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MSK 100 test 1 > Lecture 6: Intro to brachial plexus and shoulder girdle muscles > Flashcards

Lecture 6: Intro to brachial plexus and shoulder girdle muscles Flashcards

1
Q

What is the major nerve network supplying the upper limb?

A

Brachial Plexus

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2
Q

The brachial plexus s formed by the union of what?

A

Anterior Rami (C5-T1)

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3
Q

Where is the gap that the brachial plexus passes through?

A

Between the anterior and middle scalene muscles.

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4
Q

In the inferior part of the neck, the roots of the brachial plexus unite to form what three trunks?

A

-Superior Trunk (C5 & C6)
-Middle Trunk (continuation of C7)
-Inferior Trunk (C8 & T1)

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5
Q

As the brachial plexus passes posterior to the clavicle it divides into two compartments, what are these compartments?

A

-Anterior (flexor) compartment
-Posterior (extensor) compartment

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6
Q

The division of the brachial plexus forms three chords. What are they?

A

1) Anterior divisions of the superior and middle trunks
2) Anterior division of the inferior trunk
3) Posterior divisions of all three trunks

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7
Q

Anterior divisions of the superior and middle trunks form what?

A

Lateral chord

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8
Q

Anterior division of the inferior trunk form what?

A

Medial chord

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9
Q

Posterior divisions of all three trunks form what?

A

Posterior chord

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10
Q

The brachial plexus is divided into what two parts by the clavicle?

A

Supraclavicular & Infraclavicular

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11
Q

What are the four branches of the supraclavicular part of the plexus?

A

1) Dorsal scapular nerve (C5 root)
2) Long thoracic nerve (C5,6,7)
3) Nerve to subclavius (From superior trunk)
4) Suprascapular nerve (from superior trunk)

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12
Q

The median and lateral cords of the plexus join to form what?

A

Median nerve

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13
Q

What parts make up the infraclavicular part of the plexus?

A

-Branches of the lateral cord
-Branches of the medial cord
-Branches of the posterior cord

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14
Q

What are the branches of the the lateral cord?

A

1) Lateral pectoral nerve
2) Musculocutaneous nerve

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15
Q

What are the branches of the medial cord?

A

1) Medial pectoral nerve
2) Medial cutaneous nerve of arm
3) Medial cutaneous nerve of forearm
4) Ulnar nerve

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16
Q

What are the branches of the posterior cord?

A

1) upper subscapular nerve
2) Thoracodorsal nerve
3) Lower subscapular nerve
4) Axillary Nerve
5) Radial nerve

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17
Q

Review nerves and locations on back of card:

A
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18
Q

The brachial plexus in situ:

A

-Lateral to cervical spine
- Passes through scalene muscles
-Heads inferolaterally to travel underneath the clavicle and enter the axilla/armpit
-Associated with arterial supply of upper limb

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19
Q

The subclavian artery transitions to what as it passes under the clavicle?

A

Axillary artery

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20
Q

What is the formation of the plexus?
-Remember “5-3-6-3-5
“Real Texans Drink Cold Beer”

A

5 roots
3 trunks
6 divisions
3 cords
5 terminal branches

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21
Q

What is the arrangement of the terminal branches? “MARMU”

A

Musculocutaneous
Axillary
Radial
Median
Ulnar

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22
Q

What are the roots of the brachial plexus?

A

Anterior branches of fully formed spinal nerves

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23
Q

Which nerves make up the brachial plexus?

A

C5,6,7,8 & T1

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24
Q

Which trunks make up the brachial plexus?

A

Superior, Middle. Inferior

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25
Q

How many divisions?

A

6 divisions
-2 (superior trunk)
-2 (middle trunk)
-2 (inferior trunk)

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26
Q

Where do the 6 divisions pass under?

A

Clavicle and head towards the axilla

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27
Q

After the brachial plexus enters the axilla, they combine together to form three cords.

A

Lateral
Posterior
Medial

(their positions are named relative to the axillary artery)

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28
Q

The brachial plexus cords then form the terminal branches, what are they?

A

-musculocutaneous nerve (lateral cord)
-Axillary & Radial nerves (Posterior cord
-Median nerve (lateral & medial cord)
-Ulnar nerve (medial cord)

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29
Q

Which part of the brachial plexus passes through the scalenes muscles in the neck?

A

Roots

30
Q

Review nerve locations:

A
31
Q

What are the origins and insertions of the trapezius muscle?

A

O: upper trap-External occipital protuberance & the medial superior nuchal line of the occipital bone, the ligamentum nuchae, the SP’s of C7

Middle trap: SP of T1-T5

Lower trap: SP of T6-T12

I: Lateral 1/3 of clavicle; acromion, spine of scapula

32
Q

What action do the upper traps perform?

