Lecture 13 - Musculoskeletal 2 Flashcards

1
Q

what is the most superficial muscle on the posterior surface of the pectoral girdle?

A

the trapezius

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2
Q

the trapezius has a very extensive ________

A

origin.
- it comes from superiorly and inferiorly in relation to its insertion

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3
Q

what does the trapezius origin pass through?

A

comes from the back of the skull, runs down BEHIND the cervical processes (along the ligamentum nuchae ligament), then at C7 it pick up the spinous processes and continues along the ligamentum nuchae to the T12 level.

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4
Q

what is the insertion of the trapezius

A

clavicle and the scapula

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5
Q

the trapezius insertion is also known at the anatomical?

A

horseshoe

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6
Q

what is the primary movement of the entire trapezius?

A

retracts the scapula

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7
Q

what is the insertion of the superior trapezius only?

A

clavicle

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8
Q

what is the primary movement of the superior trapezius only?

A

elevation of the scapula

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9
Q

what is the origin of the superior trapezius only?

A

back of the skull and the cervical vertebrae

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10
Q

what is the origin of the mid trapezius only?

A

part of the cervical and top of the thoracic vertebrae

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11
Q

what is the insertion of the mid trapezius only?

A

acromion

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12
Q

what is the primary movement of the mid trapezius only?

A

retraction of the scapula

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13
Q

what is the origin of the inferior trapezius only?

A

the lower thoracic vertebrae

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14
Q

what is the insertion of the inferior trapezius only?

A

the spine of the scapula

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15
Q

what is the primary movement of the inferior trapezius only?

A

depression of the scapula

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16
Q

what happens when the superior and inferior trapezius only contract and why?

A

superior rotation of the scapula
due to the synovial joint at the acromioclavicular joint

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17
Q

what three muscles are deep to trapezius

A
  • lavator scapulae
  • rhomboid major
  • rhomboid minor
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18
Q

what is the origin and insertion of the levator scapulae

A
  • upper cervical vertebrae
    -> superior angle of the scapula
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19
Q

what is the primary movement of the levator scapulae

A

elevates the scapula
2º movement= inferiorly rotates the scapula

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20
Q

what is the origin and insertion of the rhomboid major

A

origins: C7 -> T5
Minor insertion: medial border of the scapula where the spine ends
Major insertion: the rest of the medial border

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21
Q

which is more superior, rhomboid major or minor?

A

rhomboid minor

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22
Q

true or false, rhomboid minor is smaller in width but thicker than rhomboid major

A

true

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23
Q

what is the primary movement of rhomboid major and minor?

A

retraction of the scapula

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24
Q

what is the secondary movement of rhomboid major and minor

A

elevates the scapula and inferiorly rotates the scapula

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25
Q

rank the rhomboid muscles, trapezius and latissimus dorsi in order of superficial to deep

A

trapezius -> latissimus dorsi -> rhomboid

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26
Q

what is the origin and insertion of the latissimus dorsi?

A

origin goes from T7 all the way to the saccrum.
in part originates from the iliac crest of the hip
insertion is the floor of the intertubercular groove on the anterior humerus (twists under the armpit)

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27
Q

what is unique about the origins of the latissimus dorsi?

A

it is the only muscle that originates at the other limb on the same side

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28
Q

is the latissimus dorsi a part of the pectoral girdle and why?

A

no, because it does not directly involve movement of the clavicle or scapula.

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29
Q

which muscle did we study that has an aponeurosis

A

latissimus dorsi. its muscle belly only starts a third of the way up. the rest is a flat tendon called an aponeurosis

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30
Q

what are the primary movements of the latissimus dorsi?

A

adduction of the humerus, and internally rotates the humerus

31
Q

what are the secondary movements of the

A

lower fibres can depress scapula and other fibred can inferiorly rotate the scapula by pulling on the humerus

32
Q

how does paralysis of the lower serratus interior cause a winged scapula

A

The serratus anterior normally protracts the scapula and holds it tight against the ribcage.
Without this function, the scapula becomes unstable and “floats” away from the ribs.

33
Q

which two set of muscles allow the medial border (conceptual joint) of the scapula to ‘lock’ against the chest wall?

A

the rhomboid muscles and the serratus anterior. they oppose each other an pull opposite ways on the medial border of the scapula
- stabilises the mobile base of the pectoral girdle

34
Q

what is the most mobile joint of the body

A

shoulder joint
- this means its the least stable

35
Q

what secondary movement does abduction of the shoulder joint do

A

superior rotation of the scapula

36
Q

what is circumduction?

A
  • flex and extend
  • abduct and adduct
  • internal and external rotation
37
Q

what makes the shoulder joint triaxial?

A

can circumduct.

38
Q

what is the glenoid fossa?

A

one of the articulating surfaces of the shoulder joint.
- on the scapula

39
Q

what structure surrounds the glenoid fossa to increase the depth of the socket?

