Module 3: Shoulder & Arm Flashcards
muscles in axillary fold
triceps brachii
latissimus dorsi
serratus anteror
bones of shoulder and arm
clavicle
humerus
scapula
4 joints of shoulder
sternoclavicular
acromioclavicular
glenohumeral
scapularthoracic
clavicle development + what kind sternoclavicular joint is
1st to start devel, last to complete
- why breaks easiest
- birds’ fuse/ossified to stern = wish bones
stenoclav = saddle
scapula boney landmarks (10)
acromion spine of scapula - supra/infraspinous fossas superior/inferior angle medial border lateral border infraglenoid tubercle glenoid cavity (cartilage) coracoid process subscapular fossa
boney landmarks of humerus
head of humerus - greater tubercle - lesser tubercle - intertubercle groove ^ bicep (-|- two) deltoid tuberosity other end - olecranon fossa - medial epicondyle - trochlea - lateral epicondyle
boney landmarks clavicle
acromial end (5 shape w/out top line) - trapezoid line - conoid tubercle sternal end (upside down triangle) - groove for subclavius
deltoid actions
all fibers = abduct shoulder (1st 15 deg = supspin)
anterior fibers = flex, medially rotate, & horizontally adduct the shoulder
posterior fibers = extend, laterally rotate, & horizontally abduct the shoulder
deltoid (O+I)
+ why name
O = lat 1/3 of clavicle, acromion, & spine of scap
I = deltoid tuberosity
* bc upside down delta (triangle)
why trap called wingnut
good question go watch lecture
what is the climbing muscle
latissimus dorsi
nerves for trapezius + test
spinal portion of cranial nerve XI (accessory) - shrug test
ventral ramus C2`, 3, 4
teres major (I+O+A)
extend, adduct, and medially rotate the shoulder
O= inferior angle & lower 1/3 of lat scap border
I = crest of lesser tubercle of humerus
muscles of rotator cuff (+ what is greater purpose)
supraspinatus infraspinatus teres minor subscapularis * glen-hum stability
supraspinatus (I+O+A)
- abduct the shoulder (1st 15 deg; rest 85 deg = deltoid)
- stabilize head of humerus in glenoid cavity
O = supraspinous fossa of scapula
I = greater tubercle of humerus
infraspinatus (I+O+A)
- laterally rotate & adduct shoulder
- stabilize head of humerus
O = medial 3/4 infraspinous fossa of scap
I = greater tubercle of humerus
teres minor (I+O+A) \+ function & placement
- laterally rotate & adduct shoulder
- stabilize head of humerus
O = upper 2/3 of lat scap border
I = greater tubercle of humerus - synergist for infrspin
- hidden by delts
subscapularis (I+O+A)
- medially rotate the shoulder (!!!!)
