DR 1: Back and Shoulder

Question 1

Superficial muscles of the back function

Answer 1

Attach the pectoral girdle to the trunk

Question 2

Superficial muscles of back

Answer 2

Levator scapulae
Trapezius
Rhomboids
Latissimus dorsi

Question 3

Origin of upper fibres of trapezius

Answer 3

external occipital protuberance of skull and spinal processes of cervical vertebrae

Question 4

insertion of upper fibres of trapexius

Answer 4

clavicle, acromion and spine of scapula

Question 5

middle fibres of trapezius

Answer 5

origin from spinous processes of lower thoracic vertebrae

insert into spine of scapula

Question 6

lower fibres of trapezius

Answer 6

origin from spinous processes of lower thoracic vertebrae

insert into spine and scapula

Question 7

rhomboid muscles

Answer 7

deep to trapezius muscle

Question 8

major and minor rhomboid muscles

Answer 8

origin from spinous processes of C7 and T1-T5 thoracic vertebrae and insert into medial border of the scapula

Question 9

Lattisimus dorsi

Answer 9

thoracic region of back

origin: thoracolumbar fascia of back
fibres go upwards, round inferior angle towards
insertion on floor of bicipital groove of humerus

Question 10

Serratus anterior

Answer 10

on lateral chest wall
originates as a series of individual slips from upper eight ribs
goes between ribs to the scapula
inserts at medial border of scapula

Question 11

Intermediate back muscles

Answer 11

serratus posterior superior and inferior

these are accessory respiratory muscles which help expand chest during inspiration

Question 12

Deep intrinsic muscles of back

Answer 12

within groove between spinous processes of vertebrae and angle of ribs

Question 13

Largest group of deep muscles

Answer 13

Erector spinae
Spinalis, longissiums and iliocostalis
originate from erector spinae aponeurosis

Question 14

Direction of erector spinae muscles

Answer 14

Run superiorly from erector spinae aponeurosis.

Spinales, most medial erector spinae muscle, inserts into thoracic spinous processes and skull

Longissimus, intermediate part of erector spinae, inserts into the thoracic and cervical transverse processes

iliocostalis is most lateral, and inserts mainly into the ribs

Question 15

Multifidus

Answer 15

posterior to erector spinae in the lumbar region of the back

runs superiorly, from origin on transverse processes to insertion on spinous processes (of lumbar vertebrae)

Question 16

Pectoral girdle

Answer 16

bony skeleton supporting upper limb

composed of clavicle and scapula, articulating at acromioclavicular joint

pectoral girdle articulates with trunk at sternoclavicular joint

Question 17

Sternoclavicular joint

Answer 17

articulation between pectoral girdle and trunk

Question 18

Scapula bony features

Answer 18

Anteriorly:
Acromion, coracoid, glenoid fossa, suprascapular notch, superior angle, subscapular fossa, inferior angle

Posteriorly:
supraspinous fossa, spine, intraspinous fossa, infraglenoud tubercle, supraglenoid tubercle

Question 19

Bony features of proximal end of humerus

Answer 19

head of humerus, anatomical neck (above tuberosities), greater tubercle, lesser tubercle, intertubercular sulcus, surgical neck (below tuberosities) deltoid tuberositiy

Question 20

Glenohumeral joint

Answer 20

shallow articulation between head of humerus and glenoid fossa of scapula

is a synovial ball and socket joint, allows a wide range of movement

Question 21

Supraspinatus

Answer 21

originates from supraspinous fossa, inserts onto greater tubercle

Question 22

Infraspinatus

Answer 22

Originates from infraspinous fossa, inserts onto greater tubercle

Question 23

Teres minor

Answer 23

Originates from posterior of scapula, adjacent to lateral border, attaches to greater tubercle

Question 24

Subscapularis

Answer 24

Originates from subscapular fossa, inserts into lesser tubercle of humerus

Question 25

teres major

Answer 25

posterior surface of inferior angle of scapula to medial lip of bicepital groove

Question 26

Where does the tendon of supraspinatus pass?

