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Limbs and Back > Anatomy - Shoulder and Brachial Plexus > Flashcards

Anatomy - Shoulder and Brachial Plexus Flashcards

1
Q

What muscles are involved in shoulder flexion?

A

Pectoralis major and anterior part of deltoid.

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2
Q

What muscles are involved in shoulder extension?

A

Latissimus dorsi and posteriore part of deltoid.

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3
Q

What muscles are involve in shoulder adduction?

A
  • Pectoralis major
  • Latissimus dorsi
  • Teres major
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4
Q

What muscles are involve in shoulder abduction?

A

Supraspinatus and deltoid

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5
Q

What muscles are involve in shoulder medial/internal rotation?

A
  • Pectoralis major
  • Latissimus dorsi
  • Teres major
  • Subscapularis
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6
Q

What muscles are involve in shoulder lateral rotation?

A
  • Infraspinatus
  • Teres minor
  • Supraspinatus
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7
Q

What is the lateral border of the axilla?

A

Axillary fascia

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8
Q

What is contained within the axilla?

A
  • Cords of the brachial plexus and branches
  • Axillary artery
  • Axillary vein
  • Adipose tissue with nodes
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9
Q

What are the muscular borders of the axilla?

A 
Anterior
- Pectoralis major
- Pectoralis minor
Median
- Serratus anterior (and 4th rib)
Posterior
- Subscapularis
- Latissimus dorsi
- Teres major
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10
Q

Pectoralis Major: Origin

A

Origin:

  • Clavicular; sternal half of clavicle
  • Sterno-costal; sternum and costal cartilages 1-7
  • Abdominal; rectus sheath
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11
Q

Pectoralis Major: Insertion

A

Humerus

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12
Q

Pectoralis Major: Action on the arm, shoulder girdle and thoracic cage

A

Arm: adduction, internal rotation
Shoulder girdle: ante version of scapula
Thoracic cage: elevates the ribcage (inspiration)

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13
Q

What is the shoulder girdle?

A

Scapula and clavicle.

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14
Q

Pectoralis Major: Innervation

A

Pectoral nerves from brachial plexus.

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15
Q

Pectoralis Minor:

Origin, insertion, action on shoulder girdle and thorax and nerve supply.

A

Origin: Ribs 3-5
Insertion: coracoid process of scapula
Shoulder girdle: Depression (anterior pulling of scapula)
Thorax: elevation (inspiration)
Innervation: pectoral nerves from brachial plexus

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16
Q

What is the origin of the serratrus anterior?

A

Superior: ribs 1-2
Middle: ribs 2-4
Inferior: ribs 5-9

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17
Q

What is the insertion of the serratus anterior?

A

Scapula.
Superior: superior angle
Middle: medial margin
inferior: lower angle

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18
Q

What is the action of the serratus anterior on the shoulder girdle?

A

With fixed scapula, Keeps scapula close to thoracic cage (*failure leads to wing scapula)
Superior: elevation
Middle: depression
Inferior: depression and tilts scapula to allow arm elevation

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19
Q

What is the action of the serratus anterior on the thorax?

A

With fixed scapula elevates the thoracic cage: inspiration

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20
Q

What is the nerve supply of the serratus anterior?

A

Long thoracic nerve from brachial plexus.

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21
Q

Subscapularis: origin, insertion, action and innervation.

A

Origin: subscapularis fossa
Insertion: lesser tubule of humerus
Action: medial rotation
Innervation: subscapular nerves

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22
Q

What are the five divisions of the brachial plexus?

A

Roots, Trunks, Divisions, Cords and Terminal Branches.

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23
Q

What are the roots of the brachial plexus?

A

C5, C6, C7, C8, T1.

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24
Q

What are the trunks of the brachial plexus?

A

Superior, middle and lateral trunk.

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25
Q

What are the divisions of the brachial plexus?

A

Anterior and Posterior.

* All posterior divisions to the posterior cord.

26
Q

What are the cords of the brachial plexus?

A

Lateral, posterior and medial cords.

27
Q

What are the branches of the brachial plexus?

A

Musculocutaneous, axillary, radial, medial, ulnar.

28
Q

Draw the brachial plexus.

A

*See notes.

29
Q

What are the branches from the medial cord?

A
  • Medial antebrachial cutaneous (medial cutaneous of forearm)
  • Medial brachial cutaneous (medial cutaneous of arm)
  • Medial pectoralis
30
Q

What are the branches from the superior root?

