Arm and Scapular Region Flashcards by Fatih Koc

[Feature of humerus] Projects medially and somewhat superiorly to articulate with glenoid cavity of the scapula to form the glenohumeral join

head

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[Feature of humerus] Lies between head and greater and lesser tubercles laterally

anatomical neck

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[Feature of humerus] Prominent landmarks on proximal humerus that serve as attachment sites for the four rotator cuff muscles of the glenohumeral joint

Greater and lesser tubercles

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[Feature of humerus] Separates the lesser and greater tubercles and houses tendon of long head of biceps brachii

Intertubercular sulcus (bicipital groove)

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[Feature of humerus] Insertion site for deltoid muscle, inserts onto the lateral humerus

deltoid tuberosity

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[Feature of humerus] Located between proximal part of the humerus (head, anatomical neck, and tubercles) and the shaft. Common site for fractures of humerus.

Surgical neck

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[Feature of humerus] Shallow groove which passes diagonally down humerus medial to lateral. The radial nerve and the deep brachial artery lie in this groove.

radial groove

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[Feature of humerus] Large bony protuberance that is a major palpable landmark on the medial side of the distal end of the humerus. Attachment site for some of the muscles in the anterior compartment of the forearm.

medial epicondyle

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[Feature of humerus] The ulnar nerve passes from the arm into the forearm around the posterior surface of this feature and can be palpated against the bone in this location

medial epicondyle

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[Feature of humerus] Much less pronounced than its medial counterpart. Attachment site of some of the muscles in the posterior compartment of the forearm. On the distal extremity of the bone.

lateral epicondyle

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Divides the arm into two compartments, passing from each side of the humerus to the outer sleeve of deep fascia that surrounds the limb.

Medial and lateral intermuscular septa

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Compartment of the forearm which contains major flexors and supination muscles

anterior compartment

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Compartment of the forearm which contains major extensor muscles

posterior compartment

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Muscles of the anterior arm (3)

Biceps brachii, brachialis, and coracobrachialis.

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Muscles of the anterior arm are all innervated by…

musculocutaneous nerve

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Located between the greater and lesser tubercles of the humerus, it holds the tendon of the long head of the biceps brachii muscle in the intertubercular sulcus.

Transverse humeral ligament

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Origin of the long head of the biceps brachii

supraglenoid tubercle of scapula

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Origin of the short head of the biceps brachii

coracoid process of scapula

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Insertion of the biceps brachii (both heads together)

radial tuberosity

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Actions of the biceps brachii (3)

1) powerful flexor of forearm at elbow joints
2) powerful supinator of forearm
3) weak flexor of arm at glenohumeral joint

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Flat sheet of connective tissue that fans out from the medial side of the tendon (distal end of biceps brachii) to blend with deep fascia covering the anterior compartment of the forearm

bicipital aponeurosis

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Action of the brachialis

powerful flexor of forearm at elbow joint

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Action of the coracobrachialis

flexor of arm at glenohumeral joint

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Muscle taking up the posterior compartment of the arm

triceps brachii

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Origin of the long head of the triceps brachii

infraglenoid tubercle of scapula

Origin of the lateral head of the triceps brachii

posterior surface of humerus

Origin of the medial head of the triceps brachii

posterior surface of humerus

Action of the triceps brachii muscle

extension of forearm at elbow joint

Innervation of the triceps brachii

radial nerve

Continuation of the axillary artery into the anterior arm . Terminates just below elbow joint. Descends the arm with the median nerve

brachial artery

Branches of the brachial artery (3)

1) deep brachial artery 2) superior ulnar collateral artery 3) inferior ulnar collateral artery

Courses into the posterior compartment of the arm and joins the radial nerve in the radial groove of the humerus. Terminal branches (radial and middle collateral) participate in arterial anastomosis around elbow joint

Deep brachial artery

Courses with the ulnar nerve to pass posterior to the medial epicondyle of the humerus and posterior to the elbow joint. Participates in the arterial anastomosis around the elbow joint.

Superior ulnar collateral artery

Descends anterior to the elbow joint as a branch from the brachial artery. Participates in the arterial anastomosis around the elbow joint.

