Bones of upper limb Flashcards
1
Q
- name the bone of upper limb
A
- scapula
- coracoid process
- humerus
- ulna
- radius
- clavicle
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
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
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
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
6
Q
why is the superior surface of the clavicle more smoother than the inferior aspect
A
- because inferior aspect more muscles attach
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)
8
Q
label
A
-answer
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
10
Q
which process is are anterior
A
-coracoid , the acromian is more posterior
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
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
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
14
Q
what muscles attach to greater tubercle
A
- Supraspinatus
- infraspinatus and teres minor
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
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
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,)
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
19
Q
major joints of the shoulder
A
- glenohumeral
- sternoclavicular
- acromioclavicular (where lateral end of clavicle articulates with the arcomian on the scapular )
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
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
where does the sernoclavicular joint accur
- 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
radial groove
-diagonally to the humerus shaft, the radial nerve and the brace artery lien this groove
27
what are the extrinsic muscles of the shoulder
- lie o the back and the trunk
- superfialy = trapezius and latissimus dorsi
- deep ; levator scapulae and rhomboid major and rhomboid minor
28
trapezius
- 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
how to test the trapezius
tell patient to shrug their shoudlerswhilst you push down
30
latissimus dorsi
- 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
superficial extrinsic muscles
trap and lattisimus dorsi
32
levator scapulae
- 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
rhomboids
- 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
rhomboid minor
- 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
major rhomboid
- 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
deep extrinsic muscles of arm
levator scpaule , rhomboid major and minor
37
intrinsic muscles
4 rotator cuff and teres major and deltoid
38
subscapularis
- 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
teres minor
- rginates at posterior surface fo scapula into the greater tubercle
- in by axillary
- f= laterally rotate the humerus
40
infraspinatus
- orgiantes infraspcualr fossa nad inserts middle facet forgetter tbecule
- in by suprascpaular nerve
- f =laterally rotate arm
41
Supraspinatus
- orgiantes supraspinous fossa of scapula and insets superiorly greater tubercle
- inverted subscpaular serve abduct arm 0-15 deltoid takes over
42
teres major
- 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
pectoralis major
O = clavicle, sternum and costal cartilage 1-6 ribs
- I= ;lateral lip of the bicipital groove
- F= shoulder flexion and extention
44
seraatus muscle damage?
-winging of scapula (not stayi
45
what muscles are damaged with the winged scapula
trap, rhomboids, serattus
46
with trap which is more acive
- lower
| - f elevates the scapula
47
why is clavicle movement important?
- because their movement allows the full movement of the glenohumeral joint (full functional range)
48
muscles involved in full gh joint movement
- levator scapulae, rhomboids
49
dynamic factors of the gh
rotator cuff muscles and Long head of bicep
50
how is the gh deepened
the glenoid ring
51
static factor
bones, capsule, labrum, gh ligaments, negative intra-articular pressure
52
what is the brachial plexus made of
-anterior (ventral rami) of C5-T1
