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MSS > Lecture 2 > Flashcards

Lecture 2 Flashcards

1
Q

What is the role of posterior axil-appendicular muscles?

A
  • Connect axial skeleton (trunk) to upper appendicular skeleton (upper limb) on the posterior side of the body
  • act on the pectoral girdle and/or arm
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2
Q

What are the 3 groups of muscles in the back?

A
  • Extrinsic (superficial) muscles: move upper extremity
  • Intermediate Layer: respiratory muscles
  • Intrinsic (deep) muscles: move trunk and back
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3
Q

Which are the 4 muscles that act on the pectoral girdle?

A
  • Trapezius
  • Levator Scapulae
  • Rhomboid Major
  • Rhomboid Minor
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4
Q

Where does the trapezius attach? What are its actions? What innervates the muscle? What is its blood supply?

A

Attach: Midline from occipital to spinous process of T12 vertebrae –> lateral 1/3 clavicle, spine of scapula

Actions:

  • Upper portion: elevate and upward rotate scapula
  • Middle portion - retract scapula
  • Lower portion: depress and downward rotate scapula

Innervation:
-Accessory Nerve (CN XI) *

Blood supply:
-branches of thyrocervical trunk

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5
Q

What happens when the whole trapezius muscle contracts?

A
  • just retraction of scapula

- upper and lower portions cancel each other out

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6
Q

Where does the levator scapulae attach?

A

Transverse processes of C1-C4 –> superior angle of scapula

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7
Q

Where does the rhomboid minor attach?

A

Spinous processes of C7-T1 –> medial border of scapula

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8
Q

Where does rhomboid major attach?

A

Spinous process of T2-T5 vertebrae –> medial border of scapula

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9
Q

What is the action, innervation, and blood supply of the levator scapulae, rhomboid minor, and rhomboid major?

A

Action: elevate and retract scapula

Innervation: dorsal scapular nerve

Blood supply: dorsal scapular artery (from thyrocervical trunk)

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10
Q

What is the difference in the cross-section of rhomboid minor and rhomboid major?

A

Rhomboid minor: round

Rhomboid major: flat

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11
Q

Where does the latissimus dorsi act?

A

on the arm

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12
Q

Where does latissimus dorsi attach? What is its action? What innervates the muscle? What supplies blood?

A

Attachment: spinous processes of T7-T12 vertebrae, thoracolumbar fascia, iliac crest –> anterior shaft of humerus *

Action: adducts, extends, and medially rotates arm

Innervation: thoracodorsal nerve

Blood supply: thoracodorsal artery

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13
Q

What is the triangle of auscultation? What is its clinical significance?

A
  • No large muscles, good place to listen for respiratory sounds with stethoscope
  • inferior: latissimus dorsi
  • superior: trapezius
  • Lateral:rhomboid major
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14
Q

Where do intrinsic muscles of the shoulder act? Where do they originate?

A
  • Act on the arm at the glenohumeral joint

- Orginate at the scapula

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15
Q

What are the 4 rotator cuff muscles?

A

-Supraspinatus, infraspinatus, teres minor, subscapularis (SITS)

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16
Q

Where does the supraspinatus attach? What is its action? What nerve innervates it? What blood supply?

A

Attachment

  • Scapula: Supraspinous fossa
  • Humerus: Greater tubercle (superior side)

Action: abduction of arm (first 15 degrees)

Nerve: Suprascapular nerve

Blood: Suprascapular artery

17
Q

Where does the infraspinatus attach? What is its action? What nerve innervates it? What is the blood supply?

A

Attachment:

  • Scapula: Infraspinous fossa
  • Humerus: Greater tubercle (lateral side)

Action: Lateral rotation of arm

Nerve: Suprascapular nerve

Blood: Suprascapular and circumflex scapular arteries

18
Q

Where does the teres minor attach? What is its action? What nerve innervates it? What is the blood supply?

A

Attachment:

  • Scapula: Lateral border
  • Humerus: Greater tubercle (lateral side)

Action: Lateral rotation of arm

Nerve: Axillary nerve

Blood: Circumflex scapular and posterior circumflex humeral arteries

19
Q

Where does the subscapularis attach? What is its action? What nerve innervates it? What is the blood supply?

A

Attachment:

  • Scapula: Subscapular fossa
  • Humerus: Lesser tubercle *

Action: Medial rotation of arm

Nerve: Upper and lower subscapular nerves

Blood: Subscapular artery

20
Q

What is a typical rotator cuff tear?