Inferior ulnar collateral artery

Term for a side branch off the main artery

collateral

Term for an artery that courses back in relation to the main artery (back toward the source)

recurrent

There are 8 arteries anastomosing in the elbow joint. Name the four above the elbow

1) superior ulnar collateral artery 2) inferior ulnar collateral artery 3) radial collateral artery 4) middle collateral artery

There are 8 arteries anastomosing in the elbow joint. Name the four below the elbow

1) anterior ulnar recurrent artery 2) posterior ulnar recurrent artery 3) interossesous recurrent artery 4) radial recurrent artery

[Elbow Joint Anastomosis] Pair of superior ulnar collateral artery

posterior ulnar recurrent artery

[Elbow Joint Anastomosis] Pair of inferior ulnar collateral artery

anterior ulnar recurrent artery

[Elbow Joint Anastomosis] Pair of radial collateral artery

radial recurrent artery

[Elbow Joint Anastomosis] Pair of middle collateral artery

interosseous recurrent artery

Veins of the arm (3)

1) paired brachial veins 2) cephalic vein 3) basilic vein

Pass along the medial and lateral sides of the brachial artery, receiving tributaries that accompany branches of the artery

Paired brachial veins

Passes vertically in the distal half of the arm, penetrates deep fascia to assume a position medial to the brachial artery, then becomes the axillary vein at the lower border of the teres major muscle.

Basilic vein

Passes superiorly on the anterolateral aspect of the arm and through the anterior wall of the axilla to reach the axillary vein

Cephalic vein

Sensory innervation of the superficial branch of the radial nerve

innervates skin of dorsum of hand

Motor innervation of the deep branch of the radial nerve

innervates most extensors in forearm which extend hand

Damage to the radial nerve in the radial groove results in what condition

wrist drop (loss of extension of hand)

Triangular depression anterior to the elbow

cubital fossa

Borders of the cubital fossa (superior, medial, lateral)

Superior: Imaginary horizontal line between the medial/lateral epicondyles of humerus Medial: protonator teres muscle of forearm Lateral: brachioradialis muscle of the forearm

Major contents of the cubital fossa, from lateral to medial (3)

1) tendon of the biceps brachii 2) brachial artery 3) median nerve

Located in superficial fascia in the cubital fossa. Connects cephalic vein on the lateral side of the upper limb with the basilic vein on the medial side. Separated from the brachial artery and median nerve by bicipital aponeurosis

median cubital vein

True/False: the humerus and scapula articulate

true

[Feature of Scapula] Shallow depression which articulates with the head of the humerus to form the glenohumeral joint

Glenoid cavity/fossa

[Feature of Scapula] Inferior to the glenoid caivty is the site of attachment for the long head of the triceps brachii muscle

Infraglenoid tubercle

[Feature of Scapula] Superior to the glenoid cavity and is the site of attachment for the long head of the viceps brachii muscle

Supraglenoid tubercle

[Feature of Scapula] An anterolateral projection of the spine, arches over the glenohumeral joint and articulates, via a small oval facet on its distal end, with the clavicle

acromion

[Feature of Scapula] Hook-like structure that projects anterolaterally and is positioned directly inferior to the lateral part of the clavicle

coracoid process

[Feature of Scapula] Prominent ride that subdivides the posterior surface of the scaupla into a small, superior supraspinous fossa which houses supraspinatus muscle and a much larger, inferior infraspinous fossa which houses the infraspinatus muscle.

scapular spine

Houses spuraspinatus muscle

supraspinous fossa

Houses the infraspinatus muscle

infraspinous fossa

Superficial group of extrinsic muscles of the shoulder (3)

1) trapezius 2) latissimus dorsi 3) serratus anterior

Deep group of extrinsic muscles of the shoulder (2)

1) levator scapulae | 2) rhomboids major and minor

Insertion of serratus anterior muscle

medial border of scapula

Innervation of the serratus anterior

Long thoracic nerve

Actions of the serratus anterior (3)

1) rotates scapula 2) protraction of scapula 3) anchors scapula against thoracic wall

rotator cuff muscles (4)

1) supraspinatus 2) infraspinatus 3) teres minor 4) subscapularis

Why can the head of the abducted humerus be dislocated inferiorly?