A
  • Suprascapular
  • Subscapular
  • Dorsal scapular
31
Q

What are the branches of the posterior chord?

A
  • Superior subscapular
  • Thoracodorsal (middle subscapular)
  • Inferior subscapular
32
Q

What is the branch of the lateral chord?

A

The lateral pectoral.

33
Q

Musculocutaneous Nerve:

Motor and lesion (what happens when the nerve is cut).

A

Motor: coracobrachialis, brachial and Biceps brachia
Lesion: deficiency in elbow flexion w/supinated forearm

34
Q

Axillary Nerve:

Motor and lesion.

A

Motor: deltoid, teres minor
Lesion: deficit in abduction (it can be started but not completed)

35
Q

Radial Nerve:

Motor and lesion.

A

Motor: triceps, Brachioradialis, supinator and extensors of wrist and fingers
Lesion: deficit in thumb extension (if more proximal - wrist drop and deficit in elbow extension)

36
Q

Median Nerve:

Motor and lesion.

A

Motor: pronators (teres and quadratus), flexors of wrist and fingers
Lesion: Simian hand, more proximal; deficit in lateral finger flexion (blessing hand).

37
Q

Ulnar Nerve:

Motor and lesion.

A

Motor: Flexor carpi ulnari, medial part of flexor digitorum profundus (deep), medial lumbricals, interossei
Lesion: Claw hand

38
Q

What is the nerve supply of the deltoid?

A

Axillary Nerve (C5-C6)

39
Q

What is the nerve supply of pectorals major?

A

Medial and lateral pectoral nerve (C6,7,8)

40
Q

What large muscle inserts into the upper order of the scapular spine?

A

Trapezium.

41
Q

What is the nerve supply of the trapezium?

A

Spinal accessory nerve.

42
Q

What is the nerve supply of the latissimus dorsi?

A

Thoracodorsal nerve (C6,7,8)

43
Q

What is a winging scapula?

A

When the scapula lifts away from the thoracic cage.

44
Q

What muscle lies in the supraspinous fossa?

A

Supraspinatus

45
Q

What joint is palpable at the medial end of the clavicle?

A

Sterno-clavicular joint.

46
Q

What does the clavicle do?

A
  • Provides mechanical advantage
  • Provides attachment for important bones and ligaments
  • Most frequently fractures bone
47
Q

What joint is at the lateral end of the clavicle?

A

Acromioclavicular joint (AC joint).

48
Q

What muscle lies under the acromion process?

A

Supraspinatus.

49
Q

What lies under the anterior half of the acromion between supraspinatus and the under surface of the acromion?

A

The subacromion bursa. Important landmark for steroid injection.

50
Q

What muscles are attached to the coracoid process?

A
  • Pectoralis minor
  • Coracobrachialis
  • Short head of biceps
51
Q

What is the surface landmark for the Axillary Nerve?

A
  • 5cm distil to edge of acromion

* Important for IM injections and the deltoid splitting approach to the proximal humerus.

52
Q

What is the regimental badge patch?

A

Area for sensory testing of the axillary nerve.

- Significance of injury following fracture or dislocation

53
Q

From what do the roots come from?

A

Anterior Rami.

54
Q

Where is the axilla?

A

the area under the glenobumral joint, at the junction between the upper limb and the thorax.

55
Q

What is the purpose of the axilla/why is it important?

A

it’s a passageway by which neuromuscular and muscular structures can enter and leave the upper limbs.

56
Q

What are the borders of the axilla?

A

Borders consist of 4 sides and a base with an opening at the apex

  • Apex
  • Lateral wall
  • Medial Wall
  • Anterior wall
  • Posterior wall
57
Q

How is the apex of the axilla formed?

A

The lateral border of the first rib, the superior border of the scapula and the posterior border of the clavicle.

58
Q

How is the lateral wall of the axilla formed?

A

Formed by the inter tubercular groove of the humerus.

59
Q

How is the medial border of the axilla formed?

A

Consists of the serrates anterior and the thoracic wall (ribs and intercostal muscles).

60
Q

How is the anterior border of the axilla formed?

A

Contains the pectorals major and underlying pectorals minor and subclavian muscles.

61
Q

How is the posterior border of the axilla formed?

A

Formed by the subscapularis, trees major and latissimus dorsi.

62
Q

What are the contents of the axillary nerve?

A
  • Axillary Nerve (main artery supplying upper limb)
  • Axillary Vein
  • Brachial Plexus
  • Biceps brachii and coracobrachialis
  • Axillary lymph nodes

Limbs and Back (6 decks)

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