Pectoral region and shoulder Flashcards

1
Q

What does the pectoral fascia overly?

A

Pec major and the serratus anterior

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2
Q

What is the retromammary space?

A

Loose connective tissue between the breast and the pectoral fascia. It allows the breast some degree of movement.

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3
Q

What is the axillary process or tail (of Spence)?

A

An extension of the mammary gland extending toward the axillary fossa

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4
Q

What attaches the mammary gland to the dermis?

A

Suspensory ligaments (of Cooper). They help support the mammary gland lobules.

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5
Q

What is the scapulothoracic (ST) articulation?

A

Not a true joint… ventral surface of the scapula and the posterior thoracic wall

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6
Q

What is the GH joint?

A

Glenohumeral. Joint between the head of the humerus and the scapula

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7
Q

What is the SC joint?

A

Sternoclavicular. Manubrium of sternum and clavicle

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8
Q

What is the AC joint?

A

Acromioclavicular. Scapula (acromion) and clavicle

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9
Q

What is scapulohumeral rhythm?

A

The functional relationship between the GH and ST joints to create motion in the shoulder.

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10
Q

What does the 3:2:1 ratio of the shoulder mean?

A

For every 3 degrees of elevation, 2 degrees occurs at the GH joint and 1 degree at the ST joint

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11
Q

What are extrinsic muscles and what are they also called?

A

Axioappendicular. Muscles that originate in the axial skeleton and insert on the pectoral girdle.

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12
Q

What are the posterior extrinsic muscles?

A

Trapezius
Latissimus dorsi
Levator scapulae
Rhomboid major/minor

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13
Q

What are the anterior extrinsic muscles?

A

Pectoralis major and minor
Subclavius
Serratus anterior

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14
Q

What is the coracobrachialis muscle?

A

z

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15
Q

What are the intrinsic muscles of the shoulder?

A
Deltoid
Teres major
Teres minor
Supraspinatus
Infraspinatus
Subscapularis
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16
Q

What muscles make up the rotator cuff?

A

SITS

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

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17
Q

What do ITS of “SITS” muscles do?

A

Provide downward force on the gelnoid to prevent upward translation during abduction

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18
Q

What muscle(s) are injured due to repetitive use such as throwing and swimming?

A

Inflammation of the supraspinatus tendon among others

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19
Q

What are the fibrous joints?

A

Suture, Syndemosis, Gomphosis

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20
Q

What are the cartilaginous or fibrocartilaginous joints?

A

Synchrondosis, Symphysis

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21
Q

What makes a joint biaxial?

A

Can conduct motion in 2 planes

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22
Q

The Atlanto-Occipital joint is the ____ joint.

A

Yes

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23
Q

The Atlanto-Axial joint is the ____ joint.

A

No

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24
Q

What are the attachments of the pectoralis major muscle?

A
Claviuclar head (medial half)
Sternocostal head (upper 6 costal cartilages)
Intertubercular groove of humerus
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25
Q

What is the action of pec major?

A

Adducts and medially rotates humerus

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26
Q

What is the innervation of pec major?

A

Lateral and medial pectoralis nerves

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27
Q

What are the attachments of pec minor?

A

Ribs 3-5 and corocoid process of scapula

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28
Q

What is the innervation of pec minor?

A

Medial pectoral nerve?

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29
Q

What is the action of pec minor?

A

Stabilize scapula

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30
Q

What are the attachments of the serratus anterior?

A

Lateral parts of ribs 1-8

Medial border of scapula

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31
Q

What is the innervation of the serratus anterior?

A

Long thoracic nerve

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32
Q

What is the action of the serratus anterior?

A

Protract ands upwardly rotates the scapula
holds the scapula against the thoracic wall thus damage to this muscle or long thoracic nerve will cause scapular winging

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33
Q

What is the attachment of the subclavius?

A

Junction of the first rib and costal cartilage

Inferior surface of clavicle

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34
Q

What is the action of the subclavius?

A

Anchors and depresses clavicle

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35
Q

What is the innervation of the subclavius?

A

Nerve to subclavius

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36
Q

What is the attachment of the coracobrachialis?

A

Tip of coracoid process on scapula

Medial, mid-shaft of humerus

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37
Q

What is the action of the coracobrachialis?

A

Flex and adduct the shoulder

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38
Q

What is the innervation of the coracobrachialis?

A

musculocutaneous nerve

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39
Q

What is the innervation of the deltoid muscle?

A

Axillary nerve

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40
Q

What are the attachments of the deltoid?

A

Spine of scapula
Acromion
Lateral 1/3 of clavicle
Deltoid tuberosity of humerus

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41
Q

What are the THREE actions of the deltoid?

A
  1. Anterior: shoulder flexion
  2. Middle: shoulder abduction
  3. Posterior: shoulder extension
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42
Q

What is the attachment of the teres major?

A

Inferior lateral aspect of scapula

Intertubercular groove of humerus

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43
Q

What is the action of the teres major?

A

Shoulder medial/internal rotation

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44
Q

What is the innervation of the teres major?

A

Lower subscapular nerve

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45
Q

What are the attachment of the supraspinatus?

