Pectoral Girdle, Shoulder, Arm Flashcards

1
Q

What passes through the intertubercular groove?

A

The tendon of the biceps

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2
Q

What can regional tenderness of inter tubercular groove indicate?

A

Biceps tendon inflammation

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3
Q

Where is the coracoid process palpable?

A

Palpable below the lateral third of the clavicle

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4
Q

What is superior to the spine of the scapula?

A

Supraspinous fossa where the supraspinatus muscle attaches

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5
Q

What is inferior to the spine of the scapula?

A

Infraspinous fossa where the infraspinatus muscle attaches

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6
Q

What is the inferior angle of the scapula useful for?

A

Auscultation triangle (for lungs) sits medially to the inferior angle

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7
Q

What spinous processes do the superior and inferior angles of the scapula mark?

A

T2-T7 spinous processes

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8
Q

What spinous process does the medial spine of scapula mark?

A

T3 spinous process

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9
Q

What is the medial border of the scapula of an abducted upper limb useful for?

A

Approximates the position of the oblique lung fissure

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10
Q

What type of joint is the acromioclavicular joint?

A

Synovial plane joint. Dislocation possible

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11
Q

What type of joint is the sternoclavicular joint?

A

Synovial ball and socket joint. Dislocation rare

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12
Q

Why must sternoclavicular joint injection/aspiration take place under ultrasound guidance?

A

Could pierce apex of lungs, cause pneumothorax

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13
Q

What can cause clavicle fracture?

A

FOOSH (fall onto an outstretched hand) or fall onto the lateral shoulder

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14
Q

What ligaments support the acromioclavicular joint?

A

Coracoclavicular ligaments (trapezoid and conoid)

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15
Q

What is the only joint between the upper limb and axial skeleton? and what is it supported by?

A

Sternoclavicular joint - it is supported by the costoclavicular ligament.

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16
Q

How can the coracoclavicular ligaments be torn?

A

Can be torn by AC joint dislocation

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17
Q

What does the coracoacromial ligament do?

A

Supports the shoulder joint superiorly

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18
Q

How can the coracoacromial ligament be damaged?

A

Can be ruptured by superiorly directed forces.

Can impinge supraspinatus/subacromial bursa

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19
Q

What is the order of frequency of fractures of the clavicle?

A

middle 1/3 > lateral 1/3 > medial 1/3

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20
Q

What can happen to the separated parts of the clavicle following a fracture?

A

The separated parts of the clavicle move in opposite directions due to muscle contraction and gravity

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21
Q

What structure is at risk if the surgical neck of humerus is fractured?

A

Axillary nerve

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22
Q

What structures are at risk in mid-shaft humerus fractures?

A

Radial nerve and profunda brachii artery

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23
Q

Compare the glenoid fossa to the acetabulum

A

Glenoid fossa is a shallow socket (less surface area) which ensures wide range of movement but less stability

24
Q

What is the glenoid labrum?

A

Fibrocartilage rim deepening glenoid fossa socket and stabilising joint.

25
Q

What can happen with trauma to or overuse of glenoid labrum?

A

Tear injury - can produce a snapping sensation or pain on abduction or lateral rotation

26
Q

What properties of the shoulder joint capsule mean it is more likely to dislocate?

A

The supporting tissues of the shoulder joint are relatively lax thus allowing a wide range of motion. The lower part of the joint capsule is lax and folded to permit free movement. Downward force applied to an abducted arm can dislocate the shoulder. ​

27
Q

What are the glenohumeral ligaments?

A

There are three of them. They pass from the margins of the glenoid to the humerus and support the shoulder anteriorly

28
Q

What does the trapezius do and what is it innervated by?

A
Elevates, retracts and depresses the scapula.
Accessory nerve (CN XI)
29
Q

What does the elevator scapulae do and what is it innervated by?

A

Elevates and rotates scapula.

Dorsal scapula nerve and C3, C4

30
Q

What does latissimus dorsi do and what is it innervated by?

