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Regional Gross Anatomy > Region 5 - Shoulder and Arm > Flashcards

Region 5 - Shoulder and Arm Flashcards

1
Q

What are the origins of the pectoralis major?

A

Clavicle (anterior surface of medial half)
Costal cartilages of ribs 1-6
Anterior sternum

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2
Q

What is the insertion of the pectoralis major?

A

Outer lip of bicipital groove of humerus

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3
Q

What are the functions of the pectoralis major?

A

Flexion of arm
Adduction of arm
Medial rotation of humerus

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4
Q

What is the innervation to the pectoralis major?

A

Medial pectoral nerve (C8-T1) (from medial cord)

Lateral pectoral nerve (C5-C7) (from lateral cord)

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5
Q

What are the origins of the pectoralis minor?

A

3rd-5th ribs

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6
Q

Where does the pectoralis minor insert?

A

Coracoid process

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7
Q

What are the functions of the pectoralis minor?

A

Stabilises scapula by pulling it anteroinferiorly

Can elevate ribs if shoulder fixed

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8
Q

What is the innervation to pectoralis minor?

A

Medial pectoral nerve (C8-T1) (from medial cord)

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9
Q

What is the origin of serratus anterior?

A

Lateral surface of upper 8 ribs

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10
Q

What is the insertion of serratus anterior?

A

Anterior surface of medial border of scapula

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11
Q

What are the functions of serratus anterior?

A

Protracts scapula

Rotates scapula

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12
Q

What is the innervation to serratus anterior?

A

Long thoracic nerve (C5-C7)

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13
Q

What are the origins of the trapezius?

A

Medial 1/3 of superior nuchal line (occipital bone)
Nuchal ligament
Spinous processes of C7-T12

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14
Q

What are the insertions of the trapezius?

A

Lateral 1/3 of clavicle
Acromion
Spine of scapula

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15
Q

What are the functions of the trapezius?

A

Ascending part - Depresses scapula
Transverse part - Retracts scapula
Descending part - Elevates scapula and rotate glenoid cavity

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16
Q

What is the innervation to the trapezius?

A

Motor - Spinal accessory (CN XI)

Pain - Cervical plexus (C3-C4)

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17
Q

What are the origins of latissimus dorsi?

A

Iliac crest
Thoracolumbar fascia
SPinous processes of T7-T12

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18
Q

What is the insertion of latissimus dorsi?

A

Floor of bicipital groove

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19
Q

What are the functions of latissimus dorsi?

A

Extension of arm
Adduction of arm
Medial rotation
(All useful in climbing and chin-ups)

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20
Q

What is the innervation to latissimus dorsi?

A

Thoracodorsal nerve (C6-C8) from post. cord of brachial plexus

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21
Q

What are the origins of levator scapulae?

A

Posterior tubercles of transverse processes of C1-C4

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22
Q

What is the insertion of levator scapulae?

A

Medial border of scapula between superior angle and medial end of scapular spine

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23
Q

What are the functions of levator scapulae?

A

Elevates scapula (with trapezius)
Rotates glenoid cavity inferiorly
Laterally flex neck ipsilaterally (if shoulder fixed)

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24
Q

What is the innervation to levator scapulae?

A

Dorsal scapular nerve (C3-C5)

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25
Q

What are the origins of rhomboid major?

A

Spinous processes of T2-T5

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26
Q

What is the insertion of rhomboid major?

A

Medial border of scapula (from spine to inf. angle)

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27
Q

What are the origins of rhomboid minor?

A

Nuchal ligament

Spinous processes C7-T1

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28
Q

What is the insertion of rhomboid minor?

A

Medial end of scapular spine

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29
Q

What is the function of rhomboid major and minor?

A

Retract scapula

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30
Q

What is the innervation to rhomboid major and minor?

A

Dorsal scapular nerve (C4-C5)

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31
Q

What are the origins of deltoid?

A

Lateral 1/3 clavicle
Acromion
Spine of scapula

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32
Q

What is the insertion of the deltoid?

A

Deltoid tuberosity of humerus

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33
Q

What is the function of the anterior (clavicular) part of the deltoid?

A

Flexion of arm

Medial rotation of arm

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34
Q

What is the function of the middle (acromial) part of the deltoid?

A

Abducts arm (from 10-110 degrees)

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35
Q

What is the function of the posterior (spinal) part of the deltoid?

A

Extension of arm

Lateral rotation of arm

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36
Q

What is the innervation to deltoid?

A

Axillary nerve (C5-C6) from posterior cord of brachial plexus

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37
Q

What groove does the cephalic vein run in?

A

Deltopectoral groove

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38
Q

What is the origin of the teres major?

A

Lateral border of scapula (lower 1/3 on post. surface)

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39
Q

What is the insertion of teres major?

A

Medial lip of bicipital groove of humerus

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40
Q

What are the functions of teres major?

A

Adducts arm

Medial rotation of arm

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41
Q

What is the innervation to teres major?

