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Anatomy Unit I > GA4: Pectoral & Shoulder Regions > Flashcards

GA4: Pectoral & Shoulder Regions Flashcards

1
Q

What makes up the pectoral girdle?

A

The bony ring formed by the scapula and the clavicle

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2
Q

What makes up the arm?

A

The part between the shoulder and elbow containing the humerus, plus the muscles in this region

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3
Q

What makes up the forearm?

A

The part between the elbow and wrist containing the Ulan and radius, plus the muscles in this region

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4
Q

What makes up the hand?

A

The part of the upper limb distal to the forearm containing the carpus, metacarpus, and phalanges

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5
Q

What are all the bones of the pectoral and shoulder regions?

A

Clavicle, Scapula, Humerus, Sternum, Ribs, and Glenohumeral (shoulder) joint

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6
Q

What are the parts of the scapula?

A

Glenoid cavity (fossa), infraglenoid tubercle, scapular neck, scapular spine, acromion process, coracoid process, superior border, suprascapular notch, medial (vertebral) and lateral (axillary) borders, superior and inferior angles, and supraspinous, infraspinous and subscapular fossae

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7
Q

What are the parts of the humerus?

A

Head, anatomical and surgical necks, greater and lesser tubercles (tuberosities), intertubercular (bicipital) groove or sulcus-with lateral and medial lips, shaft, deltoid tuberosity

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8
Q

What is the brachial plexus?

A

A nerve network formed by ventral rami of spinal nerves C5-T1

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9
Q

Teres Major Muscle: Origin, Insertion, Action, Innervation, Blood Supply

A

Origin: posterior side of the scapula near the inferior angle
Insertion: medial lip of the intertubercular groove, near the insertion of latissimus dorsi (anterosuperior part of the humeral shaft)
Action: extension, adduction, and medial rotation of the humerus (same actions on the humerus/glenohumeral joint as latissimus dorsi)
Innervation: Lower subscapular nerve
Blood Supply: subscapular artery

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10
Q

Deltoid Muscle: Origin, Insertion, Action, Innervation, Blood Supply

A

Origin: Lateral 1/3 of clavicle, acromion, and spine of scapula (same as the insertion of trapezious)
Insertion: deltoid tuberosity of humerus
Actions on the humerus (glenohumeral joint): anterior (clavicular) part flexes and medially rotates, lateral (acromial) part abducts, posterior part (from scapular spine) extends and laterally rotates
Innervation: Axillary nerve - courses around posterior side of surgical neck of humerus deep to deltoid
Blood supply: posterior circumflex humeral artery - courses with the axillary nerve in the quadrangular space

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11
Q

What major nerve supplies the deltoid and skin over it?

A

Axillary n.

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12
Q

What comprises the borders of the quadrangular space?

A

The quadrangular space is bordered by teres minor, teres major, long head of triceps brachii, and surgical neck of the humerus

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13
Q

What is the synovial bursa?

A

A flat sac of synovial membrane enclosing a film of slippery synovial fluid. It may be two separate bursae (subdeltoid bursa and subacromial bursa) or one large bursa

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14
Q

What is the function of the synovial bursa?

A

It functions to lubricate motion

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15
Q

Where is the synovial bursa?

A

Found between the greater tubercle of the humerus and the deltoid muscle and the acromion

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16
Q

What are the rotator cuff muscles?

A

Subscapularis, supraspinatus, infraspinatus, teres minor

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17
Q

What is the rotator cuff?

A

It is a group of four muscles (SSIT) that “cuff” the glenohumeral joint, adhering to its fibrous capsule and helping to stabilize the joint

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18
Q

Subscapularis Muscle: Origin, Insertion, Action, Innervation, Blood Supply

A

Origin: subscapular fossa (of the scapula)
Insertion: lesser tubercle (tuberosity) of the numerous
Action: medially rotates the humerus
Innervation: upper and lower subscapular nerves
Blood supply: subscapular artery

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19
Q

Supraspinatus Muscle: Origin, Insertion, Action, Innervation, Blood Supply

A

Origin: supraspinous fossa (of the scapula)
Insertion: superior part of the greater tubercle of the humerus
Actions: abducts the humerus
Innervations: suprascapular nerve - which courses through the suprascapular notch and under the transverse scapular ligament
Blood Supply: suprascapular artery - which courses over the transverse scapular ligament (not through the suprascapular notch)

