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MSK > Bones of upper limb > Flashcards

Bones of upper limb Flashcards

1
Q
  • name the bone of upper limb
A
  • scapula
  • coracoid process
  • humerus
  • ulna
  • radius
  • clavicle
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2
Q

whats the shoulder and what bones are involved in this?a whats it called? what muscle group covers these and what are they?

A
  • attachment of upper limb to the trunk
  • scapula and the clavicle , and proximal end of humerus
  • they form a pectoral girdle
  • superficial ; deltoid and the trapezius
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3
Q

describe the claviclewh

A
  • can palpate it
  • S shaped with the forward facing convex part medially and the convcave forward facing part laterally
  • lateral end (acromial) is flat whereas at the medial part (sternal) is more quadrangular
  • articulates with scapula at the acromial end where it has a more oval shaped facet
  • medial end a larger facet for mainly articulation with mandibular of sternum and to a lesser extent the first costal cartilage
  • has a conoid tubercle
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4
Q

whats special about the embryology of the clavicle

A
  • last bone to fuse at around 20-25
  • first to ossifiy in utero at 5 weeks and is only long bone with 2 primary ossification centres as part of INTERMEMBRANOUS OSSIFICATION
  • then in later teens you develop a SECONDARY OSSIFACATION CENTRE at the STERNAL EDGE and this is ENDOCHONDRAL OSSIFICATION
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5
Q

what the conoid tuberosity

A
  • located on the lateral third of the clavicle inferior aspect and also the TRAPEZOID LINE is here, this is where the CORACOCLAVICULAR ligament attaches
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6
Q

why is the superior surface of the clavicle more smoother than the inferior aspect

A
  • because inferior aspect more muscles attach
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7
Q

describe the scapula

A
  • 3 angles (S I L)
  • 3 boarders ( L M S
  • 2 faces ( costal and posterior)
  • 3 processes (spine, acromian , coracoid process)
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8
Q

label

A

-answer

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9
Q

what the joint cavity called and what does it articulate with

A

-glenoid cavity articulates with the humorous to form the glenohumeral joint cavity

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10
Q

which process is are anterior

A

-coracoid , the acromian is more posterior

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11
Q

describe the humerus proximal head

A
  • head project medially and superiorly to articulate with the glenoid cavity of the lateral border of the scapula
  • 2 tubercles greater and lesser
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12
Q

describe the tubercles of the Proximal head

A
  • Greater and lesser]
  • attatchment site for 4 rotator cuff muscles of glenohumeral joint
  • greater is more lateral and (can be seen in posterior view lesser cant), it has 3 facets; going superiorly more inferiorly, so most superior is for the attatchment of ; SUPERSPINATUS, middle facet; INFRASPINATUS, bottom; TERES MINOR
  • lesser tubercule has 1 smooth facet located anteriorly for the attacthment of SUBSCAPULARIS
  • between the tubercle is the BICIPITAL GROOVE wc is a canal and seperats the tubercle , also the tendon of the LONG HEAD BICEP PASSES THROUGH here
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13
Q

bicipital groove

A

between the tubercle is the BICIPITAL GROOVE wc is a canal and seperats the tubercle , also the tendon of the LONG HEAD BICEP PASSES THROUGH here
- on the lateral and medial lips and floor of the groove are markings for attachments ,on the lateral lip = PECTORALIS MAJOR, then floor =LATISSIMUS DORSI and medial lip = TERES MAJOR

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14
Q

what muscles attach to greater tubercle

A
  • Supraspinatus

- infraspinatus and teres minor

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15
Q

what are the lips of the bicipital groove and what does x attach to later on?

A
  • lateral = pectoralis major
  • floor = latissimus dorsi
  • medial =teres major
  • the lateral lip continues down and forms a V shape known as the DELTOID TUBEROSITY where the deltoid muscle connects midway
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16
Q

deltoid tuberity

A

d extension of the lateral lip of the bicipital groove , down to form this V shaped deltoid tuberosity mid way down the humerus where the deltoid inserts , inserts from the superior and anterior aspects and lateral third of the clavicle, acromion of scapula and lateral surface of humerus ,

  • deltoid muscle is intrinsic and has 3 heads , anterior, lateral, middle
  • innervated by axillary C 5 6
  • ANTERIOR FIBRES; involved in medially/interally rotate the arm
  • MIDDLE FIBRES ;involved in abduction of arm from 15-90 degrees ,(takes over from supraspinous wc abducts 15 degrees
  • posterior FIBRES; extend and lateral rotate the arm at the shoulder
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17
Q

scapulohumeral group of muscles?

A
  • all originate at the ; scapula or clavicle and insert into the humerus
  • 6 muscles ; deltoid ,teres major and the 4 rotator cuff muscles (, superspinatus, infraspinatus,teres major, subscapularis,)
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18
Q

most common places for fractures of the arm and why is sit important?

A
  • surgical head (proximal head)
  • dangerous because the axillary nerve and the posterior circumflex humeral artery pass into deltoid from the axillae here but rarely damaged in fractures
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19
Q

major joints of the shoulder

A
  • glenohumeral
  • sternoclavicular
  • acromioclavicular (where lateral end of clavicle articulates with the arcomian on the scapular )
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20
Q

whats an AC joint? features of the AC joint? how do you test the AC joint?

