Lecture 14: UE pt 2 Flashcards
Name the 5 MSK sections of the UE
1) Shoulder complex
2) Axilla: brachial plexus, vessels, lymphatics
3) Arm
4) Forearm
5) Wrist and Hand
1) What are the two bones of the pectoral (shoulder) girdle?
2) Is it incomplete? Explain.
1) Scapula & clavicle
2) Incomplete posteriorly; muscular articulation.
-Completed anteriorly at SC joint
List the 3 shoulder “joints”
1) Scapulothoracic muscle articulation
2) Glenohumeral/ shoulder joint
3) Acromioclavicular/ AC joint
1) What does the pectoral group do?
2) What are the 4 members of this group?
1) Move the pectoral girdle
2) Pectoralis major and minor, subclavius, serratus anterior
Deltopectoral groove borders the clavipectoral triangle for ___________ vein. to join the axillary v
cephalic vein.
1) What muscle covers superior anterior thorax?
2) List the 3 parts of its medial attachments and which inferiorly forms the ant. axillary fold
1) Pectoralis major
2) Clavicular head
-Sternocostal head
-Abdominal part: inferiorly forms anterior axillary fold
1) Where is the lateral attachment of the pectoralis major?
2) What innervates the pec. major?
1) Lateral lip of intertubercular groove
2) Pectoral nerves
1) What are the two primary jobs of the pectoralis major?
2) What two things does it assist in? Via what parts?
1) ADDucts and medially rotates shoulder
2) Forward flexion via clavicular head
-Extension via abdominal part
1) Where does the pectoralis minor lie? (layers-wise)
2) Where does it go to and from?
3) What does it stabilize and what innervates it?
1) Anterior wall of axilla
2) Medial attachment at thoracic wall (ribs 2-5) > attach. at coracoid process of scapula
3) Scapula; pectoral n.
What 3 things can you find at the coracoid process?
1) Pec. minor
2) Short head [of] biceps
3) Coracobrachialis
1) Describe where the subclavius muscle is and runs to and from.
2) What innervates the subclavius?
1) Almost horizontal; medial from rib 1, to lateral on inf. clavicle
2) Subclavian n.
1) What does the subclavius muscle do in the event of a clavicle Fx?
2) What does it tend to favor and override?
1) Provides some protection to underlying structures
2) Tends to favor distal fracture; override proximal fracture
1) Where does the serratus anterior go to and from?
2) What does it form?
3) What condition does nerve injury result in?
1) Overlies lateral thorax (rib 2-9 lateral aspect) to medial scapular margin
2) Medial wall of axilla
3) Winging scapula
1) What does the serratus anterior anchor? What does this accomplish?
2) What innervates it?
1) Scapula to posterior thorax, thereby providing fixed point for movement of arm
2) Long thoracic n.
1) “Winging scapula” is related to the dysfunction of what muscle?
2) What are the two potential causes of this dysfunction?
1) Serratus anterior
2) Long thoracic nerve injury or muscle injury
What are the two groups of posterior axio-appendicular muscles? (extrinsic back muscles)
Include the two members of each group
1) Superficial posterior: Trapezius and latissimus dorsi
2) Deep posterior: Levator scapulae and rhomboids
List the 3 parts of the trapezius
1) Descending (superior)
2) Middle
3) Ascending (inferior)
What posterior muscle does direct attachment of pectoral girdle to trunk?
Trapezius
1) Describe how the trapezius attaches to the midline
2) Describe how it attaches to the lateral side
1) Midline from occipital protuberance to spinous processes of T12
2) Lateral 1/3 of clavicle, acromion, and spine of scapula
1) What innervates the trapezius with motor?
2) What does weakness in this muscle cause?
1) Spinal Accessory n., CN XI
2) Drooping shoulder
List what each part of the trapezius muscle does
1) Descending: elevates scapula
2) Middle: pulls it back
3) Ascending: depresses scapula + lowers shoulders
1) Where does the latissimus run to and from?
2) What nerve innervates it?
