Exam 2 Flashcards
5 muscles that originate on the vertebral column or skull
Trapezius Rhomboid Major Rhomboid Minor Levator Scaula Latissimus Dorsi
Trapezius:
Origin - (4)
Insertion - (2)
Actions - (3)
Trapezius:
Origin - External Occipital Protuberance (EOP), Superior nuchal line, Ligamentous nuchae and C7-T12
Insertion - Clavicle and Acromion Process/Spine of Scapula
Actions - Stabilize Scapula, (upper) Elevate Scapula, (mid/lower) Adduct/Depress Scapula
Trapezius Nerve Supply:
Motor…
Sensory…
Motor innervation from Spinal Accessory Nerve (XI)
Sensory innervation from C3 and C4
Trapezius weakness can lead to… (2)
Deepening of shoulder
Shoulder drops
Rhomboid major and minor are (deep/superficial) to the trapezius.
Deep
Rhomboid Major:
Origin -
Insertion -
Origin - Spines of Upper Thoracic Vertebrae
Insertion - Vertebral Border of Scapula
Rhomboid Minor:
Origin -
Insertion -
Origin - Spines of lower cervical and first thoracic
Insertion - Vertebral border of scapula
Muscle deep to the trapezius on the side of the neck
Levator Scapula
Levator Scapula:
Origin - (1)
Insertion - (2)
Actions - (3)
Origin - Transverse Process of Upper Cervicals
Insertion - Superior Angle/Proximal Medial Border of Scapula
Actions - Elevate/Adduct/Stabilize Scapula
Innervation of Rhomboids and Levator Scapula
Dorsal Scapular Nerve (C5)
Damage to the Dorsal Scapular Nerve and/or C5 would result in… (2)
Difficulty completely adducting scapula
Scapula sits further from midline
Latissimus Dorsi: Origin - (4) Insertion - (1) Actions - (2) Nerve Supply (1)
Origin - Spines of lower thoracic and lumbar vertebrae, Thoracodorsal Fascia, Crest/Ilium, Lower Ribs
Insertion - Intertubercular Groove of Humerus
Actions - Extends/Adducts/Medial-Rotate Humerus, Forced Expiration
Nerve Supply - Thoracodorsal (C6, C7, C8)
Depression found at the LOWER portion of the latissimus dorsi…
Three landmarks…
Significance…
Lumbar Triangle
Latissimus Dorsi, Ilium Crest, External Oblique
Location of posterior abdominal wall hernia
Depression at the SUPERIOR border of the latissimus Dorsi…
Three landmarks…
Significance…
Triangle of Auscultation
Latissimus Dorsi, Trapezius, Vertebral Border of Scapula
Where lung sounds can be heard
Broad muscular sheet that passes posteriorly around thoracic cage from an extensive costal attachment to a more limited scapula attachment.
Serratus Anterior
Serratus Anterior: Origin: Insertion: Actions: (3) Nerve Supply:
Origin: Upper 8 or 9 ribs
Insertion: Vertebral Border of Scapula
Actions: Stabilize and Abduct Scapula, Forced Inspiration (when humerus abducted)
Nerve Supply: Long Thoracic (C5, C6, C7)
Winged Scapula
Long Thoracic Nerve Palsy
Signs of Long Thoracic Nerve Palsy… (2)
Vertebral Border of Scapula Raised from posterior thoracic wall.
Difficulty raising the arm overhead
Three causes os long thoracic nerve palsy
Trauma/Subluxation
Traction Injuries involving shoulder
Recumbency (for an extended period)
6 Scapular Muscles
Deltoid Supraspinatus Infraspinatus Subscapularis Teres Minor Teres Major
4 rotator cuff muscles
Supraspinatus
Infraspinatus
Subscapularis
Teres Minor
Large muscle forms the roundness of the shoulder and is divided into three portions, each with a different origin and actions.
Deltoid
Deltoid: Origin: (3) Insertion: Actions (3) Nerve Supply:
Origin: Clavicle, Acromion Process, Spind of Scapula
Insertion: Deltoid Tuberosity of Humerus
Actions Supply: Flex + Medially Rotate Humerus, Abduct Humerus, Extension + Laterally rotate humerus
Nerve Supply: Axillary Nerve (C5 & C6)
Atrophy of the deltoid (_______ ________).
Due to…
Crutch Paralysis
(due to) Axillary Nerve Injury
Three causes of axillary nerve injury (deltoid atrophy)
Fracture surgical neck of humerus
Dislocation of shoulder joint (humerus/scapula)
Pressure of a crutch in the axilla
Loss of sensation may occur over the _______ aspect of the ____ with an axillary nerve injury (deltoid atrophy)
LATERAL aspect of the ARM
Supraspinatus: Origin: Insertion: Actions: (3) Nerve Supply:
Origin: Supraspinatus Fossa of Scapula
Insertion: Greater Tuberosity of Humerus
Actions: Initiate Abduct of Humerus, Laterally Rotate Humerus, Stabilize Shoulder
Nerve Supply: Suprascapular (C5/C6)
Supraspinatus:
Lies _______ to the trapezius.
Tendon of insertion passes under the _______ _______ and over the top of the ________ to reach its insertion on the ________
Its tendon of insertion is separated from the acromion process by the _________ and _________ bursa.
DEEP to trapezius.
Tendon of insertion passes under the ACROMION PROCESS and over the top of theSHOULDER to reach its insertion on the HUMERUS.
Its tendon of insertion is separated from the acromion process by the SUBACROMIAL and SUBDELTOID BURSA.
Rotator Cuff Tendonitis: (2)
Irritation and inflammation of the supraspinatus tendon.
Also known as SHOULDER IMPINGEMENT SYNDROME.
