Pectoral Region & Shoulder Flashcards

1
Q

Deltopectoral groove

A

Surface of pectoral and shoulder
Furrow between deltoid and pectorals major muscles
Carries cephalic vein (towards axillary vein) -
Drains entire upper limb

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2
Q

Cephalic vein

A

Drains entire upper limb

Runs along deltopectoral groove

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3
Q

Anterior axillary fold

A

On pectorales major muscle

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4
Q

Interdigitations of serratus anterior

A

Seen anterolaterally at origin, ribs 1-8 or 9

Heart beat is clearest at 5th intercostal space

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5
Q

Sternal angle

A

At level of intervertebral disc between T4-T5

At level of second costal cartilage

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6
Q

Mammary gland

A

Modified sweat glands
Have numerous ducts
Found in hypodermic superficial to pec major
Involved in lympatic drainage to axillary and parasternal nodes

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7
Q

Lympathic drainage

A

From mammary glands to axillary lymph nodes and parasternal nodes

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8
Q

Axillary lymph nodes

A

Main lymphatic drainage path
Cancer cells can lodge here and produces metasteses
These nodes communicate head and neck

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9
Q

Parasternal nodes

A

Lymphatic drainage
Communicate with other breast, liver, heart, and lungs
Cancer cells may spread to cranial cavity and brain via communication between:
intercostal venous vein and
vertebral venous plexus

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10
Q

Cutaneous innervation for pectoral and shoulder region

A

Ventral rami of thoracic spinal nerves

Supraclavicular nerves

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11
Q

Ventral rami of thoracic spinal nerves

A
Mixed nerves (sensory & motor)
Starting with T1
Lateral cutaneous branches and
Anterior cutaneous branches
Supply thoracic wall
(continues to become intercostal nerve as it passes into ribs)
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12
Q

Supraclavicular nerves

A

C3 and C4 from cervical plexus

Supply skin over clavicular region, shoulder, and thoracic wall above T2

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13
Q

Pectoral region fasciae

A

Pectoral fascia
Clavipectoral fascia
Costocoracoid membrane

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14
Q

Pectoral fascia

A

Envelopes pec major and attaches to clavicle and sternum

Continuous with axillary & abdominal fascia, which becomes superficial back fascia

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15
Q

Clavipectoral fascia

A

Deep to pec major
Envelopes subclavius muscle and pec minor muscle
Attaches laterally to coracoid process
Attaches superiorly to the clavicle
Medially known as “costcoracoid membrane”

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16
Q

Costocoracoid membrane

A

Medial specialization of the clavipectoral fascia
Attaches laterally to coracoid process
Attaches medially to clavicle and first rib

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17
Q

Pectoral region muscles

A

Pec major
Pec minor
Subclavius

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18
Q

Shoulder region muscles

A
Deltoid
Supraspinatus
Infraspinatus
Teres major
Teres minor
Subscapularis
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19
Q

What sits deep to pec minor muscle?

A

Axillary artery and brachial plexus cords

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20
Q

Cutaneous innervation of shoulder region

A

Superior shoulder:
supraclavicular nerves from cervical plexus
Inferior Deltoid:
branch from axillary nerve supplies skin

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21
Q

Which muscles are part of the rotator cuff?

A
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Teres major
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22
Q

Spaces of pectoral/shoulder region

A

Triangular space

Quadrangular space

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23
Q

Triangular space

A
Borders:
Teres minor (superior)
Teres major (inferior)
Long head of Triceps Brachii (lateral)
Contains:
Scapular circumflex artery
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24
Q

Quadrangular space

A
Borders:
Teres minor (superior)
Teres major (inferior)
Long head of Triceps Brachii (medial)
Diaphysis of the humerus (lateral)
Contains:
Posterior humeral circumflex artery and axillary nerve
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25
Q

Arteries supplying pectoral/shoulder region

A

Suprascapular artery
Posterior humeral circumflex artery
Scapular circumflex artery
Scapular anastomosis

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26
Q

Supscapular artery

A

Branch of subclavian a.
Passes posteriorly deep to trapezius
Passes superiorly to transverse scapular lig.
Passes deep to supraspinatus

27
Q

Posterior humeral circumflex artery

A

Branch of axillary a.
Winds medially around surgical neck of humerus
Emerges through quadrangular space with axillary n.

28
Q

Scapular circumflex artery

A

Branch of axillary a.

Passes posteriorly through axilla to emerge through the triangular space

29
Q

Scapular anastomosis

A
Supplies rotator cuff muscles
Sources from subclavian and axillary a.
Junction to: 
transverse cervical a.
scapular circumflex a.
posterior humeral circumflex a.
suprascapular a.
small acromial branches from the axillary
30
Q

Nerves supplying pectoral/shoulder region

A

ALL C5 & C6
Axillary n.
Suprascapular n.
Upper & Lower Scapular N.

31
Q

Axillary nerve

A

C5 & C6
Arises from brachial plexus
Travels with Posterior humeral circumflex
Emerges through quadrangular space
Sensory to skin over inferior portion of deltoid

32
Q

Suprascapular nerve

A

C5 & C6
From brachial plexus
Passes posteriorly deep to trapezius
Passes inferiorly to transverse scapular ligament (with suprascapular vein)

33
Q

Upper and lower scapular nerve

A

C5 & C6
From brachial plexus
Enters subscapularis from ventral surface

34
Q

Shoulder Joint &

Accessory Shoulder Joints

A
Composed of three joints:
Sternoclavicular joint
Acromioclavicular  joint
Glenohumeral joint
May also include:
"Scapulothoracic joint"
35
Q

Sternoclavicular Joint
Where?
What type of joint?
Features?