A
  • its a plane-type synovial joint with 2 atypical features; 1) artcular surface of joint are lined with fribocartilage instead of hyaline\, and 2) joint cavity divided by articular disc
  • inferior aspect of joint reenforced by trapezius muscle
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21
Q

coracoclavicualr ligament

A
  • at the acromian head of the clavicle , and the coracoid process of the scapula, there are 2 parts to it, the coracoid ligaments runs from coracoid to the conoid tubercle , and the trapeziod ligament wc runs from coracoid process to the repeziod line of clavicle
22
Q

what are the ligaments on the coracoid process

A
  • coracoid ligament (trapezoid and the coracoid)

- coracoacrmial ligament

23
Q

fractures of the scapula

A

rarely happen only in high speed collison

24
Q

what are the articulations of th scapula

A
  • scapulothoracic )between the costal space and the scapula
  • AC
  • GHjoint
  • subacromial space
  • sternoclavicular
25
Q

where does the sernoclavicular joint accur

A
  • between the clavicular notch and the manubrium of the sternum
  • synovial and saddle shaped, separated by articular disc, allows movement of clavicle in the anteroposterior and vertical plane
  • reinfocred by ligaments anteriorsternoclavicular and costoclavicular
  • allows you. to; elevate the shoulders orabdct shoulders 90 degree angle(elevates the scapular by rotating at thescapulothoracic joint /proteraction of the shoulders/retraction of the shoulders/rptation above the head arms as rotation transmitted to clavicle by coraclavicular ligaments and intern rotate the sternoclavicular joint
26
Q

radial groove

A

-diagonally to the humerus shaft, the radial nerve and the brace artery lien this groove

27
Q

what are the extrinsic muscles of the shoulder

A
  • lie o the back and the trunk
  • superfialy = trapezius and latissimus dorsi
  • deep ; levator scapulae and rhomboid major and rhomboid minor
28
Q

trapezius

A
  • descending, ascend and trasnverse
  • O= external occipital protrudent of the skill, the nuchae ligament and runs along spinous C7-12 (after the niche ligament ends at C7)
  • I= the clavicle, acromion and the spine of scapula ,
  • innervated by spinal accessory nerve and proprioceptor fibres of C3 C4
  • f= scapula elevation and depression, lateral rotation the scapula, scapula retraction
29
Q

how to test the trapezius

A

tell patient to shrug their shoudlerswhilst you push down

30
Q

latissimus dorsi

A
  • part of the scapulohumeral group as it inserts on the floor of the bicipital groove
  • originates at theT6-t12 borders deeper than trapezius
    -innervate by the thoracodorsal nerve
    F =extend the arm, abduct and medially rotate the upper limb
31
Q

superficial extrinsic muscles

A

trap and lattisimus dorsi

32
Q

levator scapulae

A
  • originates from transverse process of C1-4 and inserts of the medial border of scapula , Deep to the trap, but superifical to the rhomboid major and minor
  • inneravted by Dorsal scapular nerve
  • action = levator scapulae elevates the scapula, (brings shoulder t ears) and allows shoulder blade to move so glenoid humeral joint to have full functional range
  • whiplash can cause spasm of this muscle
33
Q

rhomboids

A
  • major and amino, they both lie deep to the levator scapulae (c1-4 in, dorsal scapular nerve C5 branch)
  • minor is smaller and superior to major
34
Q

rhomboid minor

A
  • originates from spinous process C7-t1
  • inserts on medial border of scapula
  • in by dorsal scapular Neve
  • retracts the scapula and rotates the medial border to glenoid cavity is inferiorly once it have been abdcted to90
35
Q

major rhomboid

A
  • orgiantes t2-t5 and inserts on medial boarder of scapula be scapular spine and inferior border of scapulaa
  • in by dorsal scapular nerve (branch of C5)
  • retracts the scapula, rotates the medial borders that the glenoid fossa is rotates inferiorly and the arm can be Brought back to anatomical position post a90 degree abduction
36
Q

deep extrinsic muscles of arm

A

levator scpaule , rhomboid major and minor

37
Q

intrinsic muscles

A

4 rotator cuff and teres major and deltoid

38
Q

subscapularis

A
  • orgiantes at the scapula from subscpaular fossa and inserts into lesser tubercle ,in by upper and lower subscapular nerves
  • f = medially rotate the arm
39
Q

teres minor

A
  • rginates at posterior surface fo scapula into the greater tubercle
  • in by axillary
  • f= laterally rotate the humerus
40
Q

infraspinatus

A
  • orgiantes infraspcualr fossa nad inserts middle facet forgetter tbecule
  • in by suprascpaular nerve
  • f =laterally rotate arm
41
Q

Supraspinatus

A
  • orgiantes supraspinous fossa of scapula and insets superiorly greater tubercle
  • inverted subscpaular serve abduct arm 0-15 deltoid takes over
42
Q

teres major

A
  • O = posterior surface fo inferior angle of scapula
    inserts on medial lip
    -in lower subscaualr nerve
  • f =abduct and extend arm and shoulder mediallyrotates
43
Q

pectoralis major

A

O = clavicle, sternum and costal cartilage 1-6 ribs

  • I= ;lateral lip of the bicipital groove
  • F= shoulder flexion and extention
44
Q

seraatus muscle damage?

A

-winging of scapula (not stayi

45
Q

what muscles are damaged with the winged scapula

A

trap, rhomboids, serattus

46
Q

with trap which is more acive

A
  • lower

- f elevates the scapula

47
Q

why is clavicle movement important?

A
  • because their movement allows the full movement of the glenohumeral joint (full functional range)
48
Q

muscles involved in full gh joint movement

A
  • levator scapulae, rhomboids
49
Q

dynamic factors of the gh

A

rotator cuff muscles and Long head of bicep

50
Q

how is the gh deepened

A

the glenoid ring

51
Q

static factor

A

bones, capsule, labrum, gh ligaments, negative intra-articular pressure

52
Q

what is the brachial plexus made of

A

-anterior (ventral rami) of C5-T1

MSK (17 decks)

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