Common causes of rotator cuff tendonitis (5)
Genetic Weakness around rotator cuff Excess stress/repetition Trauma/Injury Calcium Deposits
Rotator Cuff Tear:
Tendon usually ruptures at or near…
Creates difficulty carrying out… (action)
rupture at or near INSERTION
difficulty with ABDUCTION of ARM
Drop Test:
Test of rotator cuff tear.
Lower the fully abducted limb slowly - limb will drop suddenly if torn.
Bursitis of Supraspinatus:
Inflammation of bursa that separates the tendon from the acromion process (SUBDELTOID and SUBACROMIAL)
Muscle often used with the teres minor
Infraspinatus
Infraspinatus: Origin: Insertion: Actions: (2) Nerve Supply:
Infraspinatus: Origin: Infraspinatus Fossa of Scapula Insertion: Greater Tuberosit of Humerus Actions: Laterally Rotates Humerus, Stabilize Shoulder Joint Nerve Supply: Suprascapular (C5 and C6)
Muscle that occupies the ventral surface of the scapula.
Subscapularis
Subscapularis: Origin: Insertion: Actions: (2) Nerve Supply: (2)
Subscapularis:
Origin: Axillary Border of Scapula
Insertion: Lesser Tuberosity of Humerus
Actions: Medial Rotates Humerus, Stabilizes shoulder joint
Nerve Supply: Upper and Lower Subscapular (C5 and C6)
A narrow muscle which is found parallel to the axillary border of the scapula, between the infraspinatus and the trees major.
Teres Minor
The trees minor can sometimes be fused with the __________
Infraspinatus
Teres Minor: Origin: Insertion: Actions: (2) Nerve Supply:
Teres Minor: Origin: Axillary Border of Scapula Insertion: Greater Tuberosity of Humerus Actions: Laterally Rotates Humerus, Stabilizes Shoulder Joint Nerve Supply: Axillary (C5 and C6)
A well developed muscle which, along with the latissimus dorsi helps form the posterior wall of the axilla
Teres Major
Teres Major: Origin: Insertions: Actions: (2) Nerve Supply:
Teres Major: Origin: Inferior Angle of Scapula Insertions: Medial Lip of the Intertubercular Groove of Humerus Actions: Adducts/Medial Rotates Humerus Nerve Supply: Lower Subscapular (C6)
The space between the teres major and minor is divided by…
Long Head of Triceps Brachii
The two smaller spaces created by the division made by the long head of triceps brachii
Quadrilateral
Triangle
The quadrilateral space contains…
Axillary Nerve
Humeral Circumflex Blood Vessels
Triangular Space contains…
Circumflex Scapular branch of the Subscapular Artery
Ligaments can be classified as either…
Extrinsic (extracapsular)
Intrinsic (intracapsular)
Structure that separates extrinsic and intrinsic ligaments.
Capsular Ligament
Extrinsic - Superficial to Capsular Ligament
Intrinsic - Deep to Capsular Ligament
Ligaments prevent movement by acting either as a _____ or as a _____
Rope or Wall
Joint by which the upper limb articulates with the axial skeleton.
Sternoclavicular Joint
Most stable joint of the upper extremity.
Sternoclavicular Joint
SC joint articulates with… (3)
Sternal end of the clavicle
Clavicular and costal notches of the sternum
Medial end of first rib
The articulating surfaces of the SC joint are poorly adapted to one another. This is overcome by a piece of cartilage know as the ________ ______.
Articular Disc
SC Joint:
Classified as…
The _______ _______ surrounds the joint.
Nerve supply: (2)
SC Joint:
Plane Gliding Joint
CAPSULAR LIGAMENT surrounds joint
Nerves: Supraclavicular and Subclavius
Ligaments Associated with the SC Joint:
Anterior and Posterior SC Ligament
Reinforces Capsular Ligament
Prevent excessive Protraction/Retraction
Extrinsic Like a Wall
Ligaments Associated with the SC Joint:
Interclavicular
Attached to Sternal Ends of Both Clavicles
Prevents displacement when carrying heavy object
Extrinsic like a Rope
Ligaments Associated with the SC Joint:
Costoclavicular
Attached to Costal Impression of clavicle and 1st rib
Limits Elevation at medial end
Extrinsic like a Rope
Acromioclavicular Joint:
Joint Type:
Nerve Supply: (3)
Acromioclavicular Joint:
Plane Gliding Joint
Nerve Supply: Dorsal Scapular, Suprascapular, Axillary
Ligaments of the Acromioclavicular Joint:
Superior and Inferior Acromioclavicular
Reinforces Capsular Ligament
Keep clavicle in contact with acromion process
Extrinsic like a rope
Ligaments of the Acromioclavicular Joint:
Coracoclavicular
Connects clavicle with coracoid process
Divided into CONOID and TRAPEZOID portion
Extrinsic like a rope
Dislocation of the Acromioclavicular Joint is know as… (2)
Shoulder Separation
Shoulder Pointer
Joint that has the greatest range of motion.
Glenohumeral Joint (Shoulder)
Glenohumeral Joint: 2 articulation points: Fibrocartilage Rim: Type: Nerve Supply: (2)
Glenohumeral Joint: 2 articulation points: Head of Humerus/Glenoid Cavity of Scapula Fibrocartilage Rim: Glenoid Labrum Type: Ball and Socket Nerve Supply: Axillary and Suprascapular
Ligaments of the Should Joint: Capsular Ligament (2)
Surrounds Joint
Opening in inferior lateral portion where long head of biceps brachii
Ligaments of the Shoulder Joint:
Glenohumeral (1)
Prevents lateral rotation of the humerus
*Most limited movement of shoulder
Ligaments of the Shoulder Joint: Transverse Humeral (1)
Keeps long head of biceps brachii in place