Exam #6: Scapular & Pectoral Regions Flashcards

1
Q

Review the bony landmarks of the clavicle.

A

Netter card

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2
Q

Review the bony landmarks of the scapula.

A

Netter card

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3
Q

Review the bony landmarks of the humerus.

A

Netter card

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4
Q

What is the difference between the anatomical and surgical necks of the humerus?

A

Anatomical= just distal to the humeral head; separates the head from the tubercles

Surgical= thinnest part of the humerus is commonly injured & most commonly requires surgery

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5
Q

List the 3 major joints of the shoulder from medial to lateral. What types of joints are these?

A

Medial= Sternoclavicular (saddle)

Intermediate= Acromioclavicular (plane)

Lateral= Glenohumeral (ball & socket)

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6
Q

Review the radiographic anatomy of the shoulder.

A

N/A

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7
Q

What is the function of the sternoclavicular joint?

A

Transmission of force from the thorax to the arm

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8
Q

What ligaments compose the sternoclavicular joint?

A
  • Anterior & posterior sternoclavicular ligaments

- Interclavicular ligaments

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9
Q

What is the function of the acromioclavicular joint?

A

Holds the clavicle onto the scapula

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10
Q

What ligaments form the acromioclaicular joint?

A

1x Acromioclavicular ligament

2x Coracoclavicular ligaments

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11
Q

What is an AC separation?

A

Tearing of the acromioclavicular & coracoclavicular ligaments

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12
Q

Where does a clavicle fracture usually occur?

A

Weakest point= between medial 2/3 & lateral 1/3 of the clavicle

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13
Q

What are the typical mechanisms for an AC joint separation & clavicle fracture?

A

1) Fall onto an outstretched arm

2) Fall onto a shoulder

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14
Q

Clinically, how can you tell the difference between AC separation and clavicle fracture?

A

With a clavicle fracture the patient will naturally have a tendency to hold the injured arm “up” to take weight off of it

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15
Q

What ligaments form the glenohumeral joint?

A

Superior= coracoacromial ligament–>superior reinforcement

Anterior= glenohumeral ligaments–>joint capsule

  • Superior
  • Middle
  • Inferior

Glenoid labrum

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16
Q

What is the most common presentation of a shoulder dislocation?

A

Inferior & anterior b/c of a lack of inferior ligaments + posterior muscles (rotator cuff)

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17
Q

What are the axio-appendicular muscles of the shoulder?

A

Muscles that attach from the body (thorax) to the shoulder; these are the “extrinsic” muscles of the shoulder

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18
Q

What are the scapulohumeral muscles of the shoulder?

A

Muscles of the shoulder itself; these are the intrinsic muscles of the shoulder

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19
Q

List the anterior axio-appendicular muscles of the shoulder.

A

Pectoralis major
Pectoralis minor
Subclavius
Serratus anterior

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20
Q

List the posterior axio-appendicular muscles of the shoulder.

A
Trapezius 
Lat. dorsi 
Levator scapulae 
Rhomboid major 
Rhomboid minor
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21
Q

List the scapulohumeral muscles of the shoulder.

A
Deltoid 
Teres major 
Supraspinatus 
Infraspinatus 
Teres minor 
Subscapularis
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22
Q

What is the function of the pectoralis major muscle?

A

Adduction and medial rotation arm

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23
Q

What nerves innervates the pectoralis major?

A

Medial & lateral branches of the pectoral nerve

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24
Q

What is the function of the pectoralis minor?

A

Stabilization of the scapula on the trunk

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25
Q

What nerve innervates the pectoralis minor?

A

Medial pectoral nerve

*Remember minor= only 1 branch b/c its small & “m” for medial

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26
Q

What is the function of the subclavius?

A

Depression of the clavicle

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27
Q

What nerve innervates the subclavius?

A

Nerve to the subclavius

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28
Q

What is the function of the serratus anterior?

A
  • Protracts the scapula
  • Rotates the scapula
  • Holds the scapula onto the rib cage
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29
Q

What nerve innervates the serratus anterior?

A

Long thoracic nerve

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30
Q

What is clinically important to remember about the anatomical location of the long thoracic nerve? What happens when there is damage to this nerve?

A
  • The long thoracic nerve (serratus anterior) is a very superficial structure contained within the subcutaneous tissue; thus it is commonly injured
  • Damage= “winged scapula” & the individual is unable to abduct the arm past 90 degrees i.e. overhead
31
Q

What is the function of the trapezius?

A

Elevates, retracts, rotates (with serratus anterior), and depresses the scapula

*Note that the trapezius has a very large origin; thus, it has the widest variety of functions

32
Q

What is the only muscle not innervated by brachial plexus?

A

Trapezius

33
Q

What nerve innervates the trapezius muscle?

A

Accessory nerve or CN XI

34
Q

What is the function of the levator scapulae, rhomboid minor, and rhomboid major?

A

Elevation and retraction of the scapula

35
Q

What muscles are innervated by the dorsal scapular nerve?

A

Levator scapulae
Rhomboid major
Rhomboid minor

36
Q

What is the function of the Latissimus Dorsi?

A

Adduction, extension, and medial rotation of the humerus

37
Q

What nerve innervates the Latissimus Dorsi?

