Module 7 Flashcards
Which fossa is found on the costal surface of the scapula?
Supraspinous fossa
Infraspinous fossa
Subscapular fossa
Subscapular fossa
Explanation
The subscapular fossa is located on the costal surface of the scapula and it is the origin point of the subscapularis muscle. The supraspinous fossa is located superior to the spine and is the origin point of the supraspinatus muscle. The infraspinous fossa is located inferior to the spine and it is the origin point of the infraspinatus.
Which of the following borders of the scapula is located in close proximity to the vertebral column?
Lateral border
Medial border
Superior border
Medial border
Which bony prominence (projection) is located on the posterior aspect of the scapula?
Spine of the scapula
Acromion process
Coracoid process
Spine of the scapula
Explanation
The spine of the scapula is located posteriorly. The acromion process is located posterolaterally from the coracoid process and is located medial to the acromion. It sits superior to the glenoid and projects anterolaterally,
Which of the following is a bony landmark of the proximal humerus? Select all that apply.
-inferior angle
-greater tubercle
-lesser tubercle
-spinoglenoid notch
-surgical neck
greater tubercle
lesser tubercle
surgical neck
The acromioclavicular joint is formed by the articulation of which two structures?
The glenoid cavity of the scapula and the humeral head
The acromial end of the clavicle and the acromion process of the scapula
The sternal end of the clavicle and the clavicular notch of the manubrium of the sternum.
The acromial end of the clavicle and the acromion process of the scapula
Which ligament prevents the scapula from being displaced medially beneath the clavicle?
Coracohumeral
Acromioclavicular
Coracoacromial
Coracoclavicular
Coracoclavicular
True or False: The glenohumeral joint is a ball and socket synovial joint that allows; two degrees of freedom: flexion/ extension and abduction and adduction.
False
Explanation
This statement is false: glenohumeral joint is a ball and socket synovial joint that allows: three degrees of freedom: flexion/ extension; abduction/ adduction; internal (medial) and external (lateral) rotation
What structures form the coraco-acromial arch? Select all that apply
-deltoid
-acromion process
-coracoid process
-coracohumeral ligament
-coracoacromial ligament
Acromion process
Coracoid process
Coracoacromial ligament
Which of the following structures serves to deepen the glenoid cavity?
Glenoid labrum
Coracohumeral ligament
Subacromial bursa
Glenoid Labrum
Explanation
The glenoid labrum is fibrocartilaginous tissue that is attached to the glenoid cavity of the scapula and it serves to deepen the cavity. The coracohumeral ligament is a ligament that runs between the coracoid process of the scapula and the anterior aspect of the greater tubercle and it strengthens the joint capsule superiorly. The subacromial bursa is positioned between the acromion process, coracoacromial ligament and the deltoid superiorly and the supraspinatus tendon and joint capsule inferiorly. It facilitates movement of the deltoid over the joint capsule and the supraspinatus tendon under the coracoacromial arch.
Which of the following ligaments converts the intertubercular sulcus into a canal?
Coracohumeral
Transverse humeral
Glenohumeral
Transverse humeral
Explanation
The transverse humeral ligament runs between the greater and lesser tubercles and it converts the sulcus into a canal. The tendon of the long head of the bicep in its synovial sheath runs through this canal.
What structure is a fibrocartilage ring that helps to stabilize glenohumeral joint?
labrum
coracoacromio ligament
bicipital groove
subacromial bursae
Labrum
What location on the upper extremity does the brachial artery branch off to the radial and ulnar artery?
Axilla
Carpal Tunnel
Cubital Fossa
Bicipital Groove
Cubital Fossa
Which of the following muscles can be easily palpated lateral to the sternum and inferior to the clavicle?
Trapezius
Pectoralis major
Deltoid
Pectoralis Major
Explanation
The pectoralis major can be easily palpated moving laterally from the sternum and inferior to the clavicle. The trapezius is an extrinsic back muscle that acts on the scapula and is easily palpated posteriorly. The deltoid caps the shoulder and can be palpated over the shoulder joint.
True or False: The posterior axillary fold is formed by the teres major muscle and the tendon of the latissimus dorsi.
True
Which structures form the boundaries of the clavipectoral triangle? Select all that apply.
Clavicular portion of the pectoralis major muscle
Trapezius
Deltoid
Clavicle
Sternum
Clavicular portion of the pectoralis major muscle
Deltoid
Clavicle
(cephalic vein)
Explanation
The triangle is formed by the clavicle superiorly, the clavicular portion of the pectoralis major inferiorly, and the deltoid laterally. The tip of the coracoid process of the scapula can be palpated in this triangle.
