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204- MSK > Anatomy of the shoulder region > Flashcards

Anatomy of the shoulder region Flashcards

1
Q

Which two anatomical structures form the pectoral girdle?

A

Clavicle

Scapula

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2
Q

State the skeletal components of the shoulder and the two joints

A
  • Clavicle - acromion
  • Scapula - coracoid
  • Humerus - greater and lesser tubercle, intertubercular sulcus (bicipital groove)

Joints

  • glenohumeral joint
  • acromioclavicular joint
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3
Q

What is the function of the ligaments of the shoulder region?

State the 4 ligaments

A

Stabilise/support the shoulder region. They are very strong

Coracoclavicular
Acromioclavicular
Coracoacromial
Glemohumeral (superior, middle and inferior)

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4
Q

Describe the ligaments around the coracoid

A

Coracoclavicular

  • two parts
  • major stabilising ligament

Coracoacromial

  • forms arch
  • provides support for head of humerus
  • prevents superior dislocation
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5
Q

Describe the glenohumeral joint

location, type, movement

A

From the glenoid fossa of the scapula and head of humerus

  • Highly mobile ball and socket joint
  • Abduction/adduction
  • Flexion/extension
  • Lateral/medial rotation
  • Circumduction
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6
Q

Consider abduction of the arm

State the name, origin and insertion of the muscle responsible for this.

How do the fibres contribute to this movement?

Which nerve supplies it?

A

Deltoid
Origin: spine of scapula + acromion+ clavicle
Insert: deltoid tuberosity

Posterior fibres: extension + lateral rotation
Anterior fibres: flexion + medial rotation

Supplied by axillary nerve

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7
Q

Consider adduction of the arm

State the names of the muscles involved

A

Latissimus dorsi

Pectoralis major

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8
Q

Which other (not muscles) structures facilitate abduction and adduction of the arm?

A

Glenohumeral joint accomodates parts of movement

Rotation of scapula increases range of movement
- Abduction: Upper fibres of trapezius move acromion superiorly, lower fibres trapezius move crest of spine inferiorly, serratus anterior moves medial border laterally

  • Adduction: levator scapulae moves superior border superiorly, rhomboids move medial border medially.
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9
Q

Which structures are involved in flexion of the arm?

A 
Anterior fibres of deltoid
Short and long head of biceps
Coracoid
Coracobrachialis
Brachialis- flexes forearm
Supraglenoid tubercle
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10
Q

Which structures are involved in extension of the arm?

A 
Long head of triceps
Lateral and medial head of triceps extend forearm
Olecranon
Posterior fibres of deltoid 
Latissimus dorsi
Infraglenoid tubercle
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11
Q

How does the stability of the glenohumeral joint have clinical relevance?

A

Unstable structure due to large humeral head and shallow glenoid fossa

Most frequently dislocated joint (ant. dislocation common as humeral head descends inferiorly and ends up anterior)

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12
Q

State 5 factors that increase the stability of the shoulder

A
  • Coracoacromial arch
  • Glenohumeral ligaments
  • Deepening of glenoid fossa by glenoid labrum
  • Long heads of biceps (above) and triceps (below)
  • Tendons of rotator cuff muscles
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13
Q

Which structure prevents superior dislocation?

Which structue supports anterior of joint?

Which structure deepens glenoid fossa?

A

Coracoacromial arch (acromion + coraacromial ligament)

Glenohumeral ligaments (superior, middle and inferior)

Glenoid labrum

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14
Q

State the origins of the long head of the biceps and triceps

What kind of joint?

A

Origin of the long head of biceps= supraglenoid tubercle
- passes through to capsule

Origin of the long head of tricep= infraglenoid tubercle

SPLINT JOINT

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15
Q

State the rotator cuff muscles

Describe the tendons of the rotator cuff muscles

A
  • 4 muscles (supraspinatus, infraspinatus, subscapsularis, teres minor)
  • Surround joint on all sides except inferiorly
  • Tendon insert on humerus close to joint
  • fuse with the join capsule
  • forms cuff around joint
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16
Q

State the origin and insertion of the rotator cuff muscles

A

Supraspinatus
Origin: supraspinous fossa of scapula
Insert: Greater tubercle of the humerus

Infraspinatus
Origin: infraspinous fossa of scapula
Insert: Greater tubercle of the humerus

Subscapularis
Origin: Subscapular fossa, on the costal surface of the scapula
Insert: Lesser tubercle of the humerus

Teres minor
Origin: Posterior aspect of scapula
Insert: Greater tubercle of the humerus

17
Q

What is the function of the rotator cuff muscles together and individually?

A

Stabilise humeral head on glenoid fossa

Supraspinatus- initiate abduction
Infraspinatus- lateral rotation
Teres minor- lateral rotation
Subscapular- medial rotation

18
Q

Describe teres major

A

Function

  • stabilises humerus during abduction (eccentric contraction)
  • medial rotation

Insert: medial lip of bicipital groove
Origin: inferior angle of scapula

19
Q

Describe the blood supply of the shoulder

A
  • Rich bloody supply
  • Scapula anastomosis allows continuous supply of blood to shoulder region during movement. From subclavian and axillary arteries

Anastomosis provided subscapular, dorsal scapular and suprascapular artery

20
Q

Consider rotator cuff injuries

Why is supraspinatus most commonly injured?

A

Limited space for tendon under coracoacromial arch

==> Supraspinatus impingement due to repetitive overhead activities (common in throwers, athletes)

21
Q

Describe the nerve supply to the shoulder

A

Posterior cord from the brachial plexus within the axilla, below pec major.

  • Axillary supplies deltoid and teres minor
  • Radial supplies triceps brachii
  • Lower subscapular nerves supplies teres major
  • Suprascapular nerve supplies supraspinatus and infraspinatus
  • Thoracodorsal nerve supplies latissimus dorsi
22
Q

What structures form the quadrangular space?

What is its clinical relevance?

A

Superior: teres minor
Inferior: teres major
Anterior: Humerus
Posterior: long head of triceps

Axillary nerve and posterior circumflex humeral artery pass through (nerve supply to deltoid and teres minor and badge area).
Fracture of surgical nerve can damage axillary nerve and vessel

23
Q

State the nerve supply of pectoralis major

A

Lateral pectoral nerve from the lateral cord of the brachial plexus

Medial pectoral nerve innervates both pectoralis major/minor

Medial cutaneous nerves to arm and foraem

204- MSK (16 decks)

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