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Gross Anatomy > Lecture 3: Upper Limb-Shoulder Girdle > Flashcards

Lecture 3: Upper Limb-Shoulder Girdle Flashcards

1
Q

Acromion

A

process of scapula that joins to the clavicle

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2
Q

Glenoid Cavity

A

ball and socket of joint on scapula that connects scapula to humerus

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3
Q

coracoid process

A

medial to glenoid cavity of scapula

muscle and ligament atachment

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4
Q

Calvicle functions (3)

A
  1. attach the upper limb to the trunk as part of “shoulder girdle”
  2. protects the underlying neurovascular structures supplying the upper limb
  3. transmits force from the upper limb to the axial skeleton
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5
Q

Shoulder joint/glenohumoeral

A

humerous articulates with the glenoid fossa of the scalpula

represents the major articulation of the shoulder girdle

most mobile joint in human body

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6
Q

Acromioclavicular joint

A

involves the lateral end of the clavicle and the acromion of the scalpula

can be palpated during shoulder examination, 2-3 cm medially to the tip of the shoulder

no muscles act directly on the joint, but the joint allows for axial rotation and anteropsterior movements

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7
Q

Subaracromial Bursa

Location
function

A

L: Lies between deltoid muscle and joint capsule in the superiolateral aspect of the joint

superficial to supraspinatus tendon

function: reduces friction underneath deltoid muscle- allowing for increased range of motion

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8
Q

subscapular bursa

Location
function

A

Location: between supscapularis tendon and the scapula

function: reduces wear and tear on the tendon during movement at the shoulder joint

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9
Q

Bursitis

A

iflammation of bursa, can be a cause of shoulder pain

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10
Q

Glenohumeral ligament

location
function

A

L: made up of a superior, middle, and inferior ligament
responsible for connecting the glenoid fossa to the humerus

f: protect the shoulder and prevent it from dislocating-primary stabilizer

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11
Q

Deltoid

insertion
blood supply
innervation
actions

A

attached to the spine of the scapula and lateral third of the clavicle

Inserstion/apex: attached to lateral body of humerous on a point known at deltoid tuberosity

BS: receives blood from thoracoacromial branch of axillary artery

Innervation: axillary nerve

Actions:

  • anterior fibers=flexion and medial rotation
  • posterior=extension and lateral roation
  • lateral fibers=major abductor of the arm
  • ambulation=anterior of the deltoid works with pectoralis major when walking
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12
Q

Muscles of the soulder (12)

A
  1. deltoid
  2. pec major
  3. trapezius
  4. latissimus dorsi
  5. levator scapulae
  6. rhomboid major
  7. thomboid minor
  8. supraspinatus
  9. infraspinatus
  10. teres minor
  11. subscalpularis
  12. serattus anterior
  13. teres major
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13
Q

Scapula

A

triangular flat bone/”shoulder blade”

muscles that move the arm attach to fossa (depressions) in the scapula
-supraspinous fossa, infraspinous fossa

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14
Q

Calcivle overview

A

joins the sternum anteriorly and the scapula laterally to help support the shoulder
-most frequent broken bone due to FOOSH (fallen onto outstretched hand) or blows to the shoulder

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15
Q

Humerous

A

proximal region articulates with the glenoid fossa on scalpula, forming glenohumiral joint

distally-humerous joind with head of radius and trochlear notch of ulna

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16
Q

Dorsal muscles of Upper limb (4)

A
  1. Trapezius
  2. latissimus dorsi
  3. levator scapulae
  4. rhomboid major
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17
Q

Trapezius

location
insertion
movement

A

L: triangular muscle that covers posterior neck and extends across the posterior shoulder - most superficial

I: inserts on clavicle and scapula

M: enables raising of shoulders and pulling back of shoulders
-accessory nerve to shrug shoulders
can also extend head and move side to side

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18
Q

Latissumus dorsi

Location
Origin
Movement

A

L: wide muscle of lower back and lateral trunk

O: from vertebral spine in middle of lower back, covers inferior half of thoracic region forming posterior portion of axilla

M:extends arm, bringing it down
primer mover in arm adduction and medial rotation of upper limb

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19
Q

Rotator Cuff muscles (4)

A
  1. Supraspinatus
  2. Infraspinatus
  3. Teres Minor
  4. Subscalpularis

*SITS

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20
Q

Supraspinatus

function
isolate
A

assists in abduction and external rotation of the shoulder

-Isolate: empty can

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21
Q

Infraspinatus

function
isolate
A

assists in external rotation and abduction of the shoulder

Isolate: hold arm, flex at 90 degrees adducted, attempt to resist during external rotation

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22
Q

Teres Minor

A

assists in external rotation and abduction

-contributes up to 45% of external rotation, may compensate for tears of infraspinatus

23
Q

Anterior fibers of deltoid

A

flexion and medial rotatio

24
Q

posterior fibers of deltoid

A

extension and lateral rotation

25
Q

lateral fibers of deltoid

A

major abductor of the arm

26
Q

ambulation of deltoid

A

anterior head of deltoid works with pec. major when walking

27
Q

Brachail plexus parts (5)

A
  1. roots- c5, c6, c7, c8, t1
  2. trunks- superior, middle, inferior
  3. divisions- anterior and posterios
  4. cords- lateral, posterial, medial
  5. branches
    - musculocutaneous (c5, c6, c7)
    - axillary (c5,c6)
    - radial (c5,c6,c7,c8,t1)
    - Median (c5, c6, c7, c8, t1)
    - ulnar c7, c8, t1

**Read That Darn Cadaver Book

28
Q

Roots of brachial plexus (5)

A

C5, C6, C7, C8, T1

29
Q

Trunks of brahcial plexus (3)

A

superior, middle, inferior

30
Q

Divisions of brachial plexus (2)