- stabilize head of humerus
O = subscapular fossa of scap
I = lesser tubercle of humerus
rhomboid major (O+I+A)
adduct, elevate, & downward rotate scap
O = spin pro t2-t5
I = medial border of the scapular -|- scap spine & inf angle
rhomboid minor (I+O+A)
adduct, elevate, & downward rotate of scap
O = spin pro c7- t1
I = upper portion of med bord of scap (across from spine of scap)
how levator scapula affect scap + where positioned
- unilaterally elevate and downwardly rotate scapula or fixated scap
- deep to trap
pectoralis major actions
all fibers - adduct & medially rotate shoulder - assist elevate thorax w forced inhalation (w arm fixed) upper fibers - flex & horizontally adduct shoulder lower fibers - extend shoulder
pec major (I+O)
O = med 1/2 clav, sterrn, & cartilage of rib 1-6 I = crest of greater tubercle of humerus
pec minor (O+I+A) \+ fun fact
- depress, abduct, & downwardly rotate scap
- w scap fixed = assist elevate thorax w forced inhal
O = ribs 3-5 (can vary)
I = medial surface of coracoid process of scap - surgical landmark for axillary artery
subclavius (O+I+A)
+ function
- depress & draw clav anteriorly
- elevate rib 1 to assist w inhal
- stabilize sternoclavicular joint
O = rib 1 & cartilage
I = inferior surface of middle 1/3 of clav - anchors sternal end of clav if there is a lateral-acting force to the scapular end of clav
biceps brachii (O+I+A) \+ what joints cross & 1 fun fact
- flex elbow (not when pronated)
- @ 90de flexion = supinated forearm & flex shoulder
O - short head = coracoid process
- long head = supraglenoid tubercle
I - tuberosity of radius
- aponeurosis of bicep brachii
- glenohumeral joint, elbow, radial humeral joint
- ~10% of ppl 3rd head
triceps brachii (I+O+A) \+ 1 fun fact
- all heads = extend elbow
- long head (stabilize/stunt) = extend and adduct shoulder
O - long head = infraglenoid tubercle of scap
- lateral head = post surface of prox of the humerus
- medial head = post surface of distal half of humerus
I = olecranon process of ulna - lateral head = strongest w resistance
coracobrachialis (O+I+A)
+ function
- flex & adduct shoulder
O = coracoid process of scapula
I = medial surface of mid humeral shaft - stabilizes GH, shunt
structures of the axilla + why name
armpit pyramid
- point = cervical axillary canal = path for vascular function
- brachial veins & ulnar nerve
base = skin, fat, fascia
sides
- ant pec major
- supscap
- med serratus anterior
- teres major
- latissimus dorsi
intertubercular groove of humerus
* bit ouchie/ticklish bc not want touch bc vulnerable areacoracoclavicular ligament
clav to coracoid
trapezoid & conoid
acromioclavicular ligament
- clav to acromion
- shoulder separation
ligaments of shoulder (6)
coracoclavicular acromioclavicular supraspinatus & subscapularis tendons coracohumeral coracoacromial infraspinatus and teres minor tendons
glenoid cavity
not circle
- :. stability issues
cartilage
surrounded by articular capsule
8 carpal bones
so long to pinky here comes the thumb
scaphoid lunate triquetrum pisiform hamate capitate trapezoid trapezium sca lu tri, pisi ham cap trap trap
boney landmarks of forearm and hand
radius/ulna - radial styloid - ulnar styloid - shafts - olecranon process (ulna) metacarpals & phalanges - base - shaft - hand
4 primary groups of forearm and hand muscles
- act at elbow
- move wrist and fingers
- pivot rad/ulna
- thumb
elbow movement & muscles
flexion = bicep extension = tricep
radial-ulnar joint movement and muscles
supination - bicep & supinator pronation - pronator teres - bi quad
wrist action and muscles
extension = extensor carpi radialis/ulnaris flexion = flexor carpi radialis/ulnaris abduction = ulnar deviation adduction = radial deviation
hand and finger movements
extension
flexion
adduction
abduction
thumb movements
flexion extension opposition adduction abduction
brachialis (I+O+A)
flex elbow
- most force