A

Thoracodorsal nerve

38
Q

What muscles are involved in the elevation of the shoulder?

A

Mainly the trapezius

  • levator scapulae
  • rhomboids
39
Q

What forces and muscles are involved in the depression of the shoulder?

A

Mainly gravity

  • Pectoralis muscles
  • Lat. dorsi
  • Trapezius
  • Serratus anterior
40
Q

What muscles are involved in the protraction of the scapula?

A

Mainly the serratus anterior

- Pectoralis muscles

41
Q

What muscles are involved in the retraction of the scapula?

A

Mainly the trapezius

  • Rhomboids
  • Lat. dorsi
42
Q

What muscles are involved in superior rotation of the scapula?

A

Trapezius

Serratus anterior

43
Q

What muscles are involved in inferior rotation of the scapula?

A

Mainly the Lat. Dorsi

  • gravity
  • Levator scapulae
  • Rhomboids
  • Pectoralis muscles
44
Q

What is the function of the deltoid?

A

Deltoid= flexes, abducts, & extends the arm at the shoulder

- Lateral= abduct
- Anterior= flex
- Posterior= extend
45
Q

What nerve innervates the deltoid?

A

Axillary nerve

46
Q

What is the function of the teres major?

A

Adducts & medially (internally) rotates the humerus *assists the latissimus dorsi

47
Q

What nerve innervates the teres major?

A

Lower subscapular nerve

48
Q

What two intrinsic muscles of the shoulder DO NOT form the rotator cuff?

A

Deltoid

Teres major

49
Q

What four muscles make the rotator cuff?

A

Remember SITS

S= Supraspinatus 
I= Infraspinatus 
T= Teres minor 
S= Subcapularis
50
Q

What is the function of the supraspinatus?

A

Abduction of the humerus (first 15 degrees) & then the deltoid kicks in

*Note that this is the only intrinsic muscle of the shoulder that DOES NOT rotate the humerus

51
Q

What is the function of the infraspinatus?

A

lateral rotator of the humerus

52
Q

What is the function of the teres minor?

A

lateral rotator of the humerus

53
Q

What two muscles perform lateral rotation of the humerus?

A

Infraspinatus
Teres minor

*There are NO other muscles laterally rotate the humerus; if there is damage, humerus is medially rotated at rest because of a lack of tonic innervation

54
Q

What is the function of the subscapularis?

A

Medial rotation of the humerus

55
Q

What are the three major branches of the subclavian artery?

A

Common carotid
Vertebral
Thyrocervical trunk

56
Q

What are the branches of the thyrocervical trunk?

A

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57
Q

What is the axillary artery?

A

Continuation of the subclavian artery past the lateral border of the 1st rib

58
Q

Where does the axillary artery end? What does it become?

A

Ends at the inferior border of the teres major

*Becomes the brachial artery

59
Q

What are the borders of the first part of the axillary artery?

A

1st rib–> medial pectoralis minor

60
Q

What are the borders of the second part of the axllary artery?

A

Posterior to the pectoralis minor

61
Q

What are the borders of the third part of the axillary artery?

A

Lateral pectoralis minor–> teres major

62
Q

What artery branches from the first part of the axillary artery?

A

Superior thoracic a. (1st & 2nd intercostal spaces)

63
Q

What arteries branch from the second part of the axillary artery?

A

Thoraco-acromial artery

  • Pectoral
  • Deltoid
  • Acromial
  • Clavicular

Lateral thoracic artery (serratus anterior m.)

64
Q

What arteries branch from the third part of the axillary artery?

A
  • Subscapular artery
    1) Circumflex scapular
    2) Thoracodorsal (Lat. dorsi m.)
  • Anterior circumflex humeral artery
  • Posterior circumflex humeral artery
65
Q

What arteries anastomose in the region of the scapula?

A
  • Dorsal scapular & thoracodorsal–in the region of the inferior angle of the scapula
  • Suprascapular & circumflex scapular–in the region of the posterior arcomion
66
Q

What arteries anastomose in the region of the humerus?

A

Anterior & posterior circumflex humeral

67
Q

What is the triangular space? What are the borders?

A

This is a surgical landmark for the circumflex scapular artery

  • Lateral= long head of the biceps
  • Superior= teres minor
  • Inferior= teres major
68
Q

What are the borders of the quadrangular space?

A
  • Lateral= surgical neck of the humerus
  • Medial= long head of the triceps
  • Superior= teres minor
  • Inferior= teres major
69
Q

What are the contents of the quadrangular space?

A

1) Axillary nerve

2) Circumflex humeral artery

70
Q

What is the clinical importance of the quadrangular space?

A

Fracture of the surgical neck of the humerus damages the contents of this space
- Damage to the axillary nerve leads to atrophy of the deltoid muscle

71
Q

What deep veins accompany the axillary artery?

A

Axillary vein

Inferior= brachial 
Superior= subclavian
72
Q

Describe the superficial veins of the upper limb.

A
  • Lateral cephalic vein & medial basilic vein join at the medial cubital vein
  • BOTH continue into the upper arm as the veins of the same name
73
Q

Describe the association between the axillary lymph nodes & cancer.

A

The more lateral the lymph nodes with metastasis, the better the prognosis for cancer