A

Sole point of connection between the trunk and upper limb
Multiaxial synovial joint
Joint capsule is thickest anteriorly
Articulating fibrous disc within the capsule
(divides cavity into TWO synovial cavities)
Clavicle lined with fibrocartilage
Sternum lined with hyaline cartilage
Capsule reinforced by ligaments

36
Q

Acromioclavicular Joint

A

Plane joint
Clavicle rides higher than acromiom process
Small articular capsules with fibrocartilage articulating disc
Capsule reinforced by ligaments

37
Q

Scapulothoracic Joint

A

Not a true joint
Considered as part of shoulder region
Represents how scapula sits over thorax

38
Q

Glenohumeral Joint

A
"Shoulder joint"
Ball & Socket
Most of stability due to muscle tendons
Has Loose articular capsule
Reinforced by RC tendons, and ligaments
39
Q

What reinforces the acromioclavicular joint?

A

Acromioclavicular lig.
Coracoclavicular lig.
Conoid lig. (medial)
Trapezoid lig. (lateral)

40
Q

Coracoclavicular ligament

A

Provides strength to the AC joint because weak articular capsule

41
Q

Conoid ligament

A

Medial
Fibers run posteriomedially from coracoid process
Checks forward rotation of clavicle on scapula
Prevents posterior displacement

42
Q

Trapezoid ligament

A

Lateral
Fibers run posterolaterally from coracoid process
Checks backward rotation of clavicle on scapula
Checks slide of acromiom process under clavicle
Prevents anterior displacement

43
Q

Movements of Acromioclavicuolar joint?

A

Gliding of acromiom process on clavicle
Rotation of clavicle on scapula
Closed pack position = 90* of shoulder abduction

44
Q

Nerve supply of acromioclavicular joint?

A

Suprascapular and lateral pectoral nerves

45
Q

Nerve supply of acromioclavicular joint?

A

Suprascapular and lateral pectoral nerves

46
Q

Articular capsule of Glenohumeral joint

A

LOOSE!
Taught superiorly, loose anteroinferiorly
Attached to scapula and anatomical neck of humerus to labrum
Capsule strengthened by tendons and lig.

47
Q

Rotator cuff tendons

A

Reinforces loose articular capsule of glenohumeral joint
Blend with articular capsule
Hold humeral head in place
Checks superoposterior displacement of humeral head

48
Q

Glenohumeral ligaments

A

Reinforces loose articular capsule of glenohumeral joint
Are WITHIN the capsule on anterior wall
Appear as a “thickening” of capsule
They check anterior displacement of humeral head
Has THREE parts:
Superior glenohumeral lig.
small
from anterior supraglenoid tubercle to lesser tubercle of humerus
horizontal fibers
Middle glenohumeral lig.
Arises near superior glenohumeral lig. and travels to lesser tubercle
Inferior glenohumeral lig.
anteroinferior region of glenoid fossa to dorsal surface of anatomical humeral check

49
Q

Coracohumeral ligaments

A

Reinforces loose articular capsule of glenohumeral joint

50
Q

Tendon of the long head of the biceps brachii

A

Reinforces loose articular capsule of glenohumeral joint

51
Q

Coracohumeral ligaments

A

Reinforces loose articular capsule of glenohumeral joint
Blends with capsule
Attaches to anatomical neck near greater tubercle

52
Q

Tendon of the long head of the biceps brachii

A

Reinforces loose articular capsule of glenohumeral joint
Passes through joint, pierces capsule
Attaches to glenoid labrum, continuous with
Strengthens capsule anterosuperiorly

53
Q

Openings of articular capsule in glenhohumeral joint

A

Represent potential weak spaces
Near intertubercular groove (for long head of biceps brachii tendon)
Near subscapular bursa
Subacromial bursa

54
Q

Inferior glenohumeral lig.

A

Reinforces loose articular capsule of glenohumeral joint
Part of glenhohumeral ligaments
(three of them)
anteroinferior region of glenoid fossa to dorsal surface of anatomical humeral check

55
Q

Inferior glenohumeral lig.

A

Reinforces loose articular capsule of glenohumeral joint
Part of glenhohumeral ligaments
(three of them)
anteroinferior region of glenoid fossa to dorsal surface of anatomical humeral check

56
Q

Dislocations of GH joint

A

Tend to be inferior and anterior
Least protected region of capsule
Triceps muscle prevents inferior/posterior dislocations

57
Q

Bursae of GH Joint

A

Subacromial/Subdeltoid - outside of capsule

Subscapular - communicates with capsule

58
Q

Bursae of GH Joint

A

Subacromial/Subdeltoid - outside of capsule

Subscapular - communicates with capsule

59
Q

Coracoacromial ligament

A

Forms a roof over GH joint

Helps prevent superior displacement of humeral head

60
Q

Triceps brachii muscle tendons

A

Strengthens capsule posteriorly

61
Q

Blood supply of GH joint

A
Anastomosis among:
Subscapular a.
Anterior humeral circumflex a.
Posterior humeral circumflex a.
Scapular circumflex a.
62
Q

Nerve supply of GH joint

A

Tends to send “twigs” to joint capsule
Suprascapular
Axillary
Subscapuar n.

63
Q

Movements of GH Joint

A
Shoulder Flexion
Shoulder Extension
Abduction
Adduction
Lateral Rotation
Medial Rotation