Rotator cuff tendons are not present below the shoulder joint

Innervation of the supraspinatus

suprascapular nerve

Actions of the supraspinatus muscle (2)

1) initiates abduction of arm | 2) stabilizes glenohumeral joint

Innervation of the infraspinatus muscle

Suprascapular nerve

Actions of the infraspinatus (2)

1) externally rotates arm | 2) stabilizes glenohumeral joint

Innervation of the teres minor muscle

axillary nerve

Actions of the terres minor (2)

1) externally rotates arm | 2) stabilizes glenohumeral joint

Innervation of the subscapularis muscle (2)

Upper and lower subscapular nerves

Actions of the subscapularis muscle (2)

1) internally rotates arm | 2) stabilizes glenohumeral joint

Non-rotator cuff intrinsic muscles of the shoulder (2)

1) teres major | 2) deltoid

Innervation of the teres major muscle

Lower subscapular nerve

Actions of the teres major muscle (2)

1) internally rotates arm | 2) extends arm

Innervation of the deltoid

axillary nerve

Actions of the deltoid muscle (3)

1) anterior/clavicular part: flexes arm 2) middle/acromial part: abducts arm 3) posterior/spinal part: extends arm

Muscle that initiates abduction of the arm (first 15 degrees) and then the muscle which takes it from 15-180 degrees

supraspinatus; deltoid

After the arm hits 90 degrees of abduction and the humerus bumps into the acromion, which two muscles assist with upward scapular rotation to continue abduction

serratus anterior and trapezius muscles

Term. Synovial sac filled by a capillary film of synovial fluid. Sac is located between tendon and bone or tendon and another muscle to reduce friction between these structures.

Bursa

synovial sac lying between supraspinatus tendon and acromion and deltoid muscle.

subacromial bursa

Name of condition. Inflamation (subacromial bursitis) results in pain durin abduction of arm from 60-120 degrees.

painful arc syndrome

Most commonly torn tendon of the rotator cuff

supraspinatus tendon

What happens when you have a torn tendon in the rotator cuff

patient can't initiate abduction of arm

This substance deposits in degenerative, inflamed tendons of the rotator cuff, adhering to subacromial bursa and joint capsule. Tendon and capsule can tear resulting in communication of bursa to joint cavity.

Calcium

Boundaries of the quadrangular space (4)

1) inferior margin of the teres minor 2) surgical neck of the humerus 3) superior margin of the teres major 4) lateral margin of the long head of the triceps brachii

Contents of the quadrangular space (2)

1) axillary nerve | 2) posterior circumflex humeral artery

Boundaries: long head of the triceps brachii, shaft of the humerus, and inferior margin of the teres major. What's the structure?

Triangular interval

Contents of the triangular interval (2)

1) radial nerve | 2) deep artery of the arm

Boundaries: long head of the triceps brachii, superior margin of the teres major, inferior margin of the teres minor. What's the structure?

triangular space

Contents of the triangular space (1)

1) circumflex scapular artery

Arterial anstomoses around the shoulder joint are formed by branches of the _____ _____ of the subclavian artery and the _____ _____ of the 3rd part of the ______ artery

thyrocervical trunk; subscapular branch; axillary artery

Branches of thyrocervical trunk from subclavian artery (2)

1) suprascauplar artery | 2) transverse (superficial) cervical artery

Branch of the thyrocervical trunk from subclavian artery. Passes to posterior side of scapula

suprascapular artery

Branch of the thyrocervical runk from subclavian artery. Has a deep branch which passes deep to the trapezius and the rhomboids and levator scapulae at medial border of scapula. This deep branch is also called the dorsal scapular artery

Transverse (superifcial) cervical artery

Largest branch of the axillary artery. Passes alon gthe lateral border of the scapula. Circumflex scapular branch of this artery participates in the anastomoses (shoulder/)

subscapular artery

Branches of the aorta that supply the thoracic wall. A few join the transverse cervical artery at the medial border of the scapula.

Intercostal arteries

Ligations of the subclavian or axillary arteries can be made anywhere between the _____ ______ and ______ _____ and still maintain blood flow to upper extremity without blood loss

thyrocervical trunk; subscapular artery

Branch of the upper trunk of the brahcial plexus. Passes posteriorly and runs through the suprascauplar notch inferior to the suprascapular ligament to reach the supraspinatus and infraspinatus fossae.

Suprascapular nerve

Branch of the thyrocervical trunk of the subclavian artery. Passes posteriorly and runs superior to the suprascapular ligament to reach the supraspinatus and infraspinatus fossae.

Suprascapular artery