Pectoral Girdle, Upper Limb And Chest Flashcards
Name the joints of the clavicle and state their position.
The sternoclavicular joint is at the medial clavicle at the sternal articular surface and the acromioclavicular head is at the lateral end at the acromial facet.
Name the joints of the scapula and state their position.
The acromioclavicular joint is at the acromion and the glenohumeral joint is at the glenoid cavity.
Name parts of the scapula from a to j.
(letter = posterior, anterior)
a = suprascapular notch, acromioclavicular joint
b = coracoid process, acromion
c = acromioclavicular joint, coracoid process
d = acromion, glenoid cavity
e = spinoglenoid notch, circumflex scapular groove
f = glenoid cavity, lateral border
g = circumflex scapular groove, inferior angle
h = infraspinous fossa, subscapular fossa
i = spine, medial border
j = supraspinous fossa, superior angle
Name parts of the humerus from 1 to 17. (anterior, posterior)
1 = deltoid tuberosity
2 = greater tubercle
3 = intertubercular groove
4 = olecranon fossa
5 = surgical neck
6 = head(of humerus)
7 = deltoid tuberosity
8 = medial supracondylar ridge
9 = lateral epicondyle
10 = medial epicondyle
11 = anatomical neck
12 = lesser tubercle
13 = trochlea
14 = lateral supracondylar ridge
15 = capitulum
16 = radial fossa
17 = coronoid fossa
Differentiate between the left and right clavicle.
When looking superiorly and the anterior is on the right hand side, the right clavicle has an s-shape. When looking superiorly and the anterior is on the left hand side, the left clavicle has a reverse s-shape.
Name the parts of the left clavicle from left to right.
(excl. of 4 - 6)
1 = sternal head
2 = sternal facet
3 = impression for costoclavicular ligament
(4 = anterior
5 = posterior
6 = inferior surface)
7 = subclavian groove
8 = conoid tubercle
9 = trapezoid line
10 = acromial facet
11 = acromial head
Name the origins, insertion, actions and nerve supply of the pectoralis major.
Origins: upper 6 costal cartilages and anterior sternum (sternocostal head), medial clavicle (clavicular head)
Insertion: lateral lip of intertubercular groove
Actions: flexion, medial rotation and adduction of humerus
Nerve supply: medial pectoral nerve (C8,T1) and lateral pectoral nerve (C5-7)
Name the origins, insertion, actions and nerve supply of the pectoralis minor.
The pectoralis minor’s origin is from ribs 3 to 5.
Its insertion is the coracoid process.
Its actions are protraction and stabilization of the scapula.
Its nerve supply is the medial pectoral nerve (C8,T1)
Name the origins, insertion, actions and nerve supply of the serratus anterior.
The origin of the serratus anterior is from ribs 1 to 8.
Its insertion is the medial border of the scapula.
Its actions are the protraction, rotation and stabilization of the scapula.
Its nerve supply is the long thoracic nerve.
Name the origins, insertion, action and nerve supply of the subclavius.
The origin of the subclavius is the 1st rib and 1st costal cartilage.
Its insertion is the inferior surface of the clavicle.
It aids in the depressing lateral part of the clavicle.
Its nerve supply is the nerve to the subclavius (C5,6)
How are limbs formed in a foetus?
Limbs are outgrowths of the ventral body wall that undergo distal growth, differentiation and rotation.
What spinal segmental nerves end in the upper limb?
C3 to T2
What spinal segmental nerves end in the lower limb?
L2 to S4.
Draw a diagram of the upper limb’s nerve supply (the brachial plexus). 16 nerves total.
Name the origins, insertion, actions and nerve supply of the trapezius.
Origins: superior nuchal line of the occipital bone, nuchal ligament and spinous processes of C7 to T12.
Insertions: lateral 3rd of the clavicle, acromion process, spine of scapula.
Actions: Elevation, retraction and depression the scapula. (Assist in scapula’s upward rotation.)
Nerve supply: cranial nerve XI and cervical nerve (C3,4).
Name the origins, insertion, actions and nerve supply of the rhomboid major.
Origins: (Spinous processes of) T2-T5
Insertion: Medial border of the posterior scapula (from the spine to the inferior angle)
Actions: Retracts, elevates, and rotates the scapula
Nerve Supply: Dorsal scapular nerve (C4-C5)
Name the origins, insertion, actions and nerve supply of the rhomboid minor.
Origins: spinous processes of C7 and T1, and the lower part of the nuchal ligament.
Insertion: Medial border of the scapula at the level of the spine.
Actions: Retracts, elevates, and rotates the scapula.
Nerve Supply: Dorsal scapular nerve (C4-C5).
