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Gross 1 > Quiz 3 > Flashcards

Quiz 3 Flashcards

1
Q

What are the 5 muscles that originate on the vertebral column/skull?

A
  1. Trapezius
  2. Rhomboid Major
  3. Rhomboid Minor
  4. Levator Scapula
  5. Latissimus Dorsi
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2
Q

Trap - O

A

EOP
Superior Nuchal Line
Ligamentous Nuchae - over Cervicals, no Sharpey’s fibers here
Spines of the Thoracic

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3
Q

Trap - I

A

Clavicle

Acromion Process/Spine of Scapula

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4
Q

Trap - A

A
  1. Stabilizes the scapula - holds in anatomical position
  2. Upper portion - elevates
  3. Middle/lower portions - adducts (retracts) scapula
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5
Q

What is another term for weakness of the Trapezius and how does it affect the muscle?

A

Trapezius Palsy

  • shoulder drops on affected side
  • deepening of shoulder on affected side
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6
Q

Which portion of the trapezius is frequently involved in neck injuries during an auto accident?

A

Superior portion of the trap
(whiplash injury)
hyperextension/hyperflexion

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7
Q

What is the clinical examination to test for the XI cranial nerve?

A

Elevate (shrug) shoulders against resistance

test both sides at the same time to evaluate weakness

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8
Q

Rhomb Maj - O

A

Spines/upper thoracic

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9
Q

Rhomb Minor - O

A

Spines/lower cervicals and first thoracic

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10
Q

Rhomb Maj and Rhomb Minor - I

A

Vertebral border of scap

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11
Q

Levator Scap - O

A

Transverse processes/upper cervicals

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12
Q

Levator Scap - I

A

Superior angle of scap

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13
Q

Actions of Rhomboid/Levator Scap

A
  1. Elevates scap
  2. Adducts scap
  3. Stabilizes scap
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14
Q

Damage to the dorsal scapular nerve would affect which muscle(s)?

A
  1. Levator Scap
  2. Rhomboid Maj
  3. Rhomboid Min
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15
Q

Damage to the DSN results in what?

A
  1. Difficulty in adducting scap

2. Scapula on the affected side of further from the midline

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16
Q

What is the largest muscle in the body by area?

A

Latissimus Dorsi

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17
Q

What helps form the posterior fold/border of the axilla?

A

The tendon of insertion of the Lat Dorsi and the Teres Major

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18
Q

Lat Dorsi - O

A

Spines/lower thoracic/lumbar vertebrae
thoracodorsal fascia
crest/ilium
lower ribs

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19
Q

Lat Dorsi - I

A

Intertubercular groove (lesser tubercle) of humerus

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20
Q

Lat Dorsi - A

A
  1. Extends, adducts, & medially rotates humerus

2. Forced expiration

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21
Q

Weakness/damage to the Lat Dorsi results in…

A

Forward displacement of the shoulder

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22
Q

What makes up the Lumber Triangle?

A
  1. Lat Dorsi (depression at lower portion)
  2. Crest of the ilium
  3. External oblique musce
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23
Q

Clinical significance of the Lumbar Triangle?

A

Common site for a hernia of the posterior abdominal wall

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24
Q

What makes up the Triangle of Auscultation?

A

Found at the superior border of the Lat Dorsi

  1. Latissimus Dorsi
  2. Trapezius
  3. Vertebral Border of scapula
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25
Q

Why is the Triangle of Auscultation significant?

A

The thin layer of tissue here allows lung sounds to be easily heard with a stethoscope

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26
Q

How can we enlarge the Triangle of Auscultation area on a patient?

A

Having the patient abduct (protract) scapula. Ask the patient to fold their arms across their chest

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27
Q

What muscles connect the thoracic wall to the upper extremity?

A

Serratus Anterior, Subclavius, Pectoralis Major/Minor

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28
Q

Serratus anterior - o

A

Upper ribs

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29
Q

Serratus Anterior - I

A

Vertebral border of scapula

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30
Q

Serratus Anterior - A

A
  1. abducts scapula (prime mover)
  2. stabilizes scapula
  3. involved with forced inspiration but only when humerus is abducted
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31
Q

What is another name for Winged Scapula?

