Blue Boxes: Pectoral, sacpular, and deltoid regions

Question 1

absence of pectoral muscles

Answer 1

anterior axillary fold, is absent on affected side and nipple is more inferior than usual

• poland syndrome: both pec major and minor are absent
• breast hypoplasia and absence of 2-4 rib segments are also seen

Question 2

paralysis of serratus anterior

Answer 2

• injury to long thoracic nerve
• winged scapula
• upper limb may not be able to be abducted above horizontal position because serratus anterior is unable to rotate the glenoid cavity superiorly

Question 3

triangle of auscultation

Answer 3

near inferior angle of scapula

• superior horizontal border of lats, medial border of scapula, and inferolateral border of the traps
• expose even better by having patients cross arms (dra scapulae forward) and have them flex

Question 4

injury to the thoracodorsal nerve

Answer 4

vulnerable to injury during mastectomies

• vulnerable during surgery on scapular LNs
• person cannot lift body up
• person cannot use axillary crutch bc the shoulder is pushed superiorly by it
• these are primary activites for which active depression of the scapula is required

Question 5

injury to the dorsal scapular nerve

Answer 5

nerve to rhomboids

-if one side injured the scapula on the affected side is located farther from the midline than the normal side

Question 6

injury to the axillary nerve

Answer 6

• deltoid atrophies when the axillary nerve is damaged
• passes inferior to the humeral head and winds around surgical neck of humerus
• axillary nerve is usually injured during fracture of this part of the humerus
• may be damaged during dislocation of the glenohumeral joint
• damage by compression from crutches
• loss of sensation may occur over lateral side of proximal part of arm, supplied by superior lateral cutaneous nerve of the arm (cut branch of axilla)

Question 7

fracture-dislocation of proximal humeral epiphysis

Answer 7

direct blow or indirect inury of shoulder of a child can produce this
-SITS muscle tendons are stronger than epiphyseal plate so the humeral head stays in place while the humeral shaft is displaced