Which of the following muscles is a muscle of the anterior axio-appendicular group of muscles? Select all that apply.
-rhomboids
-serratus anterior
-trapezius
-pectoralis minor
-deltoid
-subclavius
Serratus anterior
Pectoralis minor
Subclavius
Which of the following muscles will have its action on the humerus?
Pectoralis minor
Teres major
Rhomboids
Serratus anterior
Teres Major
Which of the following muscles inserts on the lateral lip of the intertubercular sulcus?
Pectoralis major
Pectoralis minor
Subclavius
Serratus Anterior
Pectoralis Major
Explanation
Pectoralis major inserts on the lateral lip of the intertubercular sulcus of the humerus ( it is the only anterior axio-appendicular muscle that inserts on the humerus, and it has its action on the humerus at the GH joint). The pectoralis inserts on the coracoid process of the scapula; serratus anterior inserts on the anterior surface of the medial border of the scapula; subclavius inserts on the inferior aspect of the clavicle.
Which of the following muscles has its origin point from the rib cage? Select all that apply.
-serratus anterior
-subclavius
-pectoralis minor
-pectoralis major
-serratus anterior
-subclavius
-pectoralis minor
-pectoralis major
(all of the above)
Which of the following muscles will contribute to upward rotation of the scapula?
Serratus anterior
Pectoralis major
Subclavius
Serratus Anterior
Which of the following muscles has its insertion on the clavicle, and the acromion process and spine of the scapula?
Latissimus Dorsi
Rhomboids
Trapezius
Levator Scapulae
Trapezius
Explanation:
The trapezius inserts on the lateral 1/3 of clavicle, acromion, & spine of the scapula. The latissimus dorsi muscle inserts on the floor of the intertubercular sulcus of the humerus; rhomboids insert on the medial border of the scapula (at the level of the spine and along the length to the inferior angle); and the levator scapulae inserts on the superior part of the medial border of the scapula.
Which of the following muscles originates from the spinous processes of either the cervical and/or thoracic vertebrae? Select all that apply.
Latissimus dorsi
Levator scapulae
Trapezius
Rhomboids
Latissimus dorsi
Trapezius
Rhomboids
Which of the following muscles will adduct, internally (medially) rotate, and extend the humerus at the GH joint?
Trapezius
Latissimus dorsi
Rhomboids
Levator Scapulae
Latissimus dorsi
Explanation
The latissimus dorsi is the only muscle of the posterior axio-appendicular group that acts on the humerus producing adduction, internal (medial) rotation and extension. All of the others produce movements of the scapula.
Which of the following muscles has an origin point from the clavicle, and the acromion process and the spine of the scapula?
Deltoid
Supraspinatus
Infraspinatus
Subscapularis
Deltoid
Which of the following muscles is considered a muscle of the rotator cuff? Select all that apply.
-teres major
-teres minor
-deltoid
-supraspinatus
-infraspinatus
-subscapularis
Teres minor
Supraspinatus
Infraspinatus
Subscapularis
Which of the following muscles inserts on the greater tubercle of the humerus? Select all that apply.
-supraspinatus
-teres major
-infraspinatus
-teres minor
-subscapularis
Supraspinatus
Infraspinatus
Teres minor
Explanation
3 of the 4 muscles of the rotator cuff insert on the greater tubercle of the humerus (in order from superior to inferior): supraspinatus, infraspinatus and teres minor. The subscapularis inserts on the lesser tubercle, and the teres major inserts on the medial lip of the intertubercular sulcus of the humerus.
Which of the following muscles produces abduction, flexion and extension of the humerus at the GH joint?
Teres minor
Deltoid
Teres major
Supraspinatus
Deltoid
Explanation
The deltoid can produce abduction (middle fibers), flexion (anterior fibers), and extension (posterior fibers) of the humerus at the GH joint. The teres major produces adduction, internal (medial) rotation, and extension of the humerus at the GH joint. Supraspinatus abducts, and the infraspinatus and teres minor produce external rotation of the humerus at the GH joint.
Which of the following structures forms the quadrangular space? Select all that apply.
-teres minor
-teres major
-lateral head of the triceps
-long head of the triceps
-surgical neck of the humerus
Teres Minor
Teres Major
Long head of triceps
Surgical neck of humerus
Which structure forms the lateral boundary of the triangular space?
