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Anatomy Module III > Pectoral Region & Shoulder > Flashcards

Pectoral Region & Shoulder Flashcards

1
Q

Osteology in the pectoral region and shoulder

A

sternum
Clavicle
Scapula
Humerus

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2
Q

Clavicle

A

Sternal End and Acromial End

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3
Q

Acromial end of clavicle

A

as travel lateral - this aspect is more flattened

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4
Q

posterior scapula

A

where there are a lot of bony landmarks

spine - can palpate

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5
Q

Acromium process of scapula

A

more lateral aspect and will come from the spine as it flattens out and will ARTICULATE with the acromium process of the clavicle

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6
Q

Acromium process of scapula

A

more lateral aspect and will come from the spine as it flattens out and will ARTICULATE with the acromium process of the clavicle

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7
Q

inferior angle of scapula

A

where the medial and lateral borders of the scapula come together

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8
Q

suprascapular notch

A

allow passage of the artery and nerves to pass to the posterior aspect of the scapula

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9
Q

Glenoid Cavity

A

articulatiung with the head of the humerus

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10
Q

Humeral Head

A

smooth articular surface

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11
Q

anatomical neck

A

fused growth plate - proximal and immediately below head

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12
Q

intertubercular groove

A

bicipital groove

between greater and lesser tubercle

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13
Q

surgical neck

A

common site of fracture
as you transfer from bulky/bulbous to more narrow shaft to more thin bone
aka site of surgeries

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14
Q

deltoid tuberosity

A

site of distal attachement of the deltoid

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15
Q

Four joints of the shoulder complex

A

Sternoclavicular
Acromioclavicular
Glenohumeral
Scapulothoracic

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16
Q 
Sternoclavicular Joint
Type
Articular components
Associated structures
movements
A 
Articular components: Sternal end of the clavicle and manubrium of sternum 
MODIFIED TYPE SADDLE JOINT
FIBROCARTILAGE DISC
Movements:
Elevation/Depression
Protraction/Retraction
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17
Q 
Sternoclavicular Joint
Type
Articular components
Associated structures
movements
A 
Articular components: Sternal end of the clavicle and manubrium of sternum 
MODIFIED TYPE SADDLE JOINT/synovial
FIBROCARTILAGE DISC
Movements:
Elevation/Depression
Protraction/Retraction
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18
Q

Fibrocartilage disc in the sternoclavicular joint

A

This is the ONLY site of bony attachment between the appendicular upper skeleton and the axial skeletion so there is a lot of force coming through to this joint so this fibrocartilage disc helps with that

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19
Q 
Acromioclavicular Joint 
Type
Articular components
Associated structures
movements
A

Articular components : Acormial end of the clavicle and acromium process of the scapula
Type : plan type synovial joint
Associated structure : fibrocartilage disc (but not as substantial as the sternoclavicular fibrous disc)
Movements: GLIDING between the clavicle and scapula

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20
Q 
Glenohumeral Joint 
Type
Articular components
Associated structures
movements
A

Articular : Humeral head and glenoid fossa
Type: Ball and socket synovial joint
Movement : THREE PLANES
- flexion and extension
-abduction/adduction
-internal/external rotation
Features: then glenoid fossa is about 1/3 the size of the humeral head
BOTH NON-CONTRACTILE AND CONTRACTILE STRUCTURES ENHANCE THE G-H STABILITY

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21
Q

How does the shoulder joint compensate for being unstable with the difference in size of the glenoid fossa and the bigger size of the humeral head?

A

Having contractile and non contractile structures to enhance

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22
Q

What plane are the movements of flexion/extension
abduction/adduction and
internal and external rotation in respectively

A

Sagital
frontal/coronal
Transverse

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23
Q

Non-contractile of the glenhumeral joint

A

Coracoacromial ligament
Glenohumeral Ligaments
Glenoid labrum

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24
Q

Contractile supporting of the glenhumeral joint

A

Muscles of rotator cuff

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25
Q

Coracoacromial Ligament

A

NON-CONTRACTILE
prevents an upward glide
between the coracoid and acromium process and preventing upwards shift when doing over head activities

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26
Q

coracoacromial arch
what forms it and what features are associated with it
tendon?
preventing what?

