B6-003 Shoulder, Axilla and Arm Flashcards
the trapezius is innervated by
spinal accessory
the latissimus dorsi is innervated by
thoracodorsal
what muscles make up the rotator cuff? [4]
supraspinatus
infraspinatus
teres minor
subscapularis
what muscles provides the first 15 degrees of arm abduction?
supraspinatus
what muscle[s] provide lateral (external) rotation of the arm?
infraspinatus
teres minor
what muscle[s] provide medial (internal) rotation of the arm?
subscapularis
which muscle of the rotator cuff is located on the lesser tubercle of the humerus?
subscapularis
**the rest are on the greater tubercle
bursitis of the […] would cause painful abduction of the arm
subacromial bursa
weakness in external rotation would indicate an issue with which muscles?
teres minor
infraspinatus
the drop arm test tests which muscle?
supraspinatus
Gerber’s tests which muscle?
subscapularis
**lift off test
the empty can test (Jobe’s) tests which muscle?
supraspinatus
the inferior truck of the brachial plexus is in close proximity to […]
1st rib
**issue in thoracic outlet syndrome
the medial and lateral cords of the brachial plexus innervate […]
flexors
the posterior cord of the brachial plexus innervates […]
extensors
the cords of the brachial plexus are named for their relationship to the
axillary artery
the roots of the brachial plexus are located between
anterior and middle scalene muscles of neck
the trunks of the brachial plexus lie in the
root of the neck
the divisions of the brachial plexus lie posterior to
clavicle
the cords of the brachial plexus lie around the
axillary artery
the subclavian a. turn into the […] at the lateral border of the […]
axillary
1st rib
the axillary a. turns into the […] at the inferior border of […]
brachial
teres major
the thoraco-acromial trunk of the axillary a. supplies [4]
acromian
clavicle
pec major
deltoid
the lateral thoracic branch of the axillary a. supplies
serratus anterior
the thoracodorsal a branches off […] and supplies […]
subscapular branch of axillary
latissimus dorsi
the axillary vein branches into [2]
basilic
cephalic
the brachial artery runs with the […] nerve
median
the axillary nerve runs with the […] artery
posterior circumflex humeral
**quadrangular space
the thoracodorsal artery and nerve supply the
lattisimus dorsi
what landmarks make up the quadrangular space [4]
teres minor
teres major
long head of triceps
surgical neck of humerus
what neurovascular structures run through the quadrangular space?
axillary nerve
posterior circumflex artery
what landmarks make up the triangular interval? [3]
teres major
long head of triceps
shaft of humerus
what neurovascular structures run through the triangular interval?
radial nerve
profunda brachii a.
what neurovascular structures can be damaged with a midshaft humerus fracture?
radial nerve
profunda brachii a.
the scapular notch can ossify, entrapping what nerve?
suprascapular nerve
the suprascapular artery runs over the […], and the suprascapular nerve runs under
superior transverse scapular ligament
**army over navy
the superior ulnar collateral a. travels with the
ulnar n.
the ulnar n. travels close to which bony structure?
medial epicondyle
the profunda brachii a runs with what nerve?
radial
in the cubital fossa, the brachial a. branches into
radial a.
ulnar a.
where does the brachial artery branch?
cubital fossa
**usually, sometimes branches in axilla
the lateral thoracic a. and the […] run together to supply serratus anterior
long thoracic n.
what neurovascular structures supply the serratus anterior?
lateral thoracic a.
long thoracic n.
what is the nerve injury that can result from a proximal humerus fracture?
axillary nerve lesion
what nerve supples the anterior compartment of the arm?
musculocutaneous
what nerve supplies the posterior compartment of the arm?
