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MSK- Anatomy > Dissection 10- Posterior Shoulder and Rotator Cuff Muscles > Flashcards

Dissection 10- Posterior Shoulder and Rotator Cuff Muscles Flashcards

1
Q

What is the pectoral girdle and what is it composed of?

A

A bony ring, incomplete posteriorly, formed by the scapulae and the clavicles and completed anteriorly by the manubrium of the sternum

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2
Q

What does the sternal end of the clavicle articulate with? What is this joint called?

A

Articulates with the manubrium of the sternum, forming the sterno-clavicular joint

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3
Q

What does the acromial end of the clavicle articulate with? What is this joint called?

A

Acromion of the scapula at the acromioclavicular joint

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4
Q

What is the function of the pectoral girdle?

A

Permits articulation of the upper limb with the appendicular skeleton to offer an increased range of movement for hand function

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5
Q

What 3 joints make up the pectoral girdle?

A

Sternoclavicular, acromioclavicular and gleno-humeral

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6
Q

The pectoral girdle has a role in maintaining what position of the upper limb?

A

The relatively lateral position of the upper limb

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7
Q

How is the pectoral girdle stabilised?

A

By providing attachment points for ligaments and muscles

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8
Q

What are the 3 groups of posterior shoulder muscles?

A

Superficial posterior axio-appendicular
Deep posterior axio-appendicular
Scapulohumeral

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9
Q

What muscles are in the superficial posterior axio-appendicular group?

A

Trapezius and latissimus dorsi

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10
Q

What muscles are in the deep posterior axio-appendicular group?

A

Rhomboids and levator scapulae

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11
Q

What muscles are in the scapulohumeral group?

A

Deltoid, teres major, 4 rotator cuff muscles

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12
Q

Which of the posterior shoulder muscle groups are extrinsic shoulder muscles?

A

Superficial posterior axio-appendicular

Deep posterior axio-appendicular

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13
Q

Which of the posterior shoulder muscle groups are intrinsic shoulder muscles?

A

Scapulohumeral

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14
Q

Describe the trapezius muscle and where it is found?

A

A large, triangular muscle covering the posterior aspect of the neck, and the superior half of the trunk

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15
Q

How many parts is the trapezius muscle divided into?

These parts all have different actions where?

A

3 parts

Different actions at the joint between the scapula and thoracic wall

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16
Q

What are the 3 parts of the trapezius known as?

A

Ascending, middle and descending

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17
Q

What is the action of the descending part of the trapezius?

A

Elevates the scapula

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18
Q

What is the action of the middle part of the trapezius?

A

Retracts scapula (pulls posteriorly)

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19
Q

What is the action of the ascending part of the trapezius?

A

Depresses scapula/lowers shoulder

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20
Q

The ascending and descending parts of the trapezius work together to allow what movement?

A

Superior rotation of the glenoid fossa (rotation of the scapula)

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21
Q

Weakness of the trapezius causes what?

A

Drooping of the shoulders

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22
Q

What innervates the trapezius?

A

Spinal accessory nerve (CNXI) for motor

C3/4 spinal nerves for pain and proprioception

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23
Q

Describe the latissimus dorsi and where it passes?

A

A large fan shaped muscle which covers a wide area of the back, passing from trunk to humerus

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24
Q

The latissimus dorsi can ‘raise trunk to arm’, along with what other muscle?

A

Pectoralis major

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25
Q

As well as the climbing action, what are some other actions of the latissimus dorsi?

A

Extends, adducts and medially rotates the shoulder

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26
Q

What is the nerve supply to the latissimus dorsi?

A

Thoracodorsal nerve

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27
Q

Where do the superior and inferior thirds of the levator scapulae muscle lie?

A

Superior- deep to SCM

Inferior- deep to trapezius

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28
Q

The levator scapulae acts with what other muscle to produce what action?

A

Elevates the scapula with the descending part of the trapezius

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29
Q

The levator scapulae can rotate the scapula (inferior rotation of the glenoid fossa) with which other two muscles?

A

Rhomboids and pectoralis minor

30
Q

Where are the rhomboids found?

A

They lie deep to the trapezius, and form two parallel bands which pass inferolaterally from the vertebrae to the medial border of the scapula

31
Q

What are the actions of the rhomboids?

A

Retract the scapula

Rotate the scapula (inferior rotation of the glenoid fossa)

32
Q

What are both the deep posterior axio-appendicular muscles (levator scapulae and rhomboids) supplied by?