- only pure boy
O = distal half of anterior surface of humerus
I = tuberosity & coronoid process of ulna
brachioradialis (I+O+A)
- flex elbow
- assist pronate and supinate forearm when resisted
- quick moves
- no wrist action/no cross wrist
O = prox 2/3 of lateral supracondylar ridge of humerus
I = styloid process of radius
- no wrist action/no cross wrist
pronator teres (O+I+A)
pronate forearm
assit flex elbow
O = common flexor tendon from medial epicondyle of humerus and coronoid process of ulna
I = middle of lateral surface of radius
what 4 muscles originate at common flexor tendon
- pronator teres
- flexor carpi radialis
- palmaris longus
- flexor carpi ulnaris
(5. flexor digitorum superficialis)
pronator quadratus (I+O+A) \+ how access & 1 fun fact
pronate forearm
O = medial, anterior surface of distal ulna
I = lateral, anterior surface of distal radius
* only muscle that crosses ulna-radius
*inner wrist
* only access via dissection
supinator (O+I+A)
slow, unopposed supinate forearm O - lat epicon of hum - rad collateral lig - annular lig - supinator crest of ulna I = anterior lat surface of proximal 1/3 of radial shaft
extensor carpi radialis longus (O+I+A)
+ function
extend & abduct wrist assist flex elbow radial deviation O = distal 1/3 of lat supracondylar ridge of humerus I = base of metacarpals * clench fist
extensor carpi radialis brevis (O+I+A)
extend & abduct wrist
assist to flex elbow (synergist)
O = common extensor tendon from lat epicondyle of humerus
I = base of 3rd metacarpal
extensor carpi ulnaris (O+I+A)
extend & adduct wrist
O = common extensor tendon of lat epidon of hum
I = base of 5th metacarpal
extensor digitorum (O+I+A)
extend phalanges 2-5
assist extend wrist
O = common extensor tendon from lat epi con of hum
I = bases of middle & distal phalanges of 2nd-5th fingers
what do hand tendons do
restrict independent extension
flexor carpi radialis (O+I+A)
flex & abduct wrist
maybe flex elbow
O = common flexor tendon from medial epicondyle of humerus
I = bases of metacarpal 2&3
palmaris longus (O+I+A) * fun fact
- tense palmar fascia
- flex wrist
- maybe flex elbow
O = common flexor tendon from medial epicon of hum
I = flex retinaculum & palmar aponeurosis - not everyone has
- Achilles tendon of the wrist sorta
flexor carpi ulnaris (O+I+A+N)
-flex & adduct wrist
- assist flex elbow
O
- humeral head = common flexor tendon from medial epicon of hum
- ulnar hear = posterior surface of proximal 2/3 of ulna
I
- pisiform
- hook of hamate
- base of 5th metacarpal
N = ulnar nerve (C7,8,T1)
- only one innverv by this boy
flexor digitorum superficialis
flex fingers 2-5 flex wrist O - common flexor tendon from med epicon fo hum - ulnar collateral lig - coronoid process of ulna - interosseous membrane - proximal shaft of radius I = sides of middle phalanges of 2-5 finger
flexor digitorum profundus (O+I+A)
+ how sit
flex 2-5 fingers assist flex wrist O = anterior & medial surfaces of proximal 3/4 of ulna I - base of distal phalanges - palmar surface of 2-5 fingers * clothes ulna
anconeus (O+I+A)
+ what is called
extend the elbow
O = lateral epicondyle of humerus
I = olecranon process & posterior, proximal surface of ulna
* tense capsule @ elbow
extensor indicis (O+I+A)
extend & adduct second finger
- independence of pointer finger
O = posterior surface of distal shaft if ulna and interosseous membrane
I = tendon of extensor digitorum @ level of the 2nd metacarpal
extensor pollicis longus (O+I+A)
+ fun fact
extend the thumb abduct the wrist O = pos surface of ulna and interosseous membrane I = base of distal phalanx of thumb * anatomical snuff box
extensor pollicis brevis (O+I+A)
+ fun fact
extend thumb abduct wrist O = pos surface of radius and interosseous membrane I = base of prox phalanx of thumb * snuff
what muscles make up snuff box
- extensor pollicis longus (lat)
- extensor pollicis brevis (med)