A

NON-CONTRACTILE
formed by the smooth inferior aspect of the actomion and the coracoid process of the scapula, with the coracoacromial ligament spanning between them
Preventing SUPERIOR displacement from the glenoid cavity
THE TENDON OF THE SUPRASPINATUS MUSCLE PASSES UNDERNEATH THIS ARCH AND IS AT RISK FOR GETTING SQUEEZED -rotator cuff injury

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27
Q

Glenohumeral ligaments

A 
NON-CONTRACTILE
Superior 
Middle 
inferior 
Three reinforcement on the anterior portion which aid in holding the humerus head into the glenoid fossa - helps in the size difference between the two
28
Q

Glenoid labrum

A

NON-CONTRACTILE
fibrocartilagenous ring attaching to the margins of the glenoid fossa
-deepens the glenoid cavity

29
Q

Scapulothoracic (ST) Joint

A

physiological joint in which movement occurs between muscoskeletal structures (b/w the scapula and associated muscles and the thoracic wall), rather than an ANATOMICAL JOINT
no direct articulation

30
Q

Coracobrachialis
Attachments
Action
Innervation

A 
Intrinsic muscle of the shoulder
Attaches to tip of coracoid process 
and medial, middle 1/3 of humerus 
action : flex and adduct the shoulder 
Innervation by musculocutaneous nerve
31
Q

POSTERIOR Superficial extrinisc muscles of the shoulder

A

Trapezius

Latissimus Dorsi

32
Q

POSTERIOR -Deep layer extrinsic muscles of the shoulder

A

Levator Scapulae
Rhomboid Major
Rhomboid Minor

33
Q

POSTERIOR -Deep layer extrinsic muscles of the shoulder

A

Levator Scapulae
Rhomboid Major
Rhomboid Minor

34
Q

Trapezius
Attachments
Action
Innervation

A

Attachments: Superior nuchal line, external occipital protruberance, spinous processes c7-t12
to scapula spine, acromion, and lateral 1/3 clavicle
Action : Upper - elevates and upwardly rotates scapula
middle: adducts/retracts scapula
Lower : depresses and upwardly rotates scapula

35
Q

Arthrokinematics

A

refers to movement of joint surfaces

36
Q

Scapulothoracic movements

A

Elevation / Depression
Adduction/Retraction and Abduction/Protraction
Upward and Downward rotation

37
Q

rotation occurs with respect to what

A

the inferior angle of the scapula which is the joining of the medial border and the lateral/axillary border of the scapula

38
Q

what joints are moving when we shrug shoulders up and down

A

elevation/depression

we use the scapulothoracic joint, Sternoclavicular Joint (SC) and the acromiclavicular joint (AC)

39
Q

shoulder abduction /abduction limitations and planes

A

coronal plane (0-180 degrees)
Horizontal plane Adduct - 0-45 degrees
Abduct 0-90 degrees

40
Q

details relating to FULL shoulder abduction

A

since the subacromial space is so small with the coracoacromial arch with the tough band of fibrous tissue - during full abduction of the arm - we have to laterally rotate our humerus to move the greater tuberosity out of the way - put the lesser in this position.
in neutral position - the grester tubercle is IMMEDEATILY UNDER THIS ARCH. - easier to move with lesser in this area
occurs when putting arm over head

41
Q

Scapulohumeral Rhythm

A

Motion available to the glenohumeral joint alone would not account for the full range of motion
Remaineder of motion is CONTRIBUTED BY THE SCAPULOTHORACIC JOINT (VIA THE SC AND AC JOINTS - each joint making its contribution in a specific and consistent pattern known as the scapulohumeral rhythm
if scapula didnt move - humerus would fall right out of the small articulating surface - basically the scapula chasing around the humerus

42
Q

Range of motion by the GH joint alone

A

0-30 degrees

43
Q

Full range of motion of GH with ST contribution - details on contribution

A

30-180 degrees

past 30 degrees the ST joint has to conribute at least 1 degree of movement for every 2 degress of the GH movement

44
Q

180 degree arm abduction - what are contributions of the GH and scapula?

A

GH = 120
ST joints = 60
moves in a 2/1 ration

45
Q

how does the lower muscle group in the trapezius muscle upwardly rotate the scapula?

A

even though fibers come from below - they attach superior to the point of rotation - the inferior angle

46
Q

point of rotation on the scapula

A

inferior angle

47
Q

Latissimus Dorsi
Attachments
Action
Innervation

A

Attachments : Spinous process t7-t12, iliac crest, ribs 9-12
to intertubercular groove of humerus MEDIAL ASPECT
Action - shoulder extension, adduction and internal rotation

Fibers come medially from the back - why we see internal rotation

Innervation : thoracodorsal nerve

48
Q

Levator Scapulae muscle
Attachments
Action
Innervation

A

Reflect the trapezius
Attachments : transverse process of C1-C4 to superior medial border of scapula

Action - elevates and downwardly rotates scapula

Innervation - dorsal scapular nerve C5 (think dorsal/deep)
as this is a deep muscle