Name the origins, insertion, actions and nerve supply of the levator scapulae.
Origins: Transverse processes of C1-C4 vertebrae.
Insertion: Superior part of the medial border of the scapula.
Actions: Elevation and downward rotation of scapula, lateral flexion and extension of neck.
Nerve Supply: Dorsal scapular nerve (C4-C5) and cervical nerves (C3-C4).
Name the origins, insertion, actions and nerve supply of the deltoid.
Origin: Lateral third of the clavicle, acromion, and spine of the scapula.
Insertion: Deltoid tuberosity.
Actions: Abducts, flexes, and extends the arm.
Nerve Supply: Axillary Nerve (C5-C6)
What are the 4 rotator cuff muscles?
Supraspinatus, infraspinatus, teres minor and subscapularis
Name the origins, insertion, actions and nerve supply of the supraspinatus.
Origin: Supraspinous fossa.
Insertion: Greater tubercle.
Action: Abducts the arm (initial 15 degrees).
Nerve Supply: Suprascapular Nerve (C5-C6)
Name the origins, insertion, actions and nerve supply of the infraspinatus.
Origin: Infraspinous fossa.
Insertion: Greater tubercle.
Action: Lateral rotation of the arm.
Nerve Supply: Suprascapular Nerve (C5-C6)
Name the origins, insertion, actions and nerve supply of the teres minor.
Origin: Lateral border of the posterior scapula.
Insertion: Greater tubercle.
Action: Lateral rotation of the arm.
Nerve Supply: Axillary Nerve (C5-C6)
Name the origins, insertion, actions and nerve supply of the teres major.
Origin: Inferior angle of the posterior scapula.
Insertion: Medial lip of the intertubercular groove.
Action: Medial rotation, adduction, and extension of arm.
Nerve Supply: Lower Subscapular Nerve (C5,C6)
Name the origins, insertion, actions and nerve supply of the subscapularis.
Origin: Subscapular fossa.
Insertion: Lesser tubercle.
Action: Medial rotation of the arm.
Nerve Supply: Upper and Lower Subscapular Nerves (C5-C6)
What nerve pierces the clavipectoral fascia?
The lateral pectoral nerve.
What is the classification of the joint between the 1st rib and sternum?
Synchondrosis
Name the origins, insertion, actions and nerve supply of the long head of the biceps.
Origin: supraglenoid tubercle
Insertions: radial tuberosity and bicipital aponeurosis
Actions: flexion of the elbow and supination of the forearm. Stabilization and flexion of the shoulder.
Nerve supply: musculocutaneous nerve (C5,C6)
Name the origins, insertion, actions and nerve supply of the short head of the biceps.
Origin: coracoid process
Insertions: radial tuberosity and bicipital aponeurosis
Actions: flexion of the elbow and supination of the forearm. Stabilization and flexion of the shoulder.
Nerve supply: musculocutaneous nerve (C5,C6)
Name the origins, insertion, actions and nerve supply of the long head of the triceps.
Origin: infraglenoid tubercle
Insertion: olecranon fossa
Actions: extension of elbow, adduction of arm, stabilization and extension of shoulder.
Nerve supply: radial nerve (C6, C7, C8)
Name the origins, insertion, actions and nerve supply of the lateral head of the triceps.
Origin: posterior humerus, above the radial groove
Insertion: olecranon fossa
Action: extension of elbow
Nerve supply: radial nerve (C6, C7, C8)
Name the origins, insertion, actions and nerve supply of the medial head of the triceps.
Origin: posterior humerus, below the radial groove
Insertion: olecranon fossa
Action: extension of elbow
Nerve supply: radial nerve (C6, C7, C8)
Name the origins, insertion, actions and nerve supply of the latissimus dorsi.
Origins: spinous processes of T7 - T12, thoracolumbar fascia, iliac crest, ribs 9 - 12, inferior angle of the scapula.
Insertion: Intertubercular groove
Actions: Extension, adduction and medial rotation of the shoulder, compresses the ribcage.
Nerve supply: thoracodorsal nerve (C6, C7, C8)
Which artery pierces the clavipectoral fascia?
The thoracoacromial artery.
What spinal level is the inferior angle of the scapula?
Spinous process of T7
Which arteries are linked by the scapular anastomosis?
3rd part of the axillary (circumflex scapular) and 1st part of the subclavian artery (suprascapular).
Name the origins, insertion, actions and nerve supply of the coracobrachialis.
Origin: coracoid process
Insertion: middle third of the medial humerus.
Actions: flexion, adduction and stabilization of shoulder.
Nerve supply: musculocutaneous nerve (C5, C6, C7)
What is the axilla?
