapular anastomoses come from the subclavian artery and the axillary artery * Subclavian artery - Each divided into 3 parts by ... ... muscle: * The **... artery** branches off from the thyrocervical trunk (from 1st part of subclavian artery), which in turn arises from the first part of the subclavian artery - eventually anastomose with branches of axillary artery * The transverse cervical artery (3rd part of subclavian artery) gives off a branch, the **... ... artery**. Anastomoses with branches from axillary artery * Axillary Artery - also divided into three parts by ... ...: * First part medial * Second part posterior * Third part lateral - ... **artery** comes from this - branches from here anastomose with both branches of suprascapualr and branches from dorsal scapular
* The branches of the scapular anastomoses come from the subclavian artery and the axillary artery * Subclavian artery - Each divided into 3 parts by **scalenus anterior** muscle: * The **suprascapular artery** branches off from the thyrocervical trunk (from 1st part of subclavian artery), which in turn arises from the first part of the subclavian artery - eventually anastomose with branches of axillary artery * The transverse cervical artery (3rd part of subclavian artery) gives off a branch, the **dorsal scapular artery**. Anastomoses with branches from axillary artery * Axillary Artery - also divided into three parts by **pectoralis minor**: * First part medial * Second part posterior * Third part lateral - **subscapular** artery comes from this - branches from here anastomose with both branches of suprascapualr and branches from dorsal scapular
71
_Scapula Anastomosis_ * The branches of the scapular anastomoses come from the subclavian artery and the axillary artery * Subclavian artery - Each divided into 3 parts by ... ... muscle: * The **... artery** branches off from the thyrocervical trunk (from 1st part of subclavian artery), which in turn arises from the first part of the subclavian artery - eventually anastomose with branches of axillary artery * The transverse cervical artery (3rd part of subclavian artery) gives off a branch, the **... ... artery**. Anastomoses with branches from axillary artery * Axillary Artery - also divided into three parts by ... ...: * First part medial * Second part posterior * Third part lateral - ... **artery** comes from this - branches from here anastomose with both branches of suprascapualr and branches from dorsal scapular
* The branches of the scapular anastomoses come from the subclavian artery and the axillary artery * Subclavian artery - Each divided into 3 parts by **scalenus anterior** muscle: * The **suprascapular artery** branches off from the thyrocervical trunk (from 1st part of subclavian artery), which in turn arises from the first part of the subclavian artery - eventually anastomose with branches of axillary artery * The transverse cervical artery (3rd part of subclavian artery) gives off a branch, the **dorsal scapular artery**. Anastomoses with branches from axillary artery * Axillary Artery - also divided into three parts by **pectoralis minor**: * First part medial * Second part posterior * Third part lateral - **subscapular** artery comes from this - branches from here anastomose with both branches of suprascapualr and branches from dorsal scapular
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_Scapula Anastomosis_ * The branches of the scapular anastomoses come from the subclavian artery and the axillary artery * Subclavian artery - Each divided into 3 parts by ... ... muscle: * The **... artery** branches off from the thyrocervical trunk (from 1st part of subclavian artery), which in turn arises from the first part of the subclavian artery - eventually anastomose with branches of axillary artery * The transverse cervical artery (3rd part of subclavian artery) gives off a branch, the **... ... artery**. Anastomoses with branches from axillary artery * Axillary Artery - also divided into three parts by ... ...: * First part medial * Second part posterior * Third part lateral - ... **artery** comes from this - branches from here anastomose with both branches of suprascapualr and branches from dorsal scapular
* The branches of the scapular anastomoses come from the subclavian artery and the axillary artery * Subclavian artery - Each divided into 3 parts by **scalenus anterior** muscle: * The **suprascapular artery** branches off from the thyrocervical trunk (from 1st part of subclavian artery), which in turn arises from the first part of the subclavian artery - eventually anastomose with branches of axillary artery * The transverse cervical artery (3rd part of subclavian artery) gives off a branch, the **dorsal scapular artery**. Anastomoses with branches from axillary artery * Axillary Artery - also divided into three parts by **pectoralis minor**: * First part medial * Second part posterior * Third part lateral - **subscapular** artery comes from this - branches from here anastomose with both branches of suprascapualr and branches from dorsal scapular
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_Scapula Anastomosis_ * The branches of the scapular anastomoses come from the subclavian artery and the axillary artery * Subclavian artery - Each divided into 3 parts by ... ... muscle: * The **... artery** branches off from the thyrocervical trunk (from 1st part of subclavian artery), which in turn arises from the first part of the subclavian artery - eventually anastomose with branches of axillary artery * The transverse cervical artery (3rd part of subclavian artery) gives off a branch, the **... ... artery**. Anastomoses with branches from axillary artery * Axillary Artery - also divided into three parts by ... ...: * First part medial * Second part posterior * Third part lateral - ... **artery** comes from this - branches from here anastomose with both branches of suprascapualr and branches from dorsal scapular