- abdictor pollicis longus (lat)
abductor pollicis longus (I+O+A)
+ fun fact
abduct & extend thumb abduct wrist O = pos surface of radius and ulna, & interosseous membrane I = base of 1st metacarpal * snuff box
abductor pollicis brevis (I+O+A)
abduct thumb
assist in opposition of thumb
O = flexor retinaculum, trapezium, & scaphoid tubercles
I = base of prox phalanx of thumb
flexor pollicis longus (O+I+A)
only thumb flexor
assist to flex wrist
O = anterior surface of radius & interosseous membrane
I = base of distal phalanx of thumb
flexor pollicis brevis (O+I+A+N)
flex thumb & assist in opposition
O
- superficial head (larger) = flexor retinaculum
- deep head (smaller) = trapezium, trapezoid, and capitate
I = base of proximal phalanx of thumb
N
- superficial head = median nerve C6,7,8,T1
- deep head = ulnar nerve C8,T1
opponens pollicis (O+I+A) \+ function
opposition of thumb @ carpometacarpal joint
flex & rot imcp join
O = flex retinaculum & tubercle of trapezium
I = length of first metacarpal bone, radial surface
* picking up
adductor pollicis (O+I+A) \+ what structure for
adduct thumb (only adductor) O = capitate, metacarpals 2&3 I = base of proximal phalax of thumb * radial artery runs under belly
thumb muscles
extensor pollicis longus & brevis
abductor pollicis longus & brevis
flexor pollicis longus & brevis
opponens pollicis
pinky muscles
abductor digiti minimi
flexor digiti minimi
opponens digiti minimi
abductor digiti minimi (I+O+A)
+ placement
abduct 5th finger
assist in opposition of 5th finger
O = pisiform & tendon of flexor carpi ulnaris
I = base of phalanx of 5th finger & ulnar surface
* most superficial
flexor digiti minimi (I+O+A
flex 5h finger
assist in opposition of 5th finger towards thumb
O = hook of hamate & flexor retinaculum
I = base of proximal phalanx of 5th finger, palmer surface
opponens digiti minimi (I+O+A)
+ placement & how work
opposition of 5th finger @ carpometacarpal joint (only boy)
O = hook of hamate & flexor retinaculum
I = shaft of 5th metacarpal, ulnar surface
* deepest
* pushes in hollow of hand
palm muscles
lumbricals
palmar interossei
dorsal interossei
lumbricals of hand (O+I+A+N)
+ why name
extend & flex 2nd-5th @interphalangeal joints
O = surfaces of flexor digitorum profundus tendons
I = extensor aponeurosis on dorsa surface of phalanges
N
- fingers 2&3 = median C(6),7,8,T1
- fingers 4&5 = ulnar C(7),8,T1
* lumbricals = worms
palmar interossei (O+I+A)
- adduct & assist to flex & extend thumb, 2nd, 4th, & 5th fingers
O = base of 1st, 2nd, 4th, & 5th metacarpals
I = base of proximal phalanx of related finger and the extensor aponeurosis - anchor to and towards 3rd finger
- PAD = palmer adduct
dorsal interossei (O+I+A)
abduct, & assist to flex and extend 2nd-4th fingers
O = adjacent sides of all metacarpals
I = base of proximal phalanx of 2nd-4th fingers & extensors aponeurosis
* DAB = dorsal abductor
palmar + dorsal interossei common movements
flex metacarpophalangeal joints
extend interphalangeal joint
elbow ligaments and components
radial collateral ligaments - humerus to ulna fan and blend to head of radius annular ligament - ulna to ulna over head of radius - w blend of radial collateral ligament ulnar collateral ligament - anterior = hum med epicon to ulna - posterior = hum med epicon to olecranon process; weaker ulnar nerve - along ulnar groove - under ulnar collateral lig/along it
wrist tendons structure
flexor retinaculum
- roof for flexor tendons
extensor retinaculum
- roof for extensor tendons
ligs of interphalangeal joints
flexor digitorum superficialis tendon
- down 3rd finger
- splits at proximal interphalangeal joint for FDP tendon
flexor digitorum profundus tendon
- follows FDS tendon & goes through when split @ its insertion
- insert on distal interphalangeal joint
deep transverse metacarpal lig
- connect 2nd & 3rd, and 3rd & 4th, and 4th & 5th fingers at the metacarpals