3) What fold does the latissimus form? What else forms this fold?
1) Trunk to humerus on medial lip of intertubercular groove
2) Thoracodorsal n.
3) Posterior axillar fold; teres major m.
1) What does the latissimus dorsi act on?
2) What does it do?
1) Directly on the GH (shoulder)joint
2) ADDucts humerus from over head position (pull down in gym)
1) What is the medial attachment of the levator scapulae muscles?
2) What is the lateral attachment?
1) Posterior tubercles of transverse processes of upper C-vertebrae
2) To just below the superior angle of scapula
What innervates the levator scapulae muscles?
Dorsal scapular n.
1) The levator scapulae acts with the _________________ muscle to elevate scapula.
2) What effects does the levator scapulae have on the neck?
1) Descending (superior) trapezius m.
2) Bilaterally extend and unilaterally side flex
1) What are the both the major and minor rhomboids deep to?
2) Where do they run to/ from?
3) What nerve innervates them?
1) Deep to trapezius
2) Midline @ vertebral spinous processes to medial border of scapula (C7-T5)
3) Dorsal scapular n.
1) What do the rhomboids do?
2) What do they assist in?
3) Give an example of when these muscles are used
1) Retract and rotate scapula (with levator scapulae) depresses glenoid cavity
2) Assist serratus anterior in fixing & holding scapula against thoracic wall
3) Rowing in the gym
[Nerves of the UE]
What does each innervate?:
1) Dorsal scapular n
2) Thoracodorsal n.
3) Long thoracic n.
4) Spinal accessory n.
Important*
1) Rhomboids, levator scapulae
2) Latissimus dorsi
3) Serratus anterior
4) Trapezius
[Nerves of the UE]
What innervates each of the following?:
1) Rhomboids & levator scapulae
2) Latissimus dorsi
3) Serratus anterior
4) Trapezius
Important
1) Dorsal scapular n
2) Thoracodorsal n.
3) Long thoracic n.
4) Spinal accessory n.
List the 6 scapulohumeral muscles; incl. which are rotator cuff muscles
1) Deltoid
2) Teres major
3) Supraspinatus*
4) Infraspinatus*
5) Teres minor*
6) Subscapularis*
- SITS = rotator cuff muscles
1) What are the 3 parts of the deltoid that act separately or together?
2) What is their action together as the deltoid? When does this occur?
3) What nerve innervates the deltoid?
1) Spinal (scapula) part, acromial (scapula) part, clavicular part
2) ABDuct shoulder; fully involved after 1st 15 degrees ABD
3) Axillary n.
1) Where does the teres major come from medially?
2) Where does it go laterally? What muscle is this just posterior to?
1) Inf. lateral border & inf. angle of scapula
3) To medial lip of intertubercular sulcus
-Latissimus dorsi m.
1) What does the teres major do?
2) What does it assist in? What 2 other things assist in this?
3) What nerve innervates teres major?
1) ADDucts and internally rotates arm
2) Stabilizing shoulder joint during movement; rotator cuff mm. and deltoids
3) Lower subscapular n.
1) What do the rotator cuff muscles form?
2) What does it insert on?
3) What do the tendons blend with?
1) Musculocutaneous rotator cuff around shoulder joint
2) (Posterior aspect of) greater tubercle
3) Joint capsule
What also assists the deltoid w ABduction of the arm What part does it assist in?
Supraspinatus m.; initial 15-degrees
Of the rotator cuff muscles:
1) What does the suprascapular nerve innervate?
2) What does the axillary n. innervate?
3) What does the subscapular n innervate?
1) (S)upraspinatus & (I)nfraspinatus)
2) (T)eres minor
3) (S)ubscapularis
1) What makes up the anterior axillary fold?
2) What abt the posterior axillary fold?
1) Lat. edge of the pectoralis major m.
2) Lat. edges of the latissimus dorsi and teres major.
What 3 nerves innervate the rotator cuff muscles?
1) Suprascapular n. - SI
2) Axillary n. - T
3) Subscapular n. – S
