Chapter 69 - Anatomy of the Shoulder, Arm, and Elbow Flashcards
what is the first bone in the body to ossify?
clavicle - 5th week of gestation
it is also the last bone in the body to fuse at like 25 yo
what is the only long bone to ossify via intramembranous ossification?
clavicle
intramembranous ossification occurs without a cartilage precursor
normal shoulder motion is what percentage glenohumeral vs scapulothoracic
2/3 vs 1/3
when does the scapular body ossify?
8th week of gestation
three ossifications centers of the acromion
Meta (base)
meso (middle)
preacromion (tip)
what attaches to the coracoid process?
- coracobrachialis
- short head of the biceps
- pectoralis minor inserts onto the base of the coracoid
what is the average orientation of the glenoid?
5degrees retroverted
average orientation of the humerus
19 degrees of retroversion, 41 degrees of inclination (neck-shaft angle)
primary blood supply to the greater tuberosity
arcuate a via the ascending branch of the anterior humeral circumflex a
primary blood supply to the humeral head
posterior circumflex humeral a (previously thought to be the ascending branch of the anterior circumflex humeral a)
what are the primary SC joint stabilizers to AP translation?
posterior SC joint ligaments
What are the primary SC joint stabilizers to superior/inferior translation?
anterior SC joint ligaments
What ligaments are the primary restraints to AP translation of the AC joint
posterior and superior AC ligaments
what ligaments are the primary restraints to vertical translation of the distal clavicle
coracoclavicular ligaments
- conoid medial
- trapezoid lateral
rotator interval is composed of what?
base of coracoid medially
supraspinatus
subscap
contains: SGHL, Long head of the biceps
what ligament is most active in the position of apprehension for anterior instability (90 abduction, ER)
anterior band of the inferior gleno humeral ligament
primary restraint to anterior-inferior dislocation
role of the posterior band of the IGHL
primary static restraint against posterior inferior translation with the arm internally rotated and adducted
long thoracic nerve palsy
results from axillary dissection or aggressive scalene retraction
-> serratus anterior palsy -> MEDIAL scapular winging (scapular elevstion with medial translation and medial rotation of the inferior pole of the scapula)
spinal accessory nerve palsy
cranial nerve XI
from radical neck dissection or lymph node biopsy
-> trapezius palsy -> LATERAL scapular winging (scapular depression with lateral translation and lateral rotation of the inferior pole of the scapula)
posterior approach to the shoulder
interval:
- teres minor: axillary n
- infraspinatus: suprascapular n
what is buford complex
a cord like MGHL with a sublabral foramen anterosuperiorly just distal to the biceps insertion
what is idiopathic osteonecrosis of the capitellum called?
Panner diesase
Supinator crest
insertion point for the LUCL
on posterolateral ulna
and origin for supinator muscle
sublime tubercle
insertion point for the anterior bundle of medial collateral ligament aka anteromedial facet of the coronoid