part 2 shoulder Flashcards
Acromion belongs to ________
scaupla
name the two joints related to clavicle
acromioclavicular joint
sternoclavicular joint
Name the ligaments in the pectoral girdle
acromioclavicular ligament
coracoacromial ligament
coracoclavicular ligament
Shoulder droop may be due to dislocation of which joint?
acromioclavicular joint
+ breakage of coracoclavicular ligament
dislocation can be direct or indirect
Movement of scapular
upward rotation (Serratus anterior + trapezius (SAT) )
downward rotation (rhomboids + levator scapulae)
protraction (serratus anterior)
retraction
elevation (trapezius)
depression
Serratus anterior
from ribs to anterior medial border of the scapular
protraction and upward rotation of scapular
keep scapular close to rib cage
innervation: long thoracic nerve, damaged in breastectomy or stabbed directly, paralyze scapular does not move with forward movement, winged scapular
Trapezius
occipital bone, spinous process –> clavicle, acromion, scapular spine
upper fibers: elevation
lower fibers: depression
middle fiber: retraction
upper+lower: upward rotation (because lower fiber is attached to the scapular spine)
* innervated by accessory nerve CN XI (exception)
Movement:
Levator Scapulae + rhomboids
Glenoid down
Movement:
Trapezius + Serratus anterior
Upward rotation (SAT)
Muscle for scapular protraction
Serratus anterior
Muscle for scapular retraction
Trapezius middle fiber + Rhomboids
Muscle for scapular elevation
Trapezius upper fiber
Muscle for scapular depression
Trapezius lower fiber, Pec minor
Movement:
Trapezius middle fiber
Scapular retraction
Movement:
Serratus anterior
scapular protraction
Upward rotation
Sternocleidomastoid
head rotation to opposite direction
innervated by accessory nerve CN XI
Disease of clavicle
Midshaft fracture
Sternocleidomastoid: bone bumping up at middle of clavicle
Pec major spasm: adduction
Shoulder droops: holding limbs,
Adduction of shoulder joint
Pec Major + Latissimus dorsi
both attach anterior humerus
Pec major
adduction
medial rotation
flexion
Latissimus dorsi
adduction
medial rotation
extension
Deltoid
all movement are important Abduction: middle fiber (for testing) Flexion: anterior fiber Extension: posterior fiber innervated by axillary nerve
Deltoid injection
Intramuscular injection
2 inch down the acromion (axillary nerve 7cm down the acromion)
too posterior: radial nerve
Supraspinatus
initiate abduction 15`
Painful arc syndrome
60-120` increasing pain
Shoulder impingement occur
supraspinatus tendon press on the bursa
Muscles involved in lifting up upper limb from side to overhead
supraspinatous
deltoid
serratus anterior + trapezius
Lateral rotation of shoulder joint
Infraspinatous
Teres minor
Medial rotation of shoulder joint
Subscapularis, teres major
Subscapularis teres major
medial rotation, adduction
Quadrangular space
Teres major lateral inferior border Teres minor lateral superior border long head of the tricep lateral border humerus medial border where posterior circumflex humeral artery and axillary nerve goes to the back of the humerus
Disease of quadrangular space
Quadrangular space syndrome
shoulder pain due to compression of nerve and artery
Heavy backpack, shoulder joint dislocation, overhead sports
Shoulder joint dislocation causes
- quadrangular space syndrome –> shoulder pain
2. axillary nerve injury –> paralysis and atrophy of deltoid
Triangular interval
where radial nerve goes to the back of humerus