A

Long Thoracic Nerve Palsy

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32
Q

How does LTNP affect the serratus anterior?

A

Weakens the muscle due to damage of the LTN or its segmental innervation

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33
Q

What is the most important clinical sign of a winged scapula?

A
  • Patient has difficulty keeping vertebral border and inferior angle of scap against the posterior thoracic wall when carrying out abduction against resistance
  • Problems raising extremity over their head
  • *Pain may or may not occur**
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34
Q

What causes Long Thoracic Nerve Palsy?

A
  1. Trauma/subluxation
  2. Traction injury involving shoulder joint
  3. Recumbency for a long period of time
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35
Q

What are the 6 scapular muscles?

A
  1. Deltoid
  2. Supraspinatus
  3. Infraspinatus
  4. Subscapularis
  5. Teres Minor
  6. Teres Major
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36
Q

What are the 4 Rotator Cuff Muscles?

A

“SITS”
Supra/infraspinatus
Teres Minor
Subscapularis

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37
Q

What two criterion are necessary for a muscle to be considered a rotator cuff muscle?

A
  1. Tendon of insertion must form a cuff around the proximal part of the humerus
  2. They either laterally or medially rotate the humerus
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38
Q

What muscle is a common site for intramuscular injections?

A

Deltoid

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39
Q

Deltoid - O

A

Clavicle (anterior portion)
Acromion Process (middle portion)
Spine of scapula (posterior/spinous portion)

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40
Q

Deltoid - I

A

Deltoid Tuberosity/humerus

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41
Q

Deltoid - A (anteroir)

A

flexes/medially rotates humerus

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42
Q

Deltoid - A (middle)

A

abducts humerus

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43
Q

Deltoid - A (posterior)

A

extends/laterally rotates humerus

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44
Q

What is another name for atrophy of the deltoid?

A

Crutch Paralysis

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45
Q

What causes Crutch Paralysis?

A

Due to an injury of the axillary nerve via:

  1. Dislocation of shoulder joint
  2. Pressure of a crutch in axilla
  3. Fracture of surgical neck of humerus
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46
Q

How does atrophy of the deltoid affect the muscle appearance and function?

A
  • Flattened appearance
  • Abduction of arm is impaired
  • Loss of sensation over lateral aspect of arm
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47
Q

What branch of the axillary nerve is compromised in Crutch Paralysis?

A

Lateral brachial cutaneous branch

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48
Q

Supraspinatus - O

A

Supraspinatus Fossa of scap

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49
Q

Supraspinatus - I

A

Greater tuberosity of humerus

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50
Q

Supraspinatus - A

A
  1. Initiates abduction of humerus
  2. Laterally rotates humerus
  3. Stabilizes shoulder joint
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51
Q

How is the supraspinatus tendon of insertion separated from the acromion process?

A

Subacromial and subdeltoid bursa

This is generally more common than tendonitis, but it’s hard to distinguish the two*

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52
Q

What is Rotator Cuff Tendonitis?

A

Irritation/inflammation of the supraspinatus tendon

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53
Q

Another name for rotator cuff tendonitis?

A

Shoulder impingement syndrome

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54
Q

Common symptoms of rotator cuff tendonitis?

A
  • “Twinge”, progressing to sharp/aching pain occurring in the anterior/lateral aspect of the shoulder
  • Weak shoulder movement
  • Hot/burning feeling in shoulder
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55
Q

What causes rotator cuff tendonitis?

A
  1. Genetic (due to a hooked acromion process)
  2. Trauma/Injury
  3. Excess stress/repetition (mostly in athletes)
  4. Weakness around rotator cuff (humerus compresses tendons)
  5. Calcium deposits in tendon (mostly in elderly)
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56
Q

If someone has a rotator cuff tear, where does the tear occur?

A

Ruptures at or near insertion

Tear may be partial or complete

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57
Q

What test can be performed to check for rotator cuff tears?

