Anatomy of the Shoulder Region Flashcards
Skeletal components of the Shoulder Region
- C..
- S…
- Both referred to as the … …
- H…
- 2 joints:
- … joint
- … joint
- Clavicle
-
Scapula
- Both referred to as the Pectoral Girdle
- Humerus
- 2 joints:
- Glenohumeral joint
- Acromioclavicular joint
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The humerus has 2 tubercles- - what are they?
- What sits between these tubercle?
- The Greater tubercle and the Lesser tubercle
- The intertubercular sulcus/bicipital groove sits between them
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Where is the intertubercular sulcus/bicipital groove?
Sits between greater and lesser tubercle of the humerus
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Necks of the Humerus
- What are the necks called?
- Anatomical neck
- Surgical neck - more prone to fracture
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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.
- 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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The Glenohumeral joint is a … type of joint - between the … and …
The Glenohumeral joint is a ball and socket type of joint - between the head of humerus and the glenoid fossa
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The Acromioclavicular joint is a … type of joint - between the … and …
The Acromioclavicular joint is a synovial plane type of joint - between the acromion and clavicle
- can become dislocated
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Ligaments of the shoulder region
- Stabilize/support the shoulder region - Very strong
- Acromioclavicular, Coracoclavicular, Coracoacromial, Glenohumeral (superior, middle, inferior)
- Attachments are in the name
- Stabilize/support the shoulder region - Very strong
- Acromioclavicular, Coracoclavicular, Coracoacromial, Glenohumeral (superior, middle, inferior)
- Attachments are in the name
Coracoclavicular ligament
- Two parts - composed of the … and … ligaments
- Major … ligament
- Two parts - composed of the trapezoid and conoid ligaments
- Major stabilizing ligament
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Coracoacromial ligament
- Forms …
- Provides support for … of …
- Prevents superior …
- Forms arch
- Provides support for head of humerus
- Prevents superior dislocation
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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.
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.
Glenohumeral joint
- Highly mobile … joint
- Articulation between head of humerus and glenoid fossa
- Allows for:
- A…/…
- F…/…
- C…
- L../… rotation
- Highly mobile ball and socket joint
- Articulation between head of humerus and glenoid fossa
- Allows for:
- Abduction/Adduction
- Flexion/Extension
- Circumduction
- Lateral/Medial rotation
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
- 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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Adduction of the arm
- Performed by what 2 muscles?
- Performed by latissimus dorsi, pectoralis major
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What muscle is this?
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Latissimus dorsi
What muscle is this?
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Pectoralis major
Abduction/adduction of the arm
- … joint accommodates parts of movement
- Rotation of … increases range of movement
- Glenohumeral joint accommodates parts of movement
- Rotation of scapula increases range of movement
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Rotation of scapula increases range of movement - means i can lift arm above head - what muscles allow rotation of scapula?
- Trapezius (upper fibres and middle fibres) and Serratus anterior
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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
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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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
- 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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Flexion of the arm (upper)
- At … joint
- … brachii, c… and … fibres of … flex the upper arm
- At glenohumeral joint
-
Biceps brachii, coracobrachialis and anterior fibres of deltoid flex the upper arm
- note - brachialis flexes the forearm
-
Biceps brachii, coracobrachialis and anterior fibres of deltoid flex the upper arm
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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 …
- 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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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.
- 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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Brachialis does not act at the glenohumeral joint, it is a flexor of the …
forearm
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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
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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.
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What head of the triceps brachii extends the arm? (upper arm - not forearm)
Long head of triceps (lateral and medial head extend the forearm)
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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)
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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.
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)
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Is the Glenohumeral joint stable?
no - unstable structure (large humeral head, shallow glenoid fossa - most frequently dislocated joint
What is the most frequently dislocated joint?
Glenohumeral joint
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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
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
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
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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.
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Label the diagram
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- Top - coracoid
- Three arrows = glenohumeral ligeaments (superior, middle, inferior)
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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.
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Label the diagram (blue circle)
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Glenoid labrum - deepens glenoid fossa
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
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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
Mnemonic - Rotator cuff SITS on the shoulder
- S =
- I =
- T =
- S =
- S = Supraspinatus
- I = Infraspinatus
- T = Teres minor
- S = Subscapularis
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What are these muscles known as?
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Rotator cuff muscles
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
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Label the Rotator Cuff muscles
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- Top left - Supraspinatus
- Middle left - Infraspinatus
- Bottom left - Teres Minor
- Right - Subscapularis
The subacromial bursa is lubricating movement of the … tendon
The subacromial bursa is lubricating movement of the supraspinatus tendon
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The … bursa is an extension of the synovial membrane
The subscapular bursa is an extension of the synovial membrane
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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)
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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
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This diagram shows rotator cuff muscle insertion - label the rotator cuff muscles
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- S = Supraspinatus
- I = Infraspinatus
- T = Teres minor
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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
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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)
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The … muscle initiates the abduction of the of the arm (deltoid muscle after)
The supraspinatus muscle initiates the abduction of the of the arm.
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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
Subscapularis - responsible for … rotation of the arm
Subscapularis - responsible for medial (internal) rotation of the arm
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Teres major should also be considered with the … … muscles
Teres major should also be considered with the rotator cuff muscles
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
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What muscle is this?
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Teres major
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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)
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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
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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.
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)
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
Which rotator cuff is most commonly injured?
Supraspinatus - impingement (due to repetitive overhead activities - common in athletes - throwers)
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Supraspinatus impingement happens to … particularly …
Supraspinatus impingement happens to athletes particularly throwers (Impingement due to repetitive overhead activities)
If you injure your supraspinatus tendon, (tear or impingment), clinician is likely to take an … of it
ultrasound
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
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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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
Subclavian artery - Each divided into 3 parts by … … muscle
Subclavian artery - Each divided into 3 parts by scalenus anterior muscle
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
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Quadrangular space
Axillary nerve innervates our … muscle and teres … muscle
Axillary nerve innervates our deltoid muscle and teres minor muscle (Also badge area)
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.
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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