A

Extends, adducts and medially rotates humerus; can raise the trunk to the arm eg. dips/climbing.
Thoracodorsal nerve

31
Q

What do rhomboid minor and rhomboid major do and what are they innervated by?

A

retract and fix position of scapula.

Dorsal scapula nerve

32
Q

What does teres major do and what is it innervated by?

A

Adduction and medial rotation of humerus.

Lower sub scapular nerve

33
Q

What are the borders of the triangle of auscultation?

A

Trapezius, rhomboid major and latissimus dorsi

34
Q

What does pectoralis major do and what is it innervated by?

A

Adducts and medially rotates the should and acts as an accessory breathing muscle.
Medial and lateral pectoral nerve

35
Q

What are the attachment points of pectoralis major?

A

Attaches to clavicle, sternum and adjacent costal cartilages and the lateral side of the intertubercular groove of the humerus

36
Q

What does pectoralis minor do and what is it innervated by?

A

Depresses and protracts the scapula.

Medial pectoral nerve

37
Q

What are the attachment points of pectoralis minor?

A

Attaches to ribs 3-5 and the coracoid process

38
Q

What does the deltoid do and what is it innervated by?

A

Deltoid can bring about all shoulder movements except adduction.
Axillary nerve

39
Q

What are the attachment points of the deltoid?

A

Attaches to lateral clavicle, acromion, scapula spine and humerus

40
Q

What can damage axillary nerve?

A

1) Shoulder dislocation
2) surgical neck of humerus fracture
3) Intramuscular injection

41
Q

In which direction does shoulder dislocation most commonly occur?

A

Anteriorly

42
Q

What can happen if the axillary nerve is damaged?

A

1) Paralysis and wasting of deltoid and teres minor
2) Limb to hang limp by side
3) Loss of shoulder contour
4) Sensory loss over lateral shoulder (regimental badge region)

43
Q

Name the 4 rotator cuff muscles. What can happen if there is injury?

A

Supraspinatus, Infraspinatus, Teres minor, subscapularis.

Injury causes pain on movement and possible shoulder instability

44
Q

What are the borders of the axilla?

A
Ant =  Anterior axillary fold & contents​
Post = Posterior axillary fold & contents​
Med = Serratus anterior and lateral thoracic wall​
Lat = Intertubercular groove​
45
Q

What are the contents of the axilla?

A
  • Axillary artery
  • Distal parts of brachial plexus
  • Fat
  • Lymph nodes
46
Q

Name the axillary lymph nodes

A

Humeral, Subscapular and Pectoral drain into Central which drains into Apical and then into Supraclavicular

47
Q

What regions drain lymph to the axillary lymph nodes?

A

Arm, walls of thorax, breast and upper walls of abdomen

48
Q

What is the posterior axillary fold formed from?

A

Latissimus dorsi and teres major

49
Q

What is the anterior axillary fold formed from?

A

Pectoralis major and minor

50
Q

What is the function of the anterior compartment of the arm and what is its innervation?

A

Flexors and supinators. Innervated by Musculocutaneous nerve and some radial nerve to brachialis

51
Q

What is the function of the posterior compartment of the arm and what is its innervation?

A

Extensors innervated by radial nerve.

52
Q

What does biceps brachii do?

A

Flexes the shoulder and elbow

53
Q

What are the attachment points of the long head of biceps and short head of biceps?

A

Long head - From supraglenoid tubercle; tendon passes through intertubercular groove.
Short head - From the coracoid process

54
Q

What does the brachialis do and what is its innervation?

A

Flexes the elbow. Innervated by musculocutaneous nerve and radial nerve

55
Q

What does coracobrachialis do and what is its innervation?

A

Adducts the arm. Innervated by musculocutaneous nerve.

56
Q

What travels through quadrangular space?

A

Axillary nerve and posterior circumflex arteries travel through here and around the surgical neck of humerus​

57
Q

What travels through triangular interval and spiral groove?

A

Radial nerve and profunda artery travel through space and groove​