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20
Q

Infraspinatus Muscle: Origin, Insertion, Action, Innervation, Blood Supply

A

Origin: infraspinous fossa (of the scapula)
Insertion: posterior side of the greater tubercle of the humerus
Actions: laterally rotates the humerus
Innervation: suprascapular nerve - which reaches this muscle by passing between the acromion and neck of the scapula
Blood supply: circumflex scapular branch of subscapular artery

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21
Q

Teres Minor Muscle: Origin, Insertion, Action, Innervation, Blood Supply

A

Origin: posterior side of the scapula, near its lateral border, lateral to the origin of the teres major
Insertion: posterior side of the greater tubercle of the humerus, inferior to the insertion of the infraspinatus muscle
Action: laterally rotates the humerus
Innervation: Axillary nerve
Blood supply: circumflex scapular branch of subscapular artery

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22
Q

Pectoralis major Muscle: Origin, Insertion, Action, Innervation, Blood Supply

A

Origin: clavicular head - medial 1/3 of the clavicle, sternocostal head - sternum and costal cartilages
Insertion: lateral lip of the intertubercular groove
Actions: both heads adduct and medially rotate the humerus, clavicular head- flexes, sternocostal head flexes and but extends the flexed humerus - it also depresses and protracts the shoulder girdle by pulling on the humerus
Innervation: lateral and medial pectoral nerves
Blood supply: branches of the internal thoracic, lateral thoracic, and thoraco-acromial arteries

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23
Q

Pectoralis Minor Muscle: Origin, Insertion, Action, Innervation, Blood Supply

A

Origin: ribs 3-5 near the costochondral junctions
Insertion: coracoid process of the scapula
Actions: depresses and protracts the shoulder girdle, helps with inferior rotation of the scapula
Innervation: medial pectoral nerve - penetrates pectoralis minor then enters pectoralis major
Blood supply: lateral thoracic and thoracoacromial arteries - both are branches of the axillary artery

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24
Q

Subclavius Muscle: Origin, Insertion, Action, Innervation

A

Origin: first costal cartilage
Insertion: inferior side of the clavicle
Action: depresses clavicle and resists lateral dislocation of the clavicle
Innervation: nerve to subclavius - a small branch of the biracial plexus

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25
Q

What are the subclavius and pectoralis minor muscles embedded in?

A

They are embedded in a sheet of clavipectoral fascia, in an approximately coronal plane

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26
Q

What is the clinical application for the subclavius muscle?

A

The subclavius muscle can splint a fractured clavicle, facilitating healing, and protects vessels and nerves in the axilla against injury from the sharp ends of broken bones

27
Q

Serratus Anterior Muscle: Origin, Insertion, Action, Innervation, Blood Supply

A

Origin: First 8 ribs, laterally
Insertion: Anterior (deep) side of the Sapulpa along its entire medial border
Action: protracts the shoulder girdle by pulling the scapula anteriorly, holds the scapula to the rib cage, rotates scapula superiorly during abduction of the arm by pulling its inferior angle forward
Innervation: long thoracic nerve
Blood Supply: subscapular and lateral thoracic arteries (branches of the axillary artery), and lateral branches of the posterior intercostal arteries

28
Q

Where do most fibers of the stratus anterior muscle insert and why?

A

Most fibers of the serratus anterior muscle insert near the inferior angle for maximum leverage in rotating the Sapulpa upwards

29
Q

What does denervation of the serratus anterior muscle result in?

A

It results in “winging of the scapula” when the patient tries to push forward with hands or flex the glenohumeral joint. The inferior angle of the scapula protrudes posteriorly because the scapula is not fixed by the serratus anterior muscle. There is also a severe weakness of abduction and flexion of the arm because the scapula isn’t supported by the serratus anterior muscle

30
Q

Where does the omohyoid muscle originate?

A

It originates on the superior border of the scapula

31
Q

Where does the coracobrachialis muscle originate?

A

It originates on the coracoid process

32
Q

Where does the biceps brachii muscle originate?

A

There are two heads. The long head originates from the supraglenoid tubercle (above the glenoid fossa) and the short head originates from the coracoid process

33
Q

Where does the triceps brachii muscle originate?