radial
the medial and lateral [….] separate the arm into the anterior and posterior compartments
intermuscular septa
the […] vein courses deep to the brachial fascia in the proximal arm
basilic
the […] vein is always superficial to the brachial fascia
cephalic
the […] v. serves as a landmark for the lateral side of the arm
cephalic
the […] vein serves as a landmark for the medial side of the arm
basilic
describe lymphatic drainage on the radial (thumb) side of the upper limb
cephalic vein to deltopectoral nodes
describe the lymphatic drainage on the ulnar (pinky) side of the upper limb
follows basilic vein to cubital nodes, then to axillary nodes –> central –> apical –> clavicular —> subclavian –> thoracic or right lymphatic
breast cancer in the upper outer quadrant of the breast would spread along what lymphatic pathway?
pectoral –> central –> apical –> clavicular –> subclavian —> thoracic or right lymphatic
what nerve can be injured during a breast cancer biopsy, deinnervating serratus?
long thoracic n.
a lesion in […] would cause weakness in protraction of the scapula and
weakness in abduction above 90 degrees
long thoracic n.
a lesion in […] would cause weakness of arm extension, adduction, and medial rotation
thoracodorsal n.
a lesion in what nerve causes winged scapula?
long thoracic n.
[…] and […] rotate the scapula for abduction above 90 degrees
trapezius and serratus anterior
ossification of the scapular notch can entrap what nerve?
suprascapular
suprascapular nerve supplies what muscles?
supra and infra spinatus
a lesion in […] would cause weakness initiating abduction and lateral rotation
suprascapular n.
dorsal scapular nerve supplies which muscles?
levator scapulae
rhomboid major and minor
a lesion in […] would cause weakness in elevation, retraction, and downward rotation of the scapula
dorsal scapular nerve
what muscle initiates abduction of the arm?
supraspinatus
what muscle laterally rotates the arm?
infraspinatus
teres minor
innervates the muscles of the anterior compartment of the arm to provide flexion and supination
musculocutaneous
the musculocutaneous n pierces the […]
coracobrachialis
**can become entrapped here
provides sensory to the lateral forearm
musculocutaneous
**gives rise to lateral cutaneous branch at elbow
the […] passes through the quadrangular space along with the posterior circumflex humoral artery
axillary nerve
what nerve lies in contact with the surgical neck of the humerus?
axillary
**can be compressed with fractures
provides sensory over the lateral deltoid
axillary nerve
the median nerve crosses over the brachial artery at what anatomical landmark?
cubital fossa
pronator teres syndrome compresses the […] nerve
median
what nerve passes between the humeral and ulnar heads of the pronator teres?
median
**pronator teres syndrome
what nerve is compressed in carpal tunnel syndrome?
median
what nerve provides sensory to the lateral 3.5 digits?
median
what nerve innervates the nail beds?
median
what nerve passes posterior to the medial epicondyle of the humerus?
ulnar
what nerve causes cubital tunnel syndrome when compressed?
ulnar
what nerve is frequently injured in a fall on an outstretched hand?
ulnar
**passes through pisiform and hook of hamate
structure between pisiform and hook of hamate
Guyon canal
**ulnar n. passes through here, injured in FOOH
provides sensory to little and ring finger
ulnar
innervates the posterior (extensor) compartments of the arm and forearm
radial
what nerve can become entrapped if the supinator spasms?
radial
provides sensory to the dorsum of the hand
radial
C5-C6
axillary
C5-C7
musculocutaneous
C5-T1
radial
median
C8-T1
ulnar
C5-T1
recurrent branch of the median nerve
an anterior dislocation of the humerus could injure what nerve?
axillary
upper trunk compression could injure what nerve?
musculocutaneous
compression of the axilla due to crutches or sleeping with arm over a chair could injure what nerve?
radial
a midshaft fracture of the humerus could injure what nerve?
radial
repetitive pronation/supination such as screwdriver use could injure what nerve?
radial
a supracondylar fracture of the humerus could injure what nerve?
median
a wrist laceration could injure what nerve?
median
fracture of the medial epicondyle of the humerus could injure what nerve?
ulnar
a fractured hook of hamate from a fall on outstretched hand could injure what nerve?