A
Supraspintus fossa
Greater tubercle (posterior of humeral head)
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46
Q

What are the attachments of the infraspinatus?

A
Infraspinous fossa
Greater tubercle (posterior of humeral head)
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47
Q

Which of the SITS muscles attach the greater tubercle?

A

SIT

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48
Q

What are the attachments of the teres minor?

A
Middle part of the lateral border of the scapula
Greater tubercle (posterior of humeral head)
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49
Q

What are the attachments of the subscapularis?

A
Subscapularis fossa (anterior surface of scapula)
Lesser tubercle (anterior humeral head)
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50
Q

What is the action of the suprasinatus?

A

Abduction of humerus (first 15 degrees before deltoid takes over)

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51
Q

What is the innervation of the supraspinatus?

A

Suprascapular nerve

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52
Q

What is the inntervation of the infraspinatus?

A

Suprascapular nerve

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53
Q

What is the action of the infrasinatus?

A

Lateral rotation

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54
Q

What is the action of the teres minor?

A

Shoulder lateral rotation

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55
Q

What is the innervation of the teres minor?

A

Axillary nerve

56
Q

What is the innervation of the subscapularis?

A

upper and lower subscapular nerves

57
Q

What is the action of subscapularis?

A

Shoulder medial rotation

58
Q

What prevents elevation of the humerus when the deltoid pulls to abduct the arm?

A

Rotator cuff muscles pull down

This avoids impingement of the suprapinatus tendon under the coracoacromial arch

59
Q

Rupture of the supraspinatus tendon causes…

A

a high-riding humerus

60
Q

The brachial plexus is formed by the _____ rami of spinal nerves ___ - ____.

A

Ventral

C5-T1

61
Q

The brachial plexus innervates all muscles that function in the upper extremity except _______.

A

The trapezius

62
Q

Each spinal nerve gives rise to ______ and ______ ______.

A

Anterior and posterior rami

63
Q

What nemonic can be used to remember the “breakdown” of the brachial plexus

A

Remember To Drink Cold Beer

Roots Trunks(+) Divisions(-) Cords(+) Terminal Branches(-)

64
Q

How many roots of the brachial plexus exist?

A

5

65
Q

How many trunks?

A

3

Superior Middle Inferior

66
Q

How does each trunk divide?

A

Anterior and posterior of each

67
Q

What are the cords of the brachial plexus?

A

Medial
Lateral
Posterior

68
Q

Each brachial plexus cord divides into _____ nerves

A

2

69
Q

What parts of the brachial plexus do supraclavicular branches come off?

A

Roots and trunks

70
Q

What kind of joint is the the SC joint?

A

Saddle synovial joint w/ a fibrocartilage disc

71
Q

What are the ligaments of the SC joint?

A

Sternoclavicular
Interclavicular
Costoclavicular

72
Q

What kind of joint is the AC joint?

A

Synovial joint with a coracoacromial ligament

73
Q

What kind of joint is the GH joint?

A

Ball and socket

74
Q

What are the non-contractile structures of GH stability?

A
Glenoid labrum
Glenhoumeral ligaments
Coracohumeral ligament
Coracoacromial ligament
Transverse humeral ligament
75
Q

What are the attachments of the glenohumeral ligaments?

A

Scapula to head of the humerus. Superior, middle, inferior

76
Q

What is the transverse humeral ligament?

A

A bridge between the greater and lesser tubercles

77
Q

What stabilizes the tendon of the long head of the biceps?

A

Transverse humeral ligament

78
Q

What muscle passes under the coracoacromial arch? What is the significance?

A

Tendon of the supraspinatus, often impinged in rotator cuff injuries

79
Q

What is the coracoacromial arch?

A

Space between the coracoacromial ligament and the head of the humerus below

80
Q

What is the scapulohumeral rhythm?

A

Shoulder abduction does not occur solely in the GH joint. After a certain point of abduction, the scapula also begins to rotate. Maintains articular contact

81
Q

What are the attachments of the trapezius?

A

Superior nuchal line, external occipital protuberance, nuchal ligament, spinous processes C7-T12

Scapula spine, acromion, lateral 1/3 of clavicle

82
Q

What are the actions of the trapezius?

A

Upper: elevates and upward rotates scapula
Middle: retracts
Lower: depresses and upward rotates scapula

83
Q

What is the innervation of the trapezius?

A

Spinal accessory nerve (CN XI)

84
Q

What are the attachments of the latissimus dorsi?

A

Spinous processes T7-T12, iliac crest, thoracolumbar fascia

Intertubercualar groove of humerus

85
Q

What is the action of the latissimus dorsi?

A

Shoulder extension, adduction, and IR

86
Q

What is the innervation of the latissimus dorsi?

A

Thoracodorsal nerve

87
Q

What are the attachments of the levator scapulae?

A

Transverse processes of C1-C4

Superior medial border of scapula

88
Q

What is the action of the levator scapulae?

A

Elevation and downward rotation of scapula

89
Q

What is the innervation of the levator scapulae?

A

Dorsal scapular nerve

90
Q

What are the attachments of the rhomboid minor muscle?

