Pectoral And Pelvic Girdles Flashcards
What makes up hip bone
Ilium
Ischium
Pubis
Where does lateral flat end of clavicle articulate
With acrimonious
Where does quadrangular medial end articulate
With sternum of manubrium
How is the clavicle shaped
Rounded medial 1/3 convex anteriorly
Where are the borders of the scapula
Lateral border is outside nearest humerus
Medial border is nearest the other scapula
Angles of scapula
Superior inferior and lateral angles
Why is stenroclavicular joint strong
Disc that attaches to clavicle and manubrium and capsule adds great strength
Dislocation rare
Movement of acromioclavicular
Small range of gliding
What can happen to acromioclavicular joint
Can become arthritic and cause shoulder pain
What ligament supports acromioclavicular joint
Coracoacromial ligament superiorly
Conoid and trapezoid parts of coracoclavicular ligament (strongest) q
What ligaments support sternoclavixular joint
Costoclavicular ligament
Interclavicular ligament
What lies in the space between upper aspect of shoulder and overlying acromion,
Acromioclavicular joint and coracoacromial ligament
Subacromial bursa and the tendon of the supraspinatus muscle
Both susceptible to impingement from pathology such as arthritis in adjacent joints and repetitive strain injury
Where is gateway for pectoral girdle
Between clavicle, superior edge of scapula and first rib headed to axillary
What comes through pectoral gateway
Subclavian vessels continuing as axillary vessels
And trunks of the brachial nerve plexus
What ways do bones move in fractured clavicle
Lateral end inferior
Medial end superior
What are the concerns when faced with fractured clavicle
Close proximity to brachial plexus
Subclavian artery and vein
Where is obturator foramen of hip
Hope at pubis
Sacroiliac joint
Synovial anteriorly - supported by anterior sacro-iliac ligament
Fibrous posteriorly linked by interosseous membrane
Supporting ligaments of sacroiliac joint
Interosseous SI ligament continues as posterior SI ligament (pulles bones inwards)
Sacrospinous and sacrotuberous ligaments further support the SI joint and prevent sacrum tilting forward
What ligaments convert sciatic notches into greater and lesser sciatic foramen
Sacrospinous creates greater sciatic foramen
Sacrotuberous creates lesser sciatic foramen
Rotation is also prevented by these ligaments
Gateways into lower limb and bum
Greater sciatic foramen for sciatic nerve and gluteal NVB
obturator canal for obturator NVB
gap between inguinal ligament and pelvic bone for femoral nerve, artery and vein NVB
Where does sciatic nerve come from and go
Comes through greater sciatic foramen posteriorly and slides down inner posterior area of leg
Where can you put an intragluteal injection
Upper outer quadrant where hip bone top is
Where does sciatic nerve emerge at the butt
Inferior to piriformis and midway between ischia tuberosity and greater trochanter
Movements of scapula
Elevation depression (shrug) Protraction and retraction Upward and downward rotation(abduct arm)
Serrated anterior attachments
Ribs 1-8
to
Medial border scapula
What forms medial wall of axilla
Serratus anterior
What supplies serratus anterior
Long thoracic nerve
What causes winging of the scapula
Damage to long thoracic nerve
Trapezius is supplied by which nerve
Spinal accessory nerve (cranial nerve XI)
What does trapezius do
Elevates scapula (shrug) and retracts or braces shoulders backwards
Wing nut effect of trapezius
Upper fibres pull glenoid up
Lower fibres pull medial spine down
Assists serratus anterior in full abduction of upper limb
Attachments of trapezius
Skull, ligamentum nuchae and thoracic spines passing to lateral clavicle, acromion and spine of scapula
What supplies pectoralis major
Pectoral nerves
Attachment of pectoralis major
Clavicle head attaches to medial clavicle
Sternocostal head attaches to upper 6 costal cartilages and adjacent sternum then both attach to lateral lip of intertubercular groove sulcus of humerus
What job of pectoralis major
Adduct and internally medially rotates the humerus
What part of the axilla does pectoralis major make
Anterior axillary fold
What supplies latissimus Doris
Thoracodorsal nerve
Attachment of latissimus Doris
Lower thoracic spines, iliolumbar fascia, Lowe ribs and iliac crest passing to flow to intertubercular groove - anterior aspect of humerus
What function does latissimus Doris do
Powerful adductor and internal rotator
Extension of humerus
What part of the axilla does latissimus Dorsi make
Posterior axillary fold
Attachments of levstor scapulae
Transverse processes to superior, medial border of scapula
What does levator scapula do
Scapular elevation
Inferior rotation of the glenoid
Rhomboid minor and major attachments
Ligamentum nuchae and upper thoracic spines to medial border of scapula
Function of rhomboid major
Scapular retraction
What’s the function of pectoralis major
Stabilises scapula by holding it down and against the thoracic wall
What does the subclavius do
Anchors the clavicle
What muscles pass from scapula and clavicle to humerus and only act upon shoulder joint
Deltoid
Latissimus Dorsi
Teres major
Attachments of teres major
Inferior angle of scapula and medial lip of intertubercular groove
Job of teres major
Adducts and internally rotates
Deltoid attaches
Clavicle, acromion and spine of scapula passing to Deloris tuberositt of humerus
Deltoid job
Lies behind to side and front of shoulder joint therefor extends, abducts and flexes it
4 muscles which arise from scapula and insert into capsule of shoulder joint and humerus (rotator cuff)
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Job of infraspinatus
External rotation
Superspinatus job
Initiates abduction
Teres minor job
External rotation
Subscapularis job
Internal rotation
What muscles are crucial in keeping pelvis level when walking
Muscles that abduct the hip
What do muscles that pass from pelvis to femur anterior to hip do?