A

the glenoid labrum
- very small difference

40
Q

what are the supraglenoid and infraglenoid tubercules?

A

attachment site of muscles
supra: short head of biceps brachii
Infra:

41
Q

what fraction of the head of the humerus is in contact with the glenoid fossa

A

only about one third

42
Q

what is the anatomical neck?

A

the narrow part of the humerus right by the head

43
Q

what is the clinical importance of the surgical neck

A

the common break point of the humerus

44
Q

what connects to the greater and lesser tubercle of the humerus?

A

rotator cuff muscles
3 attach onto the greater, 1 onto the lesser

45
Q

what is another name for the inter-tubercular groove?

A

Bicipital groove

46
Q

what four features make the shoulder joint complex

A
  • glenoid labrum (fibrocartilage)
  • -
47
Q

what two articulating surfaces make up the shoulder joint?

A

the scapula’s glenoid fossa and the humerus head

48
Q

why does the fibrous capsule of the shoulder joint attach further down the humerus than other joints?

A

so the fibrous layer doesn’t get in the way (fowl on the articular bone) of adduction of the humerus

49
Q

what does the synovial membrane cover in the shoulder joint

A

lines the fibrous capsule and all other structures that aren’t articulating against cartilage or other bone.
- tendon of the biceps

50
Q

what makes the supraglenoid tubercle an intercapsular structure?

A

the fact that the tendon of the biceps brachii and therefore the supraglenoid tubercule is inside the articular capsule.

51
Q

is the infraglenoid tubercle intracapsular or extracapsular?

A

extracapsular

52
Q

why is the fibrous capsule of the shoulder joint under the arm loose, and what does this mean for the stability of the joint?

A

to allow a lot of abduction
- this means there is a loss of passive stabilisation, and must instead use active stabilisation of muscles to hold it in place

53
Q

what is the purpose of the coracoacromial ligament?

A

to prevent superior dislocation of the glenohumeral (shoulder) joint

54
Q

what is the coracoacromial arch and its function?

A

formed by the coracoid, the coracoacromial ligament and the acromion
- forms a roof over the shoulder so it can’t move superiorly and anteriorly or superiorly and posteriorly

55
Q

what is the only extracapsular ligament of the shoulder we learnt about?

A

coracoacromial ligament

56
Q

what are the three capsular ligaments of the shoulder we need to know and their attachments?

A
  • coracohumeral (coracoad -> greater tubercule)
  • transverse humeral (spans the intertubercular groove)
  • glenohumeral (glenoid labrum -> articular capsule of humerus)
57
Q

what are the three functions of the coracohumeral ligament?

A
  • strengthens the superior ‘roof’ of ligaments over the shoulder
  • prevents further adduction of the shoulder
  • suspends the humerus from the scapula along with the coracoclavicular ligaments
58
Q

what is the function of the glenohumeral ligaments?

A

supports the anterior and inferior aspect of the shoulder

59
Q

what is the function of the transverse humeral ligament?

A

covers the tendon of the long head biceps that sits in the intratubercular groove

60
Q

what are the two structures that hold the long head tendon in place?

A

pectoralis major and the transverse humeral ligament

61
Q

what protects the transverse humeral ligament from rubbing on the long head of biceps brachii

A

Sacciform synovial membrane
- basically a bulging out of the synovial membrane

62
Q

what are bursa?

A

a fluid-filled sac that reduces friction between structures like tendons, muscles, ligaments, and bones.

63
Q

what bursa protects the greater tubercule muscles from rubbing against the coracoacromial arch

A
  • subacromial bursa
    but is continuous with
  • subdeltoid bursa
64
Q

what two muscles do the bursa of the shoulder protect from abrasion from the coracoacromial arch?

A

supraspinatus and the intraspinatus of the rotator cuff

65
Q

what bursa protect the subscapularis muscle/tendon?

A

subscapular bursa

66
Q

what are the four rotator cuff muscles?

A

supraspinatus
infraspinatus
subscapularis
teres minor

67
Q

which direction do we most often get shoulder dislocation and why?

A

inferiorly, due to there not being any active stabilisation (e.g no muscles) at the inferior part of the shoulder joint

68
Q

what is anterior dislocation of the shoulder?

A

after dislocaiton, the head of the humerus is pulled anteriorly by latissimus dorsi and mostly pectoralis major

69
Q

what is the origin and insertion of the subscapularis

A

origin - subscapular fossa
insertion - lesser tubercle

70
Q

what is the only rotator cuff muscle in the anterior view and what movement does it do

A

subscapularis
internal rotation of the humerus

71
Q

what is the origin and insertion of supraspinatus, infraspinatus and teres minor?

A

supraspinous fossa
infraspinous fossa
lateral border of the scapula
insertion for all is the greater tubercle

72
Q

what is the primary movement of the teres minor and the infraspinatus?

A

external rotation of the humerus

73
Q

which rotator cuff muscle doesn’t rotate

A

the supraspinatus, which assits in arm abduction