Learning Objectives Scapular and Pectoral Regions

Question 1

What are the regional designations of the deep fascia of the upper limbs?

Answer 1

1) Deltoid
2) Pectoral
3) Axillary (floor of axilla/armpit)
4) Brachial (with anterior/posterior compartments)
5) Antebrachial) (interosseous membrane connect ulna and radius)
6) Palmar Fascia
7) Digital fibrous sheaths

Question 2

What compartmentalizes the the muscles of the arm?

Answer 2

Medial and lateral septae

Question 3

What controls elevation of scapula?

Answer 3

Trapezius (Accessory nerve), levator scapulae (dorsal scapular)

Question 4

What controls depression of the scapula?

Answer 4

Pectoralis minor (medial pectoral), trapezius (accessory nerve)

Question 5

What controls protraction of scapula?

Answer 5

Pectoralis minor (medial pectoral), serratus anterior (long thoracic nerve)

Question 6

What controls retraction of the scapula?

Answer 6

Trapezius (accessory), Rhomboid major and minor (dorsal scapular)

Question 7

What controls lateral rotation of the scapula?

Answer 7

Serratus anterior(long thoracic nerve), trapezius (accessory nerve)

Question 8

What controls medial rotation of the scapula?

Answer 8

Levator scapulae (dorsal scapular), rhomboids (dorsal scapular)

Question 9

Muscles of the pectoral region

Answer 9

Anterior-Pectoralis major, pectoralis minor, subclavius, serratus anterior
Posterior-trapezius, rhomboids, levator scapulae, latissimus dorsi

Question 10

Muscles of the scapular region

Answer 10

Deltoid, trees major, Rotator cuff (supraspinatus, intraspinatus, trees minor, subscapularis)

Question 11

Flexion at Gelnohumeral joint

Answer 11

Deltoid (Axillary nerve), pectoralis major (pectoralis median and lateral)

Question 12

Extension at Glenohumeral joint

Answer 12

Deltoid (axillary), latissimus dorsi (thoracodorsal nerve), teres major (lower sub scapular nerve), long head of triceps brachii (radial)

Question 13

Abduction at Glenohumeral joint

Answer 13

Supraspinatus (suprascapular nerve) (to 15 degrees), deltoid (to 90 degrees), serratus anterior (long thoracic), trapezius (accessory)

Question 14

Adduction at Glenohumeral joint

Answer 14

Pectoralis major (medial and lateral pectoral), latissimus dorsi (thoracolumbar), teres major (lower sub scapular nerve)

Question 15

Internal (medial) rotation Glenohumeral joint

Answer 15

Deltoid (axillary), pectorals major (medial and lateral pectoralis), latissimus dorsi (thoracolumbar), teres major (lower subscapular), long head of triceps brachia (radial)

Question 16

What muscle connects to the greater tubercle of the humerus?

Answer 16

Teres Minor (axillary) (part of rotator cuff), infraspinatus (suprascapular), supraspinatus (suprascapular)

Question 17

What muscle connects to the lesser tubercle of the humerus?

Answer 17

Subscapularis (think, LESSER or SUBpar) (upper/lower subscapular), teres major (subscapular)

Question 18

What part of the humerus does the deltoid connect to?

Answer 18

Deltoid tuberosity (be able to identify)

Question 19

Describe the scapular arterial anastomosis - what vessels contribute and how do they communicate with one another?

Answer 19

extensive arterial anastomosis around the scapula and on its costal and dorsal surfaces. it provides a connection between the third part of the subclavian and the axillary artery

Question 20

What aspect of the shoulder joint is not reinforced by the rotator cuff and what is the clinical significance of this?

Answer 20

The anteroinferior aspect of the joint is not reinforced by the rotator cuff, which makes this region of the shoulder somewhat loose, unstable and easily dislocated or strained. the muscles supporting this are constantly contracted and can sometimes lead to tendonitis

Question 21

What are the boundaries of the quadrangular space?

Answer 21

Teres minor (superior), Long head of triceps brachii (medial), surgical neck of humerus (lateral), teres major (inferior)

Question 22

What structures pass through the quadrangular space?

Answer 22

Axillary nerve that innervates the deltoid muscle and the teres minor, and the posterior humeral circumflex artery that supplies the deltoid muscle

Question 23

Describe the anatomical basis of “winged scapula”

Answer 23

damage to the long thoracic nerve prevents protraction by the serrates anterior

Question 24

Describe the relationship of the axilla nerve to the surgical neck of the humerus. What symptoms would result from a fracture of the surgical neck of the humerus?

Answer 24

Damage to the axillary nerve affects function of the teres minor and deltoid muscles, resulting in loss of abduction of arm (from 15-90 degrees), weak flexion, extension, and rotation of shoulder as well as loss of sensation of the skin over a small part of the lateral shoulder

Question 25

How do clavicular fractures typically occur?

Answer 25

often caused by an indirect force transmitted from an outstretched hand through the bones of the forearm and arm of the shoulder during a fall. usually occurs at the weakest part between the middle and lateral thirds

Question 26

Why is the medial clavicular fragment often elevated after a clavicle fracture? Why does shoulder drop occur with a clavicular fracture?

Answer 26

it is elevated by the sternocleidomastoid muscle, and the shoulder drops because the trapezius is too weak to hold up the lateral fragment that is now supporting the upper limb.

Question 27

What connects to the greater tubercle of the humerus

Answer 27

Infraspinatus, supraspinatus, and teres minor

Question 28

Where does the teres major connect distally?

Answer 28

medial lip of inter tubercular sulcus of humerus