Answer 26

through a small space unfer the coracoacromial ligament this can be impinged by overhead activities such as throwing

Question 27

Deltoid attachment

Answer 27

origin: scapula and clavicle insertion: deltoid tuberosity

Question 28

biceps brachii

Answer 28

origin: long head from supraglenoid tubercle of scapula, short head from coracoid process both heads insert into radial tuberosity and fascia of forearm via bicipital aponeurosis

Question 29

triceps brachii

Answer 29

long head from infraglenoid tubercle lateral head from humerus, superior to radial groove medial head- humerus, inferior to radial groove insertion: heads converge into one tendon distally and insert into olecranon

Question 30

coracobrachialis

Answer 30

origin: coracoid process of scapula Muscle passes through axilla and attaches to medial side of humeral shaft at deltoid tubercle

Question 31

pectoralis major

Answer 31

origin: clavicle, sternum, superior six costal cartilages insertion: bicepital groove's medial lip

Question 32

Quadrangular space

Answer 32

formed by teres minor, teres major, shaft of humerus, and long head of triceps brachi

Question 33

Axilla

Answer 33

formed by an apex, base and four walls base: skin and subcutaneous tissue which creates the axillary fossa apex (inlet): clavicle anteriorly, first rib medially, superior border of scapula posteriorly

Question 34

Axilla muscles

Answer 34

teres major, subscapularis, pectoralis major, latissimus dorsi, serratus anterior, pec minor

Question 35

Axilla anterior wall

Answer 35

pectoralis major and minor - pectoral nerves

Question 36

posterior wall of axilla

Answer 36

teres major, latissimus dorsi, subscapularis muscle supplied by branches from posterior cord of brachial plexus

Question 37

medial wall of axilla

Answer 37

serratus anterior long thoracic nerve, from C5-C7 roots of brachial plexus

Question 38

Lateral wall of axilla

Answer 38

shaft of humerus

Question 39

Contents of axilla

Answer 39

axillary artery and its branches, axillary vein and its tributaries, lymph vessels and nodes, and brachial plexus

Question 40

axillary artery formation

Answer 40

continuation of subclavian artery. Subclavian artery passes through scalene triangle, formed by anterior and middle scalene muscles and first rib, then becomes axillary artery

Question 41

axillary artery course

Answer 41

passes through axilla towards lower border of teres major to become brachial artery

Question 42

Parts of the axillary artery

Answer 42

divided into three parts by pec minor muscles. 3rd part: Anterior and posterior circumflex humeral branches wind around surgical neck of humerus, subscapular artery contributes to shoulder anastamoses

Question 43

Axillary vein

Answer 43

beside axillary artery continuation of basilic vein, terminates as subclavian vein at first rib

Question 44

basilic vein

Answer 44

medial side of arm

Question 45

cephalic vein

Answer 45

passes through the deltopectoral groove to join axillary vein within the axilla

Question 46

Trunks of brachial plexus

Answer 46

superior, middle and inferior pass through scalene triangle within subclavian artery

Question 47

divisions

Answer 47

anterior and posterior

Question 48

cords

Answer 48

directly below pectoralis minor muscle named relative to axillary artery which they sit beside lateral cord- lateral to artery medial cord - medial to artery posterior cord - posterior to artery

Question 49

terminal branches of brachial plexus

Answer 49

musculocutaneous, ulnar, medial, radial and axillary nerves

Question 50

supraspinatus

Answer 50

origin: supraspinatus fossa, inserts: anterior facet of greater tubercle of humerus

Question 51

infraspinatus

Answer 51

origin from infraspinus fossa, inserts to middle facet of greater tubercle of humerus

Question 52

teres minor

Answer 52

origin from dorsal aspect of lateral border of the scapula, inserts into lowest facet on greater tubercle of humerus

Question 53

subscapularis

Answer 53

origin from subscapular fossa, inserts to lesser tubercle of the humerus

Question 54

teres major

Answer 54

origin from inferior angle of scapula, inserts into medial lip of intertubercular sulcus of humerus

Question 55

deltoid

Answer 55

origin from lateral third of clavicle, acromion and spine of scapula inserts into deltoid tuberosity of humerus

Question 56

structures passing through quadrangular space

Answer 56

axillary nerve and posterior circumflex humeral artery

Question 57

Glenohumeral joint

Answer 57

surrounded by fibrous joint capsule attached to rim of glenoid fossa and to anatomical neck of humerus capsule strengthened by attachments of rotator cuff muscles which surround the joint on all sides except inferiorly joint also stabilised by coracoacromial ligament, forms an arch superiorly to joint glenohumeral ligament stabilise joint anteriorly shallow glenoid fossa deepened by ring of fibrocartilage known as the glenoid labrum