A

Elevation and upwardly rotate the scapula & extend the neck

33
Q

What action do the middle traps perform?

A

Retraction of the scapula

34
Q

What action do the lower traps perform?

A

Depression and aid in upward rotation of the scapula

35
Q

What is the origin and insertion of the rhomboids minor?

A

O: SP’s of C7-T1
I: Medial (vertebral) border of scapula at the root of the spine

36
Q

What are the origins and insertions of rhomboids major?

A

O: SP’s of T2-T5
I: Medial (vertebral) border of scapula inferior to spine

37
Q

What actions do the rhomboids perform?

A

Upward rotation and downward rotation

38
Q

What are the origins and insertions of levator scapula?

A

O: TP’s of C1-C4
I: Medial border of the scapulae (above the spine of the scapula)

39
Q

What are the actions of the levator scapulae?

A

Elevate the scapula

40
Q

What are the origins and insertions of Pectoralis minor?

A

O: 3rd-5th rib
I: Coracoid process

41
Q

What nerve innervates the pectoralis minor?

A

Medial nerve

42
Q

What nerve innervates the rhomboids?

A

Dorsal scapular

43
Q

What nerve innervates the traps?

A

Spinal accessory nerve (CN XI)

44
Q

What are the actions of the pectoralis minor?

A

-stabilization, depression, abduction or protraction, internal rotation, and downward rotation of the scapula

45
Q

What is the origin and insertion of the Subclavius?

A

O: First rib
I: Subclavian groove of the clavicle

46
Q

What nerve innervates the subclavius?

A

Nerve to subclavius

47
Q

What is the origin and insertion of Serratus anterior?

A

O: upper 9 ribs
I; Anterior surface of vertebral (medial) border of scapula

48
Q

What nerve innervates the serratus anterior?

A

Long thoracic nerve (C5,6,7)

49
Q

What is paralysis of the serratus anterior, due to injury of the long thoracic nerve called?

A

Winged scapula

50
Q

What happens during winged scapula?

A

Inferior angle of the medial border of the scapula is excessively prominent.

51
Q

What actions does winged scapula make difficult?

A

Pushing actions or raising arm above head

52
Q

What are the origins and insertions of the pectoralis major?

A

O: Clavicular head-Medial half of clavicle.
-Sternocostal head -sternum & costal cartilages of 1st to 7th ribs

I: lateral lip of intertubular (bicipital) groove of the humerus

53
Q

What are the actions of the pectoralis major?

A

Horizontal adduction

54
Q

What are the origins and insertions of the latissimus dorsi?

A

O: SP’s of T7-L5
Crest of ilium & sacrum
Lowest four ribs (via thoracolumbar fascia)

I: Floor of the intertubercular groove of the humerus

55
Q

What nerve innervates the latissimus dorsi?

A

Thoracodorsal

56
Q

What actions does the latissimus dorsi perform?

A

Internal rotation, adduction, and extension of the arm

57
Q

What are the origins and insertions of the deltoid muscle?

A

O: lateral clavicle (anterior fibers)
acromion (lateral fibers)
Spine of the scapula (posterior fibers)

I: Deltoid tuberosity of humerus

58
Q

What nerve innervates the deltoid?

A

Axillary

59
Q

What are the origins and insertions of the subscapularis?

A

O: Subscapular fossa
I: lesser tubercle of the humerus

60
Q

What nerve innervates the subscapularis?

A

Upper and lower subscapularis

61
Q

What are the origins and insertions of the Supraspinatus?

A

O: Supraspinous fossa
I: Greater tubercle of humerus

62
Q

What nerve innervates the supraspinatus?

A

Suprascapular nerve

63
Q

What are the origins and insertions of the infraspinatus?

A

O: infraspinous fossa
I: Greater tubercle of humerus

64
Q

What nerve innervates the infraspinatus?

A

Suprascapular nerve

65
Q

What are the origins and insertions of the Teres minor?

A

O: The superior lateral border of scapula
I: Greater tubercle of humerus

66
Q

What nerve innervates the teres minor?

A

Axillary nerve

67
Q

What are the origins and insertions of the teres major?

A

O: The inferior lateral border of the scapula
I: Medial lip of intertubercular (bicipital) sulcus (groove) of humerus

68
Q

What nerve innervates the teres major?

A

Upper and lower subscapular nerve

69
Q

What muscles are included in the rotator cuff?

A

1) Supraspinatus
2) Infraspinatus
3) Teres minor
4) Subscapularis

70
Q

What is the roll of the rotator cuff?

A

Strengthen the shoulder capsule all around except inferiorly.

71
Q

In which direction it is most common to dislocate the humerus?

A

Downward direction

72
Q

Review axillary spaces:

A

MSK 100 test 1 (7 decks)

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