ulnar
compression of the nerve against hamate as the wrist rests on handlebars during cycling could injure what nerve?
ulnar
a superficial laceration of the palm could injure what nerve?
recurrent branch of the median
what nerve injury would cause:
flattened deltoid
loss of arm abduction >15 degrees
loss of sensation over deltoid and lateral arm
axillary
what nerve injure would cause:
decreased biceps reflex
loss of forearm flexion and supination
loss of sensation over radial and dorsal forearm
musculocutaneous
most common rotator cuff injury
supraspinatus
what rotator cuff muscle is affected in a pitching injury?
infraspinatus
adducts and externally rotates arm
teres minor
internally rotates and adducts arm
subscapularis
provides first 0-15 degrees abduction
supraspinatus
provides 15-90 degrees abduction
deltoid
provides greater than 90 degrees abduction
trapezius
serratus anterior
long thoracic n. innervates
serratus anterior
accessory n. innervates
trapezius
axillary n. innvervates
deltoid
suprascapular n. innervates
supraspinatusand infraspinatus
what nerve/artery pair travels through the axilla?
long thoracic n.
lateral thoracic a.
what nerve/artery pair travels through the surgical neck of the humerus?
axillary n.
posterior circumflex a.
what nerve/artery pair travels through the midshaft of the humerus?
radial n.
deep brachial a.
what nerve/artery pair travels through the distal humerus/cubital fossa?
median n.
brachial a.
what syndrome is caused by ulnar nerve compression at the wrist and is commonly associated with cyclists?
guyon canal syndrome
the […] is in contact with the surgical head of the humerus and can be damaged by fracture or shoulder dislocation
axillary nerve
what nerve is vulnerable during a supracondylar humerus fracture?
median
the median nerve can become entrapped by […]
pronator teres
what nerve can be injured during a mid-shaft humerus fracture?
radial
formed by the pisiform bone and hook of hamate
Guyon’s canal
**ulnar nerve can be entrapped here
the […] nerve can be entrapped as it passes through the coracobrachialis
musculocutaneous
innervates pectoralis major
lateral pectoral nerve
the lateral pectoral nerve branches from the
lateral cord
what neurovascular structures pass through the quadrangular space?
axillary nerve
posterior circumflex a.
the axillary nerve and the posterior circumflex are in contact with the
surgical neck of the humerus
most likely to be torn in a rotator cuff injury
supraspinatus
initiates the first 15 degrees of arm abduction
supraspinatus
medial rotators of arm [2]
subscapularis
teres major not a rotator cuff muscle though
lateral rotators of arm [2]
infraspinatus
teres minor
lymph from the upper outer quadrant of the breast will drain into the
anterior axillary nodes
infection or cancer on the thumb side will follow the […] vein and drain into […] nodes
cephalic
infraclavicular (deltopectoral or apical axillary)
infection or cancer from the 5th digit side will follow the […] vein and drain into the […] nodes
basilic
cubital
associated with biceps tendonitis and relatively common in tennis and baseball players
torn long head of biceps
what muscles make up the anterior axillary fold? [2]
pectoralis major and minor
what muscles make up the posterior axillary fold? [3]
latissimus dorsi
teres major
subscapularis
what muscle makes up the medial side of the axilla?
serratus anterior
back muscle that elevates scapula
levator scapulae
what neurovascular structures travel through the triangular interval?
radial nerve
profunda brachii
the […] artery and nerve travel together to supply the latissimus dorsi
thoracodorsal
the ulnar nerve lies posterior to the […]
medial epicondyle
provides cutaneous sensation to the lateral area of the shoulder
axillary
[…] nerve is vulnerable during shoulder dislocations
axillary
the radial nerve provides cutaneous sensation to [2]
-posterior arm and forearm
-dorsum of lateral hand
a positive response to myotatic biceps reflex confirms the integrity of
musculocutaneous n.