A

anterior and posterior

31
Q

Cords of brachial plexus (3)

A

lateral, posterior, medial

32
Q

Branches of brachial plexus (5)

A
  1. musculocutaneous (C5, C6, C7)
  2. axillary (C5, C6, C7, C8, t1)
  3. Radial (C5, C6, C7, C8, T1)
  4. median (C5, C6, C7, C8, T1)
  5. Ulnar (C7, C8, t1)
33
Q

Axillary nerve

A

C5 and C6

innervates teres minor and deltoid muscles

34
Q

Muscolocutaneous nerve

A

C5, C6, C7

innervates brachialis, biceps brachii, and coracobrachialis muscles

35
Q

Median nerve

A

C6-c11

innervates most of the flexor muscles in the forearm, the thenar muscles, and the two lateral lumbricals associated with the index and middle fingers

36
Q

Radial nerve

A

C5-T1

innervates triceps bracii and the muscles in the posterior compartment of the forearm, primarily extensors of the wrist and fingers

37
Q

Ulnar nerve

A

C8 and T1

innervates the muscles of the hand (apart from the thenar muscles and the two lateral lumbricals) flexor carpi ulnaris and medial half of flexor digitorum profundus

38
Q

Axillary Artery

A

lies deep to the pectoralis minor and is enclosed in the axillary sheath

39
Q

Brachial artery

A

supplies the arm, branches to the right and left ulnar and radial and then digital arteries

40
Q

lympatic drainage groups of axilla(5)

A
  1. pectoral (anterior)
  2. subscalpular (posterior)
  3. brachial/humeral (lateral)
  4. central
  5. apical
41
Q

pectoral axillary lymph drainage group (anterior)

A

receives lymph primarily form the anterior thoractic wall, including most of the breast

42
Q

supscapular/posterior axillary lymph drainage group

A

receive lymph from the posterior thoracic wall and scapular region

43
Q

Brachial/humeral axillary lymph drainage

A

receive most of the lymph drained from the upper limb

44
Q

central axillary lymph drainiage

A

they receive lymph via efferent vessles from the pectoral, subscapular, and humeral axillary lymph node groups

45
Q

apical axillary lymph drainage

A

receive lymph from efferent vessles of the central axillarly lymph node groups

also received lymph from lymphatic vessles accompanying the caphalic vein

46
Q

Venous drainage

A

palmar digital veins and palmar metacarpal veins deliver deoxygenated blood from the tissues of the fingers and palm to the superficial and deep palmar venous arches

then to the radial and ulnar veins, moving back up the arm before entering the brachial vein to the axillary vein to the subclavian vein before forming the brachiocephalic vein with blood returning from the head

or

Deoxygenated blood follows…

tissues of fingers -> palmar digital veins + palmar metacarpal veins -> sperficial + deep palmar venous arches -> radial + ulnar veins -> up arm -> brachial vein -> axillary vein -> subclavian vein -> brachiocephalic vein

47
Q

median cubital vein

A

cephalic vein and basili vein meet in the middle with median cubital vein

48
Q

Cavicle fracture

categorization
risk
presentation
exams/imaging
dx
tx
A

C:categorized by location

  • 69% middle
  • 28% distal third
  • 3% proximal third

R: FOOSH, fall or blow to should, traffic accidents, sports injury

P: pain that is well localized and exacerbated by movement of the arm

  • may also report snapping or cracking sensation
  • PE may reveal hematoma, bone angulaton (may see tinting of skin), point tenderness, crepitus (grating sound from bone-bone friction)

E/I: important to perform neurovascular and lung exam, looking for other injuries particularly high impact injury

Dx: singel AP xray

tx: pain control and reduction of motion until clinical union occurs
- sling or figure 8 to restrict shoulder motion to less than 30 degrees of abduction, forward flexion, or extension
- icing intermittently during the first 48 to 72 hours
- emergent if open reduction and fixation is needed

49
Q

Dislocation of the shoulder joint

location description
cause

A

D: dislocations described by where the humeral head lies in relation to the glenoid fossa

  1. anterior 95%
  2. posterior 4% (usually from seizure or electrocution
  3. inferior 1%

C: anterior dislocation is usually causes by excessive extension and lateral rotation of the humerus.
-humeral head is forces anteriorly and inferiorly into the weakest part of the joint capsule. tearing of the joint capsule is associates with increased risk of future dislocations

  • axillary nerve runs in close proximity to shoulder joint and around the surgical neck of the humerus so it can be damaged with dislocation or with attempted reduction
  • injury to axillary nerve causes paralysis to deltoid and loss of sensation
50
Q

Rotator cuff tear

A

Cause can be multifactoral
-degeneratoin, impingement and overload may all ctonribute

-most often begin as partial tears to the supraspinatus and overtime progress to full thickness to include infraspinatus, subscalpularis, and biceps tendon

RF: sports, occupations requiring overhead activity

CP: paint and weakness over the lateral deltoid and is exacerbated by overhread activites and at night

PE:painful arch test (abduction beyone 90 degrees), drop arm test (failure to smoothly control shoulder adduction, pain and weakness with external rotaion, empty can test

Dx: plain radiographs are usuallk normal MSK US, MRI

tx: depends on duration of symptoms, shoulder dominancem type of tear and patient characteristics
- tx typically surgical repoar and/or PT

51
Q

Sapula

A

muscles that move the arm attach to the fossa in this bone

52
Q

Hill-sach’s lesions

A

impaction fracture of posterolateral humoral head against anteroinferior glenoid can occur with shoulder joint dislocation

53
Q

Bankart lesions

A

detachment of antero-inferior labrum with or without and avulsion fracture can occure following antrior shoulder joint dislocation

Gross Anatomy (14 decks)

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