A
  • Typically a tear in the supraspinatus

- due to overuse

21
Q

Where does the teres major attach? What is its action? What nerve innervates it? What is the blood supply?

A

Attachment:

  • Scapula: inferior angle
  • Humerus: anterior humeral shaft

Action: medial rotation of arm

Nerve: Lower sub scapular nerve

Blood: Circumflex scapular and subscapular arteries

22
Q

Differentiate teres major from teres minor.

A
  • Only thing in common is both have round (terse) cross sections
  • Teres Major: synergist of latissimus dorsi, both medially rotate the arm
  • Teres minor: synergist of infraspinatus, both act to laterally rotate the arm
23
Q

Where does the deltoid attach? What is its action? What nerve innervates it? What is the blood supply?

A

Attachment:

  • Scapula: spine and acromion
  • Clavicle: lateral 1/3
  • Humerus: deltoid tuberosity * (deltoid tuberosity often tagged in lab according to prof)

Action:

  • Anterior (clavicular): flexes and medially rotates arm
  • Middle (acromial): abduct arm (15-90 degrees) * primary role is of powerful abductor
  • Posterior (spinal): extends and laterally rotates arm

Nerve: Axillary nerve

Blood: Thoracoacromial artery, anterior and posterior humeral circumflex arteries

24
Q

Explain arm abduction. What is the ratio of scapular/humeral movement?

A
  • First 15 degrees: supraspinatus
  • 15-90 degrees: deltoid
  • must rotate scapula to raise arm about 90 degrees, using trapezius and serrates anterior
  • adduction involves coordinated muscle actions in 1:2 scapular/humeral ratio (both move concurrently)
25
Q

How to test for supraspinatus dysfunction

A
  • Drop arm test

- Test is positive if patient is unable to lower arm in a smooth, controlled fashion (especially last 15 degrees)

26
Q

What are the 4 anterior axis-appendicular muscles?

A

Pectoralis major, pectoralis minor, subclavius, serratus anterior

27
Q

Where does the pectoralis major attach? What is its action? What nerve innervates it? What is the blood supply?

A

Attachment:

  • Medial clavicle, sternum, costal cartilage
  • crest of greater tubercle (anterior humerus)

Action: Adduct and medially rotate arm

  • Clavicular portion: flex arm (from extended position)
  • Sternocostal portion: extend arm (from flexed position)

Innervation: lateral pectoral nerve and medial pectoral nerve

Blood: Thoracoacromial trunk (pectoral branch)

28
Q

Where do the majority of clavicular fractures occur? What are fractures characterized by?

A
  • most occur midshaft (type 1)
  • characterized by kick stand deformity
  • sternocleidomastoid muscle pulls medial fragment superiorly
  • weight of arm pulls lateral fragment inferiorly
29
Q

Where does the pectoralis minor attach? What is its action? What nerve innervates it? What is the blood supply?

A

Attachement:

  • Ribs 3-5
  • Coracoid process of scapula

Actions

  • protracts scapula
  • downward rotation of scapula (rotate glenoid fossa inferiorly)

Innervation
-Medial pectoral nerve (nerve actually goes directly through pectorals minor)

Blood: Thoracoacromial trunk (Pectoral branch)

30
Q

Where does the subclavius attach? What is its action? What nerve innervates it? What is the blood supply?

A

Attachment:

  • Rib 1
  • Clavicle

Action: Stabilize clavicle

Innervation: nerve to subclavius

Blood: Thoracoacromial Trunk (clavicular branch)

31
Q

Where does the serrates anterior attach? What is its action? What nerve innervates it? What is the blood supply?

A

Attachment:

  • Ribs 1-9
  • Medial border of scapula (anterior side) *actually sometimes considered a back muscle

Actions

  • protract and stabilize scapula on trunk
  • depression of scapula
  • upward rotation of scapula (rotates glenoid fossa superiorly)

Innervation: Long thoracic nerve

Blood: Lateral thoracic artery and thoracodorsal artery

32
Q

How do you test if serrates anterior is malfunctioning/damaged?

A
  • Have patient push against wall
  • If positive result, winged scapula will result
  • inability to protract medial scapula
  • usually trauma related
33
Q

What is a rectus sternalis?

A
  • rare anatomical variant
  • usually unilateral
  • may be misdiagnosed as cancerous mass

MSS (7 decks)

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