supplies motor innervation and proprioception to anterior compartment of arm
musculocutaneous
weakness flexing the elbow and supinating the forearm indicates a lesion in
musculocutaneous
weakness in abduction past 15 degrees of the upper limb indicates a lesion in
axillary
weakness in extension at the elbow and wrist indicates a lesion in
radial
numbness and tingling over medial part of palm and medial 1.5 digits indicates damage to
ulnar nerve
numbness and tingling of lateral forearm indicates damage to
musculocutaneous
numbness and tingling over the lateral shoulder indicate damage to
axillary
numbness and tingling over the lateral part of the palm and lateral 4.5 digits indicates damage to the
median nerve
numbness and tingling over the posterior forearm and hand indicate damage to the
radial nerve
-weakness of pronation
-flattening of thenar eminence
-numbness, tingling on palmar aspect of lateral fingers
median nerve entrapment by pronator teres
what neurovascular structures are in contact with the shaft of the humerus?
radial nerve
profunda brachii
what neurovascular structures pass through the quadrangular space?
axillary nerve
posterior circumflex a.
what neurovascular structures pass through the quadrangular space?
axillary nerve
posterior circumflex a.
what neurovascular structures are in contact with the shaft of the humerus?
radial nerve
profunda brachii
what neurovascular structures pass through the quadrangular space?
axillary nerve
posterior circumflex a.
what neurovascular structures are in contact with the shaft of the humerus?
radial nerve
profunda brachii
what neurovascular structures pass through the quadrangular space?
axillary nerve
posterior circumflex a.
what neurovascular structures are in contact with the shaft of the humerus?
radial nerve
profunda brachii
what neurovascular structures are in contact with the shaft of the humerus?
radial nerve
profunda brachii
what neurovascular structures pass through the quadrangular space?
axillary nerve
posterior circumflex a.
what neurovascular structures are in contact with the shaft of the humerus?
radial nerve
profunda brachii
what neurovascular structures pass through the quadrangular space?
axillary nerve
posterior circumflex a.
C5 and C6 form the [….] trunk of the brachial plexus
upper
C7 forms the […] trunk of the brachial plexus
middle
C8 and T1 form the […] trunk of the brachial plexus
lower
what 2 nerves does the posterior cord form?
axillary
radial
the lateral cord forms the […] nerve
musculocutaneous
the medial cord forms the […] nerve
ulnar
branches of the lateral cord and medial cord join to form the […] nerve
median
the dorsal scapular nerve branches off C5 and supplies motor for [2]
rhomboids
levator scapulae
branches of C5-C7 join to form the […] nerve
long thoracic
suprascapular branches from the […] trunk
upper
suprascapular provides motor to [2]
supraspinatus
infraspinatus
the lateral pectoral nerve branches from the […] cord
lateral
the posterior cord forms 3 smaller branches
upper subscapular
thoracodorsal
lower subscapular
does medial rotation of the scapula
subscapularis
does extension, medial rotation, and adduction at the shoulder joint
latimus dorsii
thoracodorsal n supplies
latismus dorsi
does medial rotation of the shoulder joint
subscapularis
does extension, medial rotation, and adduction at the shoulder joint
teres major
lattisimus dorsi
musculocutaneous supplies motor to [3]
coracobrachialis
brachialis
biceps brachii
musculocutaneous supplies sensory to
lateral forearm
axillary supplies motor to [2]
deltoid
teres minor
axillary supplies sensory to
posterior and lateral surface of deltoid
radial nerve supplies sensory to [3]
posterior and lateral surface of the upper limb
dorsal and lateral surface of hand
pollex
median supplies sensory to [2]
ventral and lateral surface of palm
ventral and dorsal surface digits 2 and 3
ulnar nerve supplies sensory to
ventral and dorsal 1/3 of hand
comes off the lateral cord of the upper trunk
musculocutaneous
axillary comes off the […] of the middle trunk
posterior chord
radial nerves comes off the […] of the middle trunk
posterior chord
comes off the medial and lateral cords of the lower trunk
median
comes off the medial cord of the lower trunk
ulnar