A

Dorsal scapular nerve

33
Q

Describe the scapulohumeral muscles and where they supply?

A

Relatively short muscles which pass from the scapula to the humerus and act on the glenohumeral joint

34
Q

What is a thick, powerful muscle which forms the rounded contour of the shoulder?

A

Deltoid

35
Q

What are the 3 parts of the deltoid?

A
  • Clavicular (anterior)
  • Acromial (middle)
  • Spinal (posterior)
36
Q

What happens when all three of the deltoid muscles are contracted at once?

A

The shoulder joint is abducted

37
Q

Does the deltoid muscle initiate abduction?

A

No

38
Q

The deltoid can act as a shunt muscle to try and prevent what injury?

A

Inferior displacement of the head of the humerus

39
Q

What is the action of the spinal part of the deltoid?

A

Extension of the arm at the shoulder joint

40
Q

What is the action of the acromial part of the deltoid?

A

Abduction of shoulder (beyond 15 degrees)

41
Q

What is the action of the clavicular part of the deltoid?

A

Flexion of the arm at the shoulder joint

42
Q

What are the proximal attachments of the deltoid?

A

Lateral 1/3rd of clavicle and the acromion/spine of scapula

43
Q

What is the distal attachment of the deltoid?

A

Deltoid tuberosity of humerus

44
Q

What innervates the deltoid?

A

Axillary nerve

45
Q

What must happen in order for full adduction/abduction of the shoulder to occur?

A

The scapula must rotate so that the glenoid fossa faces more inferiorly/superiorly respectively

46
Q

What is required to prevent the greater tubercle of the humerus from impugning on the acromion of scapula?

A

Superior rotation of the glenoid

47
Q

What is a thick, rounded muscle which lies on the inferolateral 1/3rd of of the scapula?

A

Teres major

48
Q

What are the actions of the teres major?

A
  • Adducts arm
  • Medially rotates arm
  • Stabiliser of the humeral head in the glenoid fossa
49
Q

What innervates the teres major?

A

Lower sub scapular nerve

50
Q

What muscles make up the rotator cuff?

A

Supraspinatus, infraspinatus, teres minor, subscapularis

51
Q

Which of the rotator cuff muscles is not a rotator of the humerus?

A

Supraspinatus

52
Q

What is the function of supraspinatus?

A

First 15 degrees of abduction of shoulder

53
Q

What are the functions of infraspinatus?

A

Stabilises head of humerus in glenoid

Lateral rotation of shoulder

54
Q

What are the functions of teres minor?

A

Stabilises head of humerus in glenoid

Lateral rotation of shoulder

55
Q

What are the functions of subscapularis?

A

Stabilises head of humerus in glenoid

Medial rotation of shoulder

56
Q

Where do the distal tendons of the rotator cuff muscles go?

A

They blend with and reinforce the fibrous joint capsule of the shoulder

57
Q

Where do the rotator cuff muscles insert?

A

Scapula

58
Q

Where do the supraspinatus, infraspinatus and teres minor muscles attach?

A

Greater tubercle of humerus

59
Q

Where does the subscapularis muscles attach?

A

Lesser tubercle of humerus

60
Q

What is the nerve supply to supraspinatus?

A

Suprascapular nerve

61
Q

What is the nerve supply to infraspinatus?

A

Suprascapular nerve

62
Q

What is the nerve supply to teres minor?

A

Axillary nerve

63
Q

What is the nerve supply to subscapularis?

A

Upper and lower subscapular nerves

64
Q

The nerves supplying the rotator cuff muscles are all branches of what?

A

The brachial plexus

65
Q

What causes painful arc syndrome?

A

Impingement of the supraspinatus tendon between the humerus and acromion process

66
Q

When will patients will painful arc syndrome have pain?

A

50-130 degrees of abduction

67
Q

What patients will throw their upper limb to the side to initiate abduction?

A

Those with supraspinatus paralysis/tear

68
Q

What are 2 common fractures of the pectoral girdle?

A

Middle third of the clavicle

Surgical/mid-shaft of the humerus

69
Q

What joint of the pectoral girdle is commonly subluxated/dislocated?

A

Acromioclavicular joint

70
Q

What is the most common rotator cuff injury?

A

Partial tear/complete rupture of the supraspinatus tendon

MSK- Anatomy (10 decks)

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