A

Drop test

  • Patient slowly lowers abducted limb
  • If tendon is torn, arm will drop suddenly at the halfway point

**Tears occur with minor trauma in patients over 50. Under 50, single traumatic injury (dislocation) can cause this injury

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58
Q

Infraspinatus - O

A

Infraspinatus Fossa of Scap

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59
Q

Infraspinatus - I

A

Greater tuberosity of humerus

60
Q

Infraspinatus - A

A
  1. Laterally rotates the humerus
  2. Stabilizes the shoulder joint

Often fused to teres minor

61
Q

Subscapularis - O

A

Subscapular Fossa of Scap (ventral surface)

**At muscle lines of attachment (deeper lines = greater muscle development)

62
Q

Subscapularis - I

A

Lesser tuberosity

63
Q

Subscapularis - A

A
  1. Medially rotates humerus

2. Stabilizes shoulder joint

64
Q

Teres Minor - O

A

Axillary border of scap

65
Q

Teres Minor - I

A

Greater tuberosity of scap

66
Q

Teres Minor - A

A
  1. Laterally rotates humerus

2. Stabilizes shoulder joint

67
Q

Teres Major - O

A

Inferior angle of Scapula

68
Q

Teres Major - I

A

Medial lip of the intertubercular groove of humerus

69
Q

Terer Major - A

A
  1. Adducts/medially rotates humerus

2. Stabilizes shoulder joint

70
Q

What divides the teres major and teres minor?

A

Long head of the triceps brachii - divided into two smaller spaces

71
Q

Quadrilateral Space

A

More lateral of the two spaces between the teres muscles

Contains the Axillary Nerve & Humeral Circumflex Blood Vessels (artery/vein)

72
Q

Triangular Space

A

Medial space containing circumflex scapula branch of the subscapular artery

73
Q

What are the two categories of ligaments?

A

Extrinsic (extracapsular) - superficial to capsular ligament
Intrinsic (Intracapsular) - deep to capsular ligament

Prevent movement by acting as either a rope or a wall

74
Q

Sternoclavicular joint articulations

A
  1. Sternal end of clavicle
  2. Clavicular/costal notches of the sternum (manubrium)
  3. Medial end of the first rib
75
Q

What are standout features of the S-C joint?

A
  • Most stable joint of upper extremity

- Where the upper limb articulates with the axial skeleton

76
Q

What is the articular disc?

A

Cartilage found in the middle of the S-C joint cavity (divides cavity in half)

77
Q

What are the functions of the articular disc?

A
  1. Prevents clavicle from being displaced at articulation with sternum
  2. Shock absorber for forces transmitted along clavicle
78
Q

What type of joint is the S-C joint?

A

Plane gliding joint (can also act as a ball and socket joint)

79
Q

This strong ligament acts like a wall and completely surrounds the S-C joint

A

Capsular Ligament

80
Q

What movements occur passively at this joint when the scapula moves?

A
  • Elevation
  • Depression
  • Protraction/Retraction
  • Rotation
81
Q

These ligaments reinforces the capsular ligament

A

Anterior/Posterior Sternoclavicular Ligament

Costoclavicular Ligament

82
Q

What ligament associated with the S-C joint is extrinsic and acts like a wall?

A

Anterior/Posterior Sternoclavicular

83
Q

What ligament is attached the the sternal ends of both clavicles?

A

Interclavicular Ligament

84
Q

What is the fxn of the interclavicular ligament?

A

Extrinsic and acts like a rope

Prevents displacement of the clavicle when one is carrying a heavy object

85
Q

What strong ligament is attached to the costal impression of the clavicle and the first rib?

A

Costoclavicular ligament

86
Q

What are the fxns of the costoclavicular ligament?

A

Extrinsic and acts like a rope
Reinforces the capsular ligament
Limits elevation at the medial end of the clavicle (monkey bars)

87
Q

What causes a dislocation of the S-C joint?

A

Direct trauma to the anterior aspect of the sternal end of the clavicle

Dislocations are rare due to strength of ligaments

88
Q

What are the grades of injury to the S-C joint?

A

Grade 1 - mild sprain
Grade 3 - complete dislocation

Injuries may be life threatening due to damage/compression of the trachea of blood vessels in the neck

89
Q

How is the acromioclavicular joint classified?