* The branches of the scapular anastomoses come from the subclavian artery and the axillary artery * Subclavian artery - Each divided into 3 parts by **scalenus anterior** muscle: * The **suprascapular artery** branches off from the thyrocervical trunk (from 1st part of subclavian artery), which in turn arises from the first part of the subclavian artery - eventually anastomose with branches of axillary artery * The transverse cervical artery (3rd part of subclavian artery) gives off a branch, the **dorsal scapular artery**. Anastomoses with branches from axillary artery * Axillary Artery - also divided into three parts by **pectoralis minor**: * First part medial * Second part posterior * Third part lateral - **subscapular** artery comes from this - branches from here anastomose with both branches of suprascapualr and branches from dorsal scapular
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The axillary artery, As it passes through the axilla, the artery is divided into three parts by ... ... muscle
**pectoralis minor**
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Subclavian artery - Each divided into 3 parts by ... ... muscle
Subclavian artery - Each divided into 3 parts by **scalenus anterior** muscle
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_Contributions to scapular anastomosis:_ * ... ... artery (off of subclavian) * ... artery (off of thyrocervical trunk off of subclavian) * ... artery (branches off of third part of axillary artery)
* **Dorsal scapular** artery (off of subclavian) * **Suprascapular** artery (off of thyrocervical trunk off of subclavian) * **Subscapular** artery (branches off of third part of axillary artery)
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_Contributions to scapular anastomosis:_ * ... ... artery (off of subclavian) * ... artery (off of thyrocervical trunk off of subclavian) * ... artery (branches off of third part of axillary artery)
* **Dorsal scapular** artery (off of subclavian) * **Suprascapular** artery (off of thyrocervical trunk off of subclavian) * **Subscapular** artery (branches off of third part of axillary artery)
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_Nerve supply to the shoulder_ * From ... plexus * Roots (anterior primary rami of C5,C6,C7,C8,T1 spinal nerves) * C5 and C6 - superior trunk, C7 - middle trunk, C8,T1 - inferior trunk) all sit over first rib just through scalene trinagle * ... nerve branches off the superior trunk - passes through suprascapular notch to reach scapula - innervate 2 off rotator cuff muscles (Supraspinatus and infraspinatus) * Trunks into posterior and anterior divisions * Posterior divisions form posterior cord * Anterior divisions form lateral and medial cord * Which cord mostly supplies the shoulder region?
* From **brachial** plexus * Roots (anterior primary rami of C5,C6,C7,C8,T1 spinal nerves) * C5 and C6 - superior trunk, C7 - middle trunk, C8,T1 - inferior trunk) all sit over first rib just through scalene trinagle * **Suprascapular** nerve branches off the superior trunk - passes through suprascapular notch to reach scapula - innervate 2 off rotator cuff muscles (Supraspinatus and infraspinatus) * Trunks into posterior and anterior divisions * **Posterior divisions form posterior cord - supply much of shoulder region** * Anterior divisions form lateral and medial cord
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The ... nerve provides motor innervation to supraspinatus and infraspinatus
The **suprascapular** nerve provides motor innervation to supraspinatus and infraspinatus
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_Cords of the brachial plexus_ * Within ... * Below pectoralis ... * ... cord sits behind ... artery
* Within **axilla** * Below pectoralis **minor** * **Posterior** cord sits behind **axillary** artery
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_Posterior cord_ * 3 branches: * Upper/lower subscapular nerves - supply ... muscle and teres ... muscle * ... nerve - supplies latissimus dorsi * Posterior cord terminates as the ... nerve and ... nerve
* 3 branches: * Upper/lower subscapular nerves - supply **subscapularis** muscle and teres **major** muscle * **Thoracodorsal** nerve - supplies latissimus dorsi * Posterior cord terminates as the **radial** nerve (innervate triceps) and **axillary** nerve (innervates deltoid and teres minor)
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_Quadrangular space_ * Borders: * Superior - Teres ... * Inferior - Teres ... * Medial - Long head of ... * Lateral - ...
* Borders: * Superior - Teres **minor** * Inferior - Teres **major** * Medial - Long head of **triceps** * Lateral - **Humerus**
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This shows the ... space
Quadrangular space
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Axillary nerve innervates our ... muscle and teres ... muscle
Axillary nerve innervates our **deltoid** muscle and teres **minor** muscle (Also badge area)
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Fracture of surgical neck can damage the ... nerve and ... ... humeral artery.
Fracture of surgical neck can damage the **axillary** nerve and **posterior circumflex** humeral artery.
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_Lateral cord_ * Terminates as ... nerve and ... nerve (this innervates arm flexors - coracobrachialis, biceps brachii and also brachialis - flexor of forearm) * Gives off a branch - lateral ... nerve - pectoralis ... innervation
* Terminates as **median** nerve and **musculocutaneous** nerve (this innervates arm flexors - coracobrachialis, biceps brachii and also brachialis - flexor of forearm) * Gives off a branch - lateral **pectoral** nerve - pectoralis **major** innervation
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_Median Nerve_ * Medial cord terminates as ... nerve along with the lateral cord, and Terminates as ... nerve * 3 minor branches from cord - Medial ... nerve, Medial cutaneous nerve of arm, Medial cutaneous nerve of ...
* Medial cord terminates as **median** nerve along with the lateral cord, and Terminates as **Ulnar** nerve * 3 minor branches from cord - Medial **pectoral** nerve, Medial cutaneous nerve of arm, Medial cutaneous nerve of **forearm**
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Year 2 Medicine (162 decks)

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