Flex the hip
What are the muscles that flex the hip?
Iliacus
Psoas major (combine as lliopsias)
Satorius
Recurs femoris
What muscles make up iliopsoas?
Psoas major
Iliacus
Where does iliopsoas attach
Iliacus from ilium
Psoas major from lumbar vertebrae
Both attach to the Lesser trochanter of femur
Sartorial attaches
From anterior superior iliac spine to anteromedial surface of tibia
What happens following fracture of femoral neck
Axis of movement changes from hip joint to femoral shaft
Iliopsoas pulls femoral neck proximal and externally rotates it
Limb looks shortened and foot turns out
What do muscles that pass from pelvis to femur, tibia or fibula lying posterior to hip joint do? Back of leg?
They extend it
Gluteus maximum
Hamstrings
Attachments of gluteus maximum
Posterior ilium and sacrum
To femur and iliotibial tract
What does gluteus maximus do
Extends hip in running, standing from sitting and climbing stairs
What supplies gluteus maximus
Inferior gluteal nerves
Where does hamstrings attach
Ischial tuberosity to tibia and fibula
What does hamstrings do
Extends hip during walking
What supplies hamstrings
Sciatic nerve
What muscles cause abduction in leg?
Muscles which pass from pelvis to femur lateral to hip joint (outside)
Trendelenburg gait
Gluteus medius
Gluteus minimums (deeper)
Iliotibial tract
What muscles cause adduction of the hip/leg?
Muscles which pass from pelvis to femur or tibia medial to hip joint (inside of leg)
Pectineus Adductor longus Adductor brevis Adductor Magnus Gracilis
What muscles cause lateral foot rotation
Small muscles which pass from pelvis to femur lying close to and posterior to the hip joint (foot point forward when walking)
Piriformis
Obturator external and internus
Superior and inferior gemelli
Quadrator femoris
Attachments of gluteus medius and minimus
Attach to ilium and greater trochanter
What supplies gluteus medius and minimus
SUPERIOR gluteal nerves
Inferior supplies the maximus
Movement of gluteus medius and minimus?
Abducts the hip
What is the function of the iliotibial tract
Aids gluteus medius and minimus in hip abduction
Where does the pectineus attach
Pubis and pubic ramus
To lesser trochanter of femur
What does pectineus muscle do
Adduction of thigh at hip
Flexion of thigh at hip
What muscles are supplies by the obturator nerve
Muscles involved in adduction
Pectineus Adductor longus Adductor brevis Adductor Magnus Gracilis
Where do adductors longus brevis and Magnus of lower leg attach
Pubic bone to the femur
Where does gracilis muscle attach
Pubic bone to the tibia
Attachment of piriformis
Sacrum to greater trochanter of femur
Attachment of obturator external and internus
Externus obturator foramen to trochanter of femur
Internus ischiopubic ramus to the greater trochanter
Where does superior and inferior gemelli attach
Superior ischium spine to obturator internus tendon
Inferior ischial tuberosity to obturator internus tendon
Where does quadrator femoris attach
Ischial tuberosity to intertrochanter crest of femur
What muscles stabilise the hip joint
All involved in lateral rotation
Piriformis
Obturator externus and internus
Superior and inferior gemelli
Quadrator femoris
What is the nerve supply of piriformis
Piriformis nerve
What does the obturator nerve supply
Obturator externus
Obturator internus
Superior gemelli
What does the quadratus femoris nerve supply
Inferior gemelli
Quadratus femoris
What attaches to the iliotibial tract
Tensor fascia latae
Gluteus maximus
What keeps the pelvis level when walking
Abductors (with adductors)
Gluteus medius, minimus and he iliotibial tract
What happens when the abductors are weak? Gluteus medius, minimus and iliotibial tract?
Causes trendelenburg gait lowering on one side when walking
What can cause trendelenburg gait
Weakened abductors due to direct injury or nerve injury during surgery or by effective shortening of the femoral neck
What is the job of lateral rotators
Stabilise joint and laterally rotate femur to keep foot pointing towards
Medial rotation is weak movement usually causing by walking momentum but some of previous muscles can contribute