A

Plane gliding joint

90
Q

What are the articulations of the a-c joint?

A

Acromial (lateral) end of the clavicle

Acromion process of the scapula

91
Q

What is the nerve supply for the A-C joint?

A

DSN, Axillary, Suprascapular

92
Q

Are movements of the A-C joint active or passive?

A

Passive - occur when scapula moves upon the thoracic cage

93
Q

What ligaments support the A-C Joint?

A
  1. Superor Acromioclavicular
  2. Inferior Acromioclavicular
  3. Coracoclavicular
94
Q

How do the superior/inferior a-c ligaments support the A-C joint?

A
  • Reinforce capsular ligament
  • Extrinsic/rope
  • Prevent the clavicle from losing contact with the acromion process
95
Q

What does the coracoclavicular ligament connect?

A

Connects the clavicle with the coracoid process of the scapula

96
Q

What are the two portions of the coracoclavicular ligament?

A

Conoid and Trapezoid

Attached respectively to the conoid tubercle and trapezoid line of clavicle

97
Q

What are the fxns of the coracoclavicular ligament?

A
  • Extrinsic/rope
  • Limits protraction, elevation, and rotation of scap
  • Holds/Suspends weighe of scap from clavicle
98
Q

What is another name for a dislocation of the A-C joint?

A

Shoulder separation

99
Q

What is a shoulder pointer?

A

An injury to the A-C joint due to a severe blow to the shoulder

100
Q

What are some features of an A-C joint dislocation?

A
  • More prominent acromion process (acromion bump)
  • lateral end of clavicle is displaced and easily palpable
  • Diminished brachial and radial pulse (only happens sometimes, due to subclavian artery compromise)
101
Q

Which joint has the greatest range of motion (also called the universal joint)

A

Shoulder (Glenohumeral) Joint
Ball and Socket Joint

This mobility makes it unstable!

102
Q

What are the articulations of the Glenohumeral joint?

A

Head of the humerus with the glenoid cavity of the scapula

103
Q

What is the Glenoid Labrum?

A

A fibrocartilage rim that deepens the articular surface of the glenoid cavity

104
Q

What is the nerve supply to the Glenohumeral joint?

A

Axillary & suprascapular

105
Q

What are the ligaments of the shoulder joint?

A

Capsular, Glenohumeral, Transverse Humeral, Coracohumeral, Coracoacromial, Suprascapular

106
Q

Where is the capsular ligament?

A
  • Surrounds shoulder joint (thin/lax)
  • Opens at the inferior lateral portion through which the long head of the biceps brachii passes out of the cavity
  • Superiorly, strengthened by ligaments and rotator cuff muscle tendons
107
Q

Where is the glenohumeral ligament? Fxns?

A
  • Within shoulder cavity
  • Strengthens anterior aspect of capsule
  • Prevents lateral rotation of humerus at shoulder joint
  • Intrinsic/Rope
108
Q

Where is the transverse humeral ligament? Fxns?

A
  • Spans intertubercular groove (converts into canal)

- Keeps the long head of the biceps brachii in place

109
Q

Where is the coracohumeral ligament? Fxns?

A
  • Strengthens the capsule from above
  • Limits lateral rotation of humerus
  • Extrinsic/rope
110
Q

Where is the coracoacromial ligament? Fxns?

A
  • Attaches to coracoid process/acromion process of scap
  • Prevents upward displacement of head of humerus
  • Extrinsic/Wall
111
Q

Where is the suprascapular ligament located?

A

Scapular notch

112
Q

What keeps the shoulder joint from dislocating?

A

Rotator cuff muscles

can occur directly or indirectly

113
Q

What is the most common type of dislocation of the shoulder joint?

A

Anterior dislocation - occurs at inferior aspect of capsular ligament

114
Q

What causes an anterior dislocation?

A

Excessive extension/lateral rotation of humerus

115
Q

What is another name for an anterior dislocation?

A

Subcoracoid dislocation
Head of humerus is forced through the anterior part of the capsular ligament and ends up lying below coracoid process

116
Q

What are common signs and complaints of a dislocation of the shoulder joint?