Long head of the triceps
Surgical neck of the humerus
Teres minor
Long head of the triceps
Explanation
The long head of the triceps forms the lateral boundary of the triangular space and the medial boundary of the quadrangular space.
Which structures can be seen in the quadrangular space? Select all that apply.
-radial nerve
-posterior circumflex humeral artery
-circumflex scapular artery
-axillary nerve
-profunda brachii artery
Posterior circumflex humeral artery
Axillary nerve
Explanation
The radial nerve and profunda brachii artery can be seen in the triangular interval (to be covered).
Which of the following structures form boundaries of the apex of the cervico- axillary canal? Select all that apply
First rib
Second rib
Deltoid
Superior edge of the scapula
Clavicular portion of the pectoralis major
Clavicle
First rib
Superior edge of the scapula
Clavicle
Which structure forms the lateral wall of the axilla?
Proximal humerus at the level of the intertubercular sulcus
Pectoralis muscles
Subscapularis, teres major & latissimus dorsi
Serratus anterior
Proximal humerus at the level of the intertubercular sulcus
True of False: Neurovascular structures traveling between neck and upper limb travel through the cervico- axillary canal.
True
Which muscle of the shoulder region is the ONLY muscle thatis NOT innervated by branches of the brachial plexus?
Serratus anterior
Trapezius
Deltoid
Latissimus dorsi
Trapezius
Which of the following branches of the brachial plexus supplies the serratus anterior?
Long thoracic nerve
Thoracodorsal nerve
Lateral pectoral nerve
Medial pectoral nerve
Long thoracic nerve
Which nerve innervates both the supraspinatus and infraspinatus?
Suprascapular
Axillary
Lower subscapular
Suprascapular
Explanation
The suprascapular nerve innervates both supraspinatus and infraspinatus; the axillary nerve innervates both the deltoid and teres minor; and the lower subscapular nerve innervates both subscapularis and teres major.
The blood supply to the muscles of the shoulder region arise from branches of subclavian and axillary arteries.
True
False
True
Explanation
This statement is true: the subclavian artery will give rise to the thyrocervical trunk which gives off the suprascapular artery (supplies supraspinatus and infraspinatus and contributes to scapular anastomoses) and the dorsal scapular artery which supplies the rhomboids, levator scapulae and the trapezius and it also contributes to the scapular anastomoses. The rest of the muscles are supplied by the branches of the axillary artery.
Which of the following arteries are branches of the thoracoacromial artery? Select all that apply.
-clavicular
-lateral thoracic
-subscapular
-pectoral
-acromial
-deltoid
Clavicular
Pectoral
Acromial
Deltoid
Explanation
The thoracoacromial artery is a branch of the axillary artery that gives rise to 4 key branches: clavicular, pectoral, acromial and deltoid arteries. The lateral thoracic and the subscapular arteries are direct branches of the axillary artery.
Which of the following arteries supply the humeral head and the GH joint with blood?
Anterior and posterior circumflex humeral arteries
Thoracodorsal and lateral thoracic arteries
Circumflex scapular and suprascapular arteries
Anterior and posterior circumflex humeral arteries
Which of the following arteries network together to form anastomoses around the scapula? Select all that apply.
-lateral thoracic
-dorsal scapular
-suprascapular
-circumflex scapular
-thoracodorsal
Dorsal Scapular
Suprascapular
Circumflex scapular
Which artery is vulnerable to damage secondary to a fracture of the surgical neck of the humerus?
Anterior circumflex humeral
Posterior circumflex humeral
Circumflex scapular
Posterior circumflex humeral
Explanation
The posterior circumflex humeral artery (and axillary nerve) travels around the neck of the humerus making it vulnerabe to damage secondary to a fracture of the surgical neck of the humerus. If the artery is damaged, avascular necrosis of the humeral head may be a secondary complication of the fracture.
Which area do you usually get blood drawn?
Median Cubital Fossa
Yes or No: Axillary nerve injury deficits..
1. Weakness when attempting to abduct the glenohumeral joint
2. Weakness when attempting to flex glenohumeral joint
3. Weakness when attempting to externally rotate
4. Sensory impairments involving the skin overlining the the biceps bracchi
5. Sensory impairments involving skin overlining the area of the deltoid
- yes
- yes
- no
- no
- yes
Identify the muscles that form the boundaries of both the quadrangular space, triangular space and the triangular interval
- Teres Major
- Long Head of Triceps
Your patient presents with isolated weakness of shoulder external rotation. Passive range of motion for external rotation is intact, and there are no other notable sensory or motor deficits noted in the upper limb. You suspect which of the following?
