Introduction to Upper Extremity and Superficial Back

Question 1

the pectoral girdle consists of

Answer 1

clavicle

scapula

Question 2

Major features of the scapula

Answer 2

spine 
coracoid process 
acromian process 
supraspinatous fossa 
subscapular fossa 
glenoid fossa 
superior and inferior angles

Question 3

sternoclavicular joint

Answer 3

anterior/posterior sternoclavicular ligaments
articular disc with two separate synovial cavities
only joint connecting upper limb to axial skeleton

Question 4

Acromioclavicular joint

Answer 4

synovial joint
superior and inferior acromioclavicular ligaments
other ligaments connect clavicle to coracoid process of scapula

Question 5

layer one of superficial hypaxial muscles of the back

Answer 5

trapezius

latissimus dorsi

Question 6

layer two of hypaxial muscles of the back

Answer 6

levator scapulae
rhomboid minor
rhomboid major

Question 7

Trapezius muscle

Answer 7

origin - medial 1/3 of superior nuchal line, external occipital protruberance, nuchal ligament, spinous process of C7-T12
Insertion - lateral 1/3 clavicle, acromion and scapular spine
Innervation: Spinal Accessory Nerve (CN XI)
Actions: Elevation, Retraction, Upward Rotation

Question 8

Latissimus Dorsi

Answer 8

Origin - spinous processes T7-12, Thoracolumbar fascia, iliac crest, inferior 3-4 ribs
Insertion - floor of intertubercular sulcus of humerus ANTERIOR SURFACE OF HUMERUS
Innervation - thoracodosal nerve (C6-C8)

Question 9

levator scapulae

Answer 9

origin - transverse process of C1-C4
Insertion - medial superior scapula
Innervation - dorsal scapular nerve (C5) cervical spine nerves (C3,C4)
Actions - elevates and rotates scapula

Question 10

Rhomboid minor

Answer 10

origin - nuchal ligament, C7, T1 spinous process
Insertion - medial scapular at spine border
innervation - dorsal scapular n
actions - elevates, retracts, downward rotation of scapula

Question 11

rhomboid major

Answer 11

origin - spinous processes T2-T5
Insertion - medial scapular border
Innervation - dorsal scapular n
Action - elevates, retracts, downward rotation of scapula

Question 12

ventral rami innervate

Answer 12

hypaxial muscles

Question 13

rotator cuff muscles

Answer 13

Supraspinatus - abduction of arm 1-15 degrees (supraspinatus n)
Infraspinatus - laterally rotates arm (suparspinatus n)
Teres minor - laterally rotates arm (axillary n)
Subscapularis - medially rotates arm (subscapularis n)

Question 14

nuchal ligament

Answer 14

very strong ligament that runs along the spinal processes of cervical vertebrae
contains a lot of elastin

Question 15

triangle of auscultation borders and use

Answer 15

Borders - trapezius, latissimus dorsi, medial scapular border
easier to hear breathing sounds

Question 16

quadrangular space borders and contents

Answer 16

borders - teres minor, humerus, long head of triceps

contents - axillary n, posterior humeral circumflex a

Question 17

triangular hiatus

Answer 17

borders - teres major insertion, humerus, long head of triceps
contents - radial n, deep brachial a

Question 18

arteries in scapular anastomoses

Answer 18

Ss Ds Cs
PT
suprascapular a (fropm thyrocervical trunk)
Dorsal scapular a (deep branch of transverse cervical a or subclavian a)
circumflex scapular a
Posterior intercostal a (from thoracic aorta)
thoracodorsal a

Question 19

suprascapular artery and nerve are separated by

Answer 19

superior transverse scapular ligament

Question 20

which rotator cuff muscle is most frequently injured in patients 55+

Answer 20

supraspinatus

because the blood supply to the tendon has been compromised

Question 21

supraspinatus inserts on

Answer 21

the greater tubercle of the humerus

Question 22

infraspinatus inserts on

Answer 22

the greater tubercle of the humerus posterior to glenohumeral joint (making it a lateral rotater)

Question 23

teres minor inserts on

Answer 23

greater tubercle of the humerus posterior to the glenohumeral joint (making it a lateral rotater)

Question 24

subscapularis is the only rotator cuff muscle that attaches

Answer 24

anterior to the glenohumeral joint (at the lesser tubercle) making it a medial rotater of the humerus

Question 25

which rotater cuff muscle is most commonly damagedi in young adults?

Answer 25

subscapularis

Question 26

elevators of scapula

Answer 26

levaetor scapulae (most powerful)
superior trapezius
rhomboids

Question 27

depressors of scapula

Answer 27

pectoralis minor
serratus anterior (inferior part)
inferior trapezius

Question 28

protractors of scapula

Answer 28

pectoralis minor

serratus anterior

Question 29

retractors of scapula

Answer 29

rhomboids
middle trapezius
latissimus dorsi

Question 30

winging of the scapula refers to

Answer 30

serratus anterior failing to hold the scapula tight to the body while raising the arms?

Question 31

muscles that elevate with superior (upward) rotation of glenoid fossa

Answer 31

superior trapezius
inferior trapezius
serratus anterior (inferior part)

Question 32

muscles that depress the scapula with inferior (downward) rotation of glenoid fossa

Answer 32

levator scapulae
rhomboids
latissimus dorsi