A
  • Loss of sensation/numbness along lateral aspect of arm/forearm (musculocutaneous and axillary)
  • Loss of rounded appearance of shoulder
  • Greater tuberosity cannot be palpated through the deltoid muscle @ lateral proximal aspect of arm
117
Q

What are the two compartments of the arm (brachium)?

A

Anterior - flexor

Posterior - extensor

118
Q

What movements are associated with the elbow joint?

A

Flexion - bending elbow joint
Extension - A return movement from flexion, increases angle between arm/forearm
Hyperextension - only occurs in some individuals (due to size of olecranon process and fossa)

119
Q

What movements are associated with the forearm at the superior and inferior radio-ulnar joints?

A

Supination - lateral rotation of the forearm (palms up). radius/ulna are parallel.

Pronation - medial rotation of forearm (palms down). radius crosses ulna anteriorly

120
Q

What is another name for the biceps brachii?

A

“Three joint muscle” - it causes movements at elbow, shoulder, and proximal radio-ulnar joints

121
Q

Biceps Brachii - O

A 
Short Head (medial) - coracoid process/scap
Long Head (lateral) - supraglenoid tubercle/scap
122
Q

Biceps Brachii - I

A

Tuberosity/radius

Shaft/ulna (bicipital aponeurosis)

123
Q

Biceps Brachii - A

A
  1. Flexion of forearm at elbow joint
  2. Supinator of forearm (prime mover)
  3. Short head: adducts humerus
  4. Long head: abducts humerus
124
Q

What muscle completely covers but does not attach to the humerus?

A

Biceps Brachii

125
Q

What are symptoms of biceps tendonitis? When does this usually occur?

A
  • Pain at proximal arm/shoulder area
  • Crepitus (cracking sound) due to narrow and/or rougher groove that can irritate the tendon

Usually occurs due to excessive flexion at the elbow joint against resistance

126
Q

What is Popeye Deformity?

A
  • Ruptured belly forms a ball near the center of the anterior aspect of the arm
  • Due to tear or rupture of the long head of the biceps tendon (occurs at origin)
127
Q

What causes Popeye Deformity?

A
  • Chronic tendonitis

- Forceful flexion of the forearm against excessive resistance (e.g. weight lifting)

128
Q

What is the bicipital reflex? How is this tested?

A
  • Tested in an examination of segmental innervation (C5 and C6)
  • Tap the biceps tendon, look for reflex of flexion at the elbow joint
129
Q

Coracobrachialis - O

A

Coracoid Process of Scap

130
Q

Coracobrachialis - I

A

Shaft of the humerus

131
Q

Coracobrachialis - A

A
  1. Flexion/weak adduction of humerus

2. Helps stabilize shoulder joint

132
Q

What nerve is always found passing through the belly of the coracobrachialis?

A

Musculocutaneous

133
Q

Brachialis - O

A

Shaft of humerus

134
Q

Brachialis - I

A

Coronoid Process of Ulna

135
Q

Brachialis - A

A

Flexes forearm at elbow joint

136
Q

Triceps Brachii - O

A

Long head: infraglenoid tubercle of humerus

Medial/Lateral: Shaft of humerus

137
Q

Triceps Brachii - I

A

Olecranon Process of Ulna

138
Q

Triceps Brachii - A

A

Extends forearm at elbow joint

139
Q

Which head of the Triceps Brachii works all of the time?

A

Medial Head

140
Q

Which head(s) of the Triceps Brachii are used only for extra force?

A

Lateral and Long heads

141
Q

How can we test the segmental innervation of the triceps brachii?

A

Tap the muscle’s tendon of insertion and look for extension reflex

142
Q

When is passive extension of the triceps brachii produced by gravity?

A

When the muscle is atrophied

143
Q

Anconeus - O

A

Lateral epicondyle of the humerus

144
Q

Anconeus - I

A

Olecranon Process

Proximal Posterior shaft of Ulna

145
Q

Anconeus - A

A

Assists (weakly) in extension of forearm

Gross 1 (3 decks)

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