A. Compression of the suprascapular nerve in the spinoglenoid foramen
B. Rotator cuff tear
C. Adhesive Capsulitis
A. Compression of the suprascapular nerve in the spinoglenoid foramen
Damage to which of the following ligaments can result in downward displacement of the scapula to the thorax?**
Acromio clavicular ligament
or
Compression of the suprascapular nerve in the spinoglenoid foramen
Acromio clavicular ligament
Name this muscle**
A.) What is the action of this muscle
B.) Name the ligament/arch that is easily palpated near it
(Supraspinatus)
A.) Abduction of glenohumeral joint
B.) Corachoachromial arch
A.)Name this space on the scapula
B.) What nerve passes over it**
A.) Suprascapular notch
B.) Suprascapular nerve
A.) Name this muscle**
B.) Main actions
A.) Rhomboid Major & Minor
B.) Retracts and downwardly rotates scapula; fixes scapula to the thoracic wall
Weakness is Serratus Anterior is due to what nerve?*
Long Thoracic nerve
The displacement of what joint is most common in shoulder separation?*
Acromio-clavicular joint
True or False: Erbs Palsy consists of lack of movement of Adduction and shoulder rotation**
False: should be abduction
Where does a patient usually get there blood drawn?*
Median Cubital Fossa
Where does a patient usually get there arm palpated?**
Brachial pulse
A.) Name this muscle
B.) Action of muscle**
A.) Infraspinatus
B.) Externally rotates the GH joint; helps hold humeral head in glenoid cavity
Where does this muscle insert and what innervates this muscle?**
(Trapezius)
A.) Insert: Spine of scapula, Acromion of scapula and lateral 1/3rd of clavicle
B.) Nerve: Spinal Accessory nerve CNXI, C3 & C4
Name this muscle **
Action
Innervation
Pectoralis Major
State yes or no: The following may or may not give a patient the ability to lift themselves up from chair at extension of the elbow: **
A.) Musculocutaneous
B.) Radial nerve
C.) Triceps
D.) Trapezius
E.) Bracchialis
a.) No
b.) Yes
c.) Yes
d.) No
e.) No
What is circled in this picture?**
A.) Name the structure it articulates
B.) Name the joint this articulation creates
Trochlear
a.) Trochlear notch of ulna
b.) Humeral ulnar joint
A.) What muscle is this?
B.) What action?**
A.) Subscapularis
B.) Medially rotates the GH joint; helps to hold the humeral head in the glenoid cavity (internal rotation of shoulder)
-What is the arrow pointing to?**
-What structure travels through there?
-What ligament encompasses that structure
-Intertubercular sulcus
-Long Head of Biceps Brachii tendon
-Transverse Humeral Ligament
a.)Name the highlighted space**
b.) What muscle inserts here
A.) Medial border of scapula
B.) Serratus Anterior
Which spaces are considered part of the Thoracic Outlet? **
a.) Scalene Triangle
b.) Subpectoral Space
c.) Costoclavicular space
Which of the following muscles serves as a wall of the axilla? Select all that apply. **
Serratus Anterior
Deltoid
Subscapularis
Pectoralis Minor
Serratus Antterior
Subscapularis
Pectoralis Minor
Fracture of the surgical neck of the glenohumerus may or may not affect these vascular structures. Yes or no***
a.) Anterior Circumflex Humeral artery
b.) Posterior Circumflex artery
c.) Circumflex Scapular artery
d.) Axillary artery
e.) Subscapular nerve
a.) no
b.) yes
c.) no
d.) yes
e.) no
a.) Name the space**
b.) Name the structure traveling through the space
a.) Quadrangular Space
b.) Axillary nerve
a.)Name the space**
b.)Name a structure traveling through the space
Scalene Triangle
Subclavian artery and superior portions of brachial plexus
The following explains overhead motion of the upper limb: A client is reaching up to a high cabinet and their glenohumeral joint is in flexion. Which of the following is responsible for this? yes or no**
a.) Flexion of glenohumeral joint
b.) Downward rotation of scapulorthoracic joint
c.) Deltoid
d.) Serratus Anterior
A.) yes
B.) no
C.) yes
D.) yes