The axilla is a 4-sided, truncated pyramidal space at the junction of the arm and the trunk.
State the boundaries of the axilla at the apex, anterior wall and posterior wall.
APEX: clavicle, scapula and lateral border of the 1st rib
ANTERIOR WALL: skin, superficial fascia, pectoralis major, pectoralis minor and clavipectoral fascia
POSTERIOR WALL: skin, superficial fascia, teres major, latissimus dorsi, subscapularis
State the boundaries of the axilla at the medial wall, lateral wall and floor.
MEDIAL WALL: 1st to 4th ribs, serratus anterior
LATERAL WALL: intertubercular groove
FLOOR: skin, superficial fascia, axillary fascia
What blood vessels and nerves run through the axilla?
The axillary artery and its branches and the axillary vein and its tributaries run through the axilla.
The cords and branches of the brachial plexus and the lateral collateral branches of intercostal nerves run through the axilla.
What muscles and tendons run through the axilla?
The long and short heads of the biceps brachii and the coracobrachialis.
Describe the beginning and end of the axillary artery.
It starts from the 1st rib as a continuation of the subclavian artery. It ends at the inferior end of teres major, continuing as the brachial artery.
State the position and branch of the 1st part of the axillary artery.
The 1st part of the axillary artery is above pec minor and has the superior thoracic artery as its sole branch.
State the position and branches of the 2nd part of the axillary artery.
The 2nd part is behind pec minor and has the thoracoacromial artery and the lateral thoracic artery as its 2 branches.
State the position and branches of the 3rd part of the axillary artery.
The 3rd part is below pec minor and has the anterior circumflex humeral artery, the posterior circumflex humeral artery and the subscapular artery (thoracodorsal and circumflex scapular) as its 3 branches.
What is the largest branch of the axillary artery?
Subscapular artery
How many axillary lymph nodes are there and where do they drain to?
There are 5: anterior, posterior, lateral, medial and apical. All nodes drain upwards to the apical node.
State the myotomes for nerve root levels C1 to T1.
C1-2: cervical flexion
C3: cervical lateral flexion
C4: scapular elevation
C5: shoulder abduction
C6: elbow flexion, wrist extension
C7: elbow extension, wrist flexion
C8: finger flexion, thumb extension
T1: finger abduction
Mnemonic device: Certain foxes like finding strange events. Some also enjoy finding exciting events; feasting fun for all.
State the myotomes for nerve root levels L1 to S2.
L1-2: hip flexion
L3: knee extension
L4: dorsiflexion
L5: great toe extension
S1: plantar flexion
S2: knee flexion
Hungry frogs keep eating delicious food. Great elephants playfully fly kites fast.
What do upper and lower brachial plexus injuries lead to?
Upper brachial plexus (C5,C6) injury leads to Erb’s palsy, paralysis of the arm. Lower brachial plexus (C8,T1) injury leads to Klumke’s palsy, atrophy and pain of the arm.
Name the origins, insertions, actions and nerve supply of the brachialis.
Origin: distal half of the anterior humerus
Insertions: coronoid process and ulnar tuberosity
Actions: elbow flexion
Nerve supply: musculocutaneous nerve (C5,6) (and radial nerve)
State the ligaments connecting the clavicle and scapula, include their attachments.
Coracoclavicular ligament consisting of the trapezoid ligament (lateral) and the conoid ligament (medial). This runs from the coracoid process to the clavicle.
Acromioclavicular ligament connecting the acromion to the clavicle.
Coracoacromial ligament.
Which arm muscle has an attachment to the antebrachial deep fascia?
The biceps brachii muscle has an attachment to the antebrachial deep fascia, particularly the bicipital aponeurosis.
Reduced blood supply to the anterior forearm is an important consideration in what type of fracture?
Supracondylar fractures of the humerus. Such fractures can cause damage to the brachial artery, leading to ischemia and may cause Volkmann’s ischemic contracture which leads to permanent deformity of hand and forearm flexion.
Where in the upper limb is the most common site of ulnar nerve injury?
The cubital tunnel (space on the medial elbow bordered by the olecranon and the medial epicondyle). The ulnar nerve passes through the cubital tunnel. It is caused by prolonged elbow flexion, stretching or trauma to the nerve. This is also seen in the Guyon’s canal in the wrist. This is called cubital tunnel syndrome and is seen often in bowlers.
State the boundaries and contents of the quadrangular space.
Superior=teres minor
Inferior=teres major
Lateral=long head of triceps brachii
Contents: axillary nerve and posterior circumflex humeral artery
What neurovascular structures are affected by a mid-humeral fracture?
Deep brachial artery and radial nerve