A

Spinous processes C7 and T1

Medial scapular at the scapular spine

91
Q

What are the attachments of the rhomboid major muscle?

A

Spinous processes T2-T5

Medial scapular border

92
Q

What is the action of the rhomboid muscles?

A

Retract and downwardly rotate scapula

93
Q

What is the innervation of the rhomboid muscles?

A

Dorsal scapular nerve

94
Q

What are the origins of the axilary artery?

A

Aorta -> BT -> subclavian -> axillary

95
Q

When does the subclavian artery become known as the axillary artery?

A

The lateral border of the 1st rib

96
Q

When does the axillary artery become known as the brachial artery?

A

Inferior border of the teres major

97
Q

What defines the regions of the axillary artery?

A

The pec minor muscle (I is proximal, II is deep, III is distal

98
Q

What branches off Axillary I?

A

Superior thoracic artery

99
Q

What branches off Axillary II?

A

Thoracoacromial trunj

Lateral thoracic artery

100
Q

What branches of Axillary III?

A

Subscapular artery ->
Circumflex scapular artery

Anterior humeral circumflex
Posterior humeral circumflex

101
Q

What is the origin of the suprascapular artery?

A

Subclavian -> thyrocervical trunk -> suprascapular

102
Q

What is the origin of the dorsal scapular artery

A

Subclavian -> dorsal scapular artey

103
Q

What is the major branch of the brachial artery?

A

Brachial profunda artery

104
Q

What happens when the brachial artery hits the elbow?

A

Divides into the radial artery and the ulnar artery (anterior and posterior interosseus arteries)

105
Q

What are the margins of the axillary vein?

A

Union of brachial and basilic veins at the inferior border to the teres major. Drain into subclavian

106
Q

What are the relative locations of the basilic and cephalic veins?

A

Basilic is more medial. Cephalic is more lateral

107
Q

When looking at the distal end of the humerus, what is the most bony process called?

A

The medial epicondyle

108
Q

What are the articulations of the arm and forearm?

A

Capitulum: H and radius
Trochlea: Trochlea and ulna

CRTU

109
Q

Which joint is more stable/articulated? radius or ulna with humerus? How does this other joint stay stable?

A

Ulnahumeral joint

thus annular ligament needed to stabilize the radius

110
Q

What is nursemaids elbow?

A

Radius dislocation from annular ligament

111
Q

What is a Monteggia fracture?

A

Dislocation of the proximal radioulnar joint in conjunction with a forearm fracture

112
Q

What is the lateral collateral ligament?

A

Ligament that blends with the annular ligament to prevent medial deviation

113
Q

What is of collateral ligament?

A

Prevents lateral deviation of elbow

114
Q

What is Tommy John syndrome?

A

Ulnar collateral ligament (aka medial collateral ligament) is replaced (e.g. in pitchers)

115
Q

Supination/pronation of the elbow is created solely by what?

A

Movement of the radius around the fixed ulna

116
Q

What are the muscles in the anterior compartment of the arm?

A
Biceps brachii (short and long head)
Brachialis
117
Q

What are the attchments of the biceps brachii?

A

Short: coracoid process of scapula
Long: supraglenoid tubercle

Both originate on radius

118
Q

What is the innervation of the biceps brachii?

A

musculocutaneous nerve

119
Q

What are the attchments of the brachialis?

A

Distal anterior humerus

Coronoid process of ulna

120
Q

What is the innervation of the brachialis?

A

musculocutaneous nerve

121
Q

What are the muscles of the posterior compartment?

A

Triceps brachii

Brachioradialis

122
Q

What are the attachments of the triceps brachii?

A

Long head: infraglenoid tubercle

Lateral head: posterior superior humerus

Medial head (deep): posterior inf. humerus

All heads: olecranon of the ulna

123
Q

What is the innervation of the triceps?

A

Radial nerve

124
Q

What are the attachments of the brachioradialis?

A

Lateral supracondylar ridge

Lateral distal radius

125
Q

What is the action of the brachioradialis?

A

Flexes elbow

126
Q

What is the innervation of the brachioradialis? Why is this unique?

A

Radial nerve. This is the only muscle innervated by the radial nerve that FLEXES rather than extends

127
Q

What are the attachments of the supinator?

A

Lateral epicondyle of humerus, crest of ulna

Lateral posterior and anterior surface of radius

128
Q

What does the supinator do?

A

Supinates forearm

129
Q

What is the innervation of the deep branch of the radial nerve?

A

Deep branch of radial nerve

130
Q

What are the actions of the biceps brachii?

A

Flexes elbow AND supinates the forearm

131
Q

What are the attachments of the pronator teres?

A

Coronoid process AND medial epicondyle (two heads)

Lateral surface of radius

132
Q

What is the action of the pronator teres?

A

Pronation of forearm and weak flexor of forearm

133
Q

What is the innervation of the pronator teres?

A

Median nerve

134
Q

What is the innervation of the pronator quadratus?

A

Anterior interosseus nerve (from median nerve)

135
Q

What are the attachments of the pronator quadratus?

A

Distal anterior ulna and distal anterior radius