49
Q

Rhomboid minor
Attachments
Action
Innervation

A

Attachments : spinous processes of C7 and T1 to medial scapular border at the level of root scapular spine

Action: Adduct/retract and downwardly rotate scapula

Innervation: Dorsal scapular nerve

50
Q

Rhomboid Major Attachments

A

Attachments: Spinous processes T2-T5 to medial scapular border from level of spine to inferior angle
Action and Innervaiton is same as the rhomboid minor

51
Q

Pectoralis Major
Attachments
Action
Innervation

A

Attachments - Sterno costal head- anterior sternum, upper six costal cartilages
Clavicular Head - Medial half of clavicle

Action- adducts and medially rotates humerus

Innervation - Medial and Lateral Pectoral Nerves

52
Q

Pectoralis Minor
Attachments
Action
Innervation

A

Attachments - Coracoid process of scapula
Ribs 3-5

Action - stabalizes scapula

Innervation - Medial Pectoral Nerve

53
Q

Serratus Anterior
Attachments
Action
Innervation

A

Attachments - external surfaces of lateral parts of ribs 1-8 and ANTERIOR surface of medial border of scapula

Action- Protracts and upwardly rotates the scapula, holds scapula against thoracic wall

Innervation - long thoracic nerve (which comes off roots of C5,6,7)

54
Q

Subclavius
Attachments
Action
Innervation

A

Attachments - junction of first rib and costal cartilage to inferior surface of medial third of clavicle

Action - anchors and depresses clavicle

Innervation - nerve to subclavius

55
Q

Intrinisic muscles of the shoulder

A
  • Coracobrachialis
  • Deltoid
  • Teres Major
  • Teres major
  • Supraspinatus
  • Infraspinatus
  • Subscapularis
  • These will all have attachments in the shoulder complex bone
56
Q

Corachobrachialis
Attachments
Action
Innervation

A

Attachments - Tip of coracoid process to the medial/middle 1/3 of the humerus

Action - flexion and weak adduction

Innervation - Musculocutaneous nerve *FLEXION

57
Q

Deltoid
Attachments
Action
Innervation

A

Attachments - Scapula spine, acromium, lateral 1/3 of clavicle to deltooid tuberosity of the humerus

Action - Anterior: shoulder flexion
Middle : Shoulder ABduction
Posterior : shoulder extension

Innervation - AXILLARY NERVE

58
Q

Teres Major
Attachments
Action
Innervation

A

Attachments : Inferior lateral aspect of posterior surface of scapula to intertubercle groove of humerus

Action - MEDIAL/ internal rotation (IR)

Innervation - Lower subscapular nerve

59
Q

Rotator cuff muscles

A 
last 4 acting in a group - SItS 
Supraspinatus
Infraspinatjus 
teres MINOR
Subscapularis
60
Q

Supraspinatus
Attachments
Action
Innervation

A

Attachments - supraspinous fossa and greater tubercle

Action - shoulder abduction

Innervation - suprascapular nerve

61
Q

Infraspinatus
Attachments
Action
Innervation

A

Attachments - infraspinous fossa and great tubercle

Action - shoulder lateral/external rotation

Innervation - suprascapular nerve

62
Q

Teres minor
Attachments
Action
Innervation

A

Attachments - middle part of lateral border of scapula to greater tubercle

Action - shoulder lateral/external rotation

Innervation - axillary nerve

63
Q

Subscapularis
Attachments
Action
Innervation

A

Attachments - subscapular fossa to lesser tubercle

Action - shoulder medial/internal rotation (IR)

Innervation - upper subscapular nerve and lower subscapular nerve

64
Q

quandrangular space

A

superior border - teres minor
inferior border = teres major
medial border = long head of the triceps brachii
lateral border = surgical neck of the humuerus

65
Q

How does the GH joint maintain dynamic stability?

A

Muscles of the Rotator Cuff
- the tendons of the 4 muscles blend with the fibrous capsule forming a cuff which reinforces the joint capsule and provides stability

all four of these muscles provide compressive forces across the GH joint, which provides dynamic stability and maintain the humerus centered within the glenoid fossa

66
Q

during shoulder elevation which rotator cuff muscles help to stabalize

A

infraspinatous
teres minor
subscapularis
- all of these have a downaward direction pull thus depress the head of the humerus - this prevents impingement of the rotator cuff under the coracoacromial arch

67
Q

rotator cuff injury

A

repetative use of rotator cuff muscles - when using limb above the horizontal - swimming/baseball - may move the humeral head and rotator cuff to impinge under the coracoacromial arch
inflammation of the supraspinatous tendon

Anatomy Module III (7 decks)

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