A

There are three heads. The long head originates on the infraglenoid tubercle of the scapula. The lateral and medial heads originate from the humeral shaft

34
Q

What does anastomose mean?

A

Communicate

35
Q

If one artery around the scapula is obstructed, will blood reach its territory?

A

Yes, all arteries around the scapula anastomose (communicate) so if one artery is obstructed, blood will reach its territory via alternative routes.

36
Q

What arteries anastomose on the dorsum of the scapula?

A

Suprascapular, dorsal scapular, subscapular, circumflex scapular, posterior circumflex humeral

37
Q

Where does the suprascapular artery come from?

A

A branch of the thyrocervical trunk (from the subclavian artery)

38
Q

Where does the dorsal scapula artery come from?

A

Arises from either the transverse cervical artery or directly from the subclavian artery

39
Q

Where does the subscapular artery come from?

A

A branch of the axillary artery

40
Q

Where does the circumflex scapular artery come from?

A

A branch of the subscapular artery

41
Q

Where does the posterior circumflex humeral artery come from?

A

A branch of the axillary artery

42
Q

Where does the Subclavian artery originate?

A

The right subclavian branches off of the brachiocephalic trunk, but the left subclavian artery branches off the arch of the aorta

43
Q

Where does the axillary artery originate?

A

It begins at the lateral border of the 1st rib

44
Q

Where does the brachial artery originate?

A

It begins at the inferior border of the teres major muscle

45
Q

What are mammary glands?

A

A modified and highly specialized type of sweat gland

46
Q

What is the anatomical location of the mammary gland?

A

Extends transversely from the lateral border of the sternum to the midaxillary line, extends vertically from the 2nd to the 6th rib, a small part may extend toward the axilla, 2/3 rests on deep pectoral fascia, 1/3 on fascia covering the serratus anterior

47
Q

What is the retromammary space?

A

The loose connective tissue between the breast and deep pectoral fascia. This is the insert area for female implants

48
Q

Where do you insert a breast implant for a female?

A

In the retromammary space

49
Q

What is the areolae?

A

The areola contains numerous sebaceous glands known as areolar glands or glands of Montgomery

50
Q

What is the nipple (papilla mammae)?

A

The nipple is mostly composed of circularly arranged smooth muscle fibers. Lactiferous ducts open into the tips

51
Q

What is a lobule?

A

A lobule is a functional unit of the breast tissue which is drained by a single Lactiferous duct and is separated from other lobule by suspensory ligaments

52
Q

How many lobes are there in the mammary gland?

A

15-20 lobes

53
Q

What is a Lactiferous duct?

A

Each lobule sends a duct to the nipple

54
Q

What is a Lactiferous sinus?

A

The enlargement of the Lactiferous duct proximal to its exit onto the nipple

55
Q

What are suspensory ligaments (of Cooper)?

A

Fibrous bands of connective tissue that connects the skin overlying the breast with the superficial fascia, thus separating the glandular tissue into 15-20 lobules

56
Q

What is the medial blood supply to the mammary gland?

A

Perforating (anterior cutaneous) branches of the internal thoracic artery also called medial mammary branches

57
Q

What is the lateral blood supply to the mammary gland?

A

Thoracoacromial artery and lateral mammary branches of the lateral thoracic artery and lateral cutaneous branches of posterior intercostal arteries

58
Q

Where is the venous drainage in the mammary glands?

A

Mainly to the axillary vein, but there is some drainage to the internal thoracic vein - follows the reverse route of the arterial supply

59
Q

Where is the lymphatic drainage of the mammary glands?

A

2/3 of breasts drain into axillary duct and 1/3 of breast drain into sternal lymphnodes

60
Q

What is the Innervation of the breast?

A

4-6 intercostal nerves: lateral and anterior cutaneous branches

61
Q

Where do the posterior cutaneous arteries arise?

A

They arise from posterior (Dorsal) branches of the posterior intercostal arteries

62
Q

Where do the lateral cutaneous arteries arise?

A

They arise directly from the posterior intercostal arteries

63
Q

Where do the anterior cutaneous arteries of the pectoral region arise?

A

They arise from the branches of the internal thoracic arteries

Anatomy Unit I (8 decks)

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