A

Lower subscapular nerve (C5-C6) from posterior cord of brachial plexus

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42
Q

What is the origins of subclavius?

A

Sternal end of 1st rib

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43
Q

What is the insertion of subclavius?

A

Middle 1/3 of inferior surface of clavicle

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44
Q

What are the functions of subclavius?

A

Depress clavicle

Move clavicle anteriorly during abduction

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45
Q

What is subclavius innervated by?

A

Nerve to subclavius (C5-C6)

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46
Q

What are the 4 rotator cuff muscles?

A

Supraspinatus
Infraspinatus
Subscapularis
Teres minor

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47
Q

What is the general function that all 4 rotator cuff muscles share?

A

Prevent dislocation from a very shallow joint that has few other supporting structures

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48
Q

What is the origin of subscapularis?

A

Subscapular fossa (anterior scapula)

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49
Q

What is the insertion of subscapularis?

A

Lesser tubercle of humerus

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50
Q

What is the function of subscapularis?

A

Medially rotate arm

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51
Q

What is the innervation to subscapularis?

A

Upper and lower subscapular nerves (C5-C7) from posterior cord of brachial plexus

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52
Q

What is the origin of supraspinatus?

A

Supraspinatus fossa (of scapula)

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53
Q

What is the insertion of supraspinatus?

A

Superior facet of greater tubercle of humerus

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54
Q

What is the function of supraspinatus?

A

Abduct arm first 10-15 degrees

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55
Q

What is the innervation to supraspinatus?

A

Suprascapular nerve (C5-C6) from superior trunk of brachial plexus

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56
Q

What is the origin of infraspinatus?

A

Infraspinatus fossa

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57
Q

What is the insertion of infraspinatus?

A

Middle facet of greater tubercle of humerus

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58
Q

What is the function of infraspinatus?

A

Laterally rotates arm

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59
Q

What is the innervation to infraspinatus?

A

Suprascapular nerve (C5-C6)

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60
Q

What is the origin of teres minor?

A

Upper 2/3 of the lateral border of scapula

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61
Q

What is the insertion of teres minor?

A

Inferior facet of the greater tubercle of humerus

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62
Q

What is the function of teres minor?

A

Laterally rotates arm

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63
Q

What is the innervation to teres minor?

A

Axillary nerve (C5-C6) from posterior cord

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64
Q

What ligaments of the shoulder joint attach to the lesser tubercle?

A

Superior, middle and inferior glenohumeral ligaments

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65
Q

What ligament of the shoulder joint attaches to the greater tubercle?

A

Coracohumeral ligament

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66
Q

What is the function of the transverse humeral ligament?

A

Holds biceps tendon in place

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67
Q

What is the shape of the coracoclavicular ligament?

A

Conoid and trapezoid

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68
Q

What is the first superior branch of the subclavian artery?

A

Vertebral artery (off of superior surface)

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69
Q

What is the second superior branch of the subclavian artery?

A

Thyrocervical trunk (off of superior surface)

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70
Q

What is the first inferior branch of the subclavian artery?

A

Internal thoracic artery

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71
Q

What is the branch of the second part of the subclavian artery?

A

Costocervical trunk

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72
Q

What are some of the possible branches of the thyrocervical trunk?

A

Suprascapular
Dorsal scapular
Ascending cervical
Inferior thyroid

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73
Q

What are the borders of the quadrangular space?

A 
Superior = Inferior margin teres minor
Inferior = Superior margin teres major
Medial = Lateral margin long head triceps
Lateral = Surgical neck of humerus
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74
Q

What is contained in the quadrangular space?

A

Axillary nerve

Posterior circumflex humeral artery

75
Q

What are the borders of the triangular hiatus/interval/space?

A 
Superior = Inferior margin teres major
Medial = Lateral margin long head triceps
Lateral = Medial humerus
76
Q

What are the contents of the triangular space?

A

Radial nerve

Profunda brachii artery

77
Q

What muscles does the clavipectoral fascia enclose?

A

Subclavius

Pectoralis minor

78
Q

What is the suspensory ligament of the clavipectoral fascia continuous with?

A

Axillary fascia

79
Q

What pierces the clavipectoral fascia?

A

Cephalic vein
Thoracoaromial artery
Lateral pectoral nerve

80
Q

What forms the anterior wall of the axilla?

A

Pectoralis major and minor
Subclavius
Clavipectoral fascia

81
Q

What forms the floor of the axilla?

A

Skin (and into arm)

82
Q

What forms the roof of the axilla?

A

Rib 1
Clavicle
Scapula

83
Q

What forms the posterior wall of the axilla?

A

Subscapularis
Teres major
Latissimus dorsi
Long head of triceps brachii

84
Q

What forms the lateral wall of the axilla?

A

Humerus

85
Q

What forms the medial wall of axilla?

A

Serratus anterior

Wall of thorax

86
Q

What are the contents of the axilla?

A 
Vessels, nerves and lymphatics for upper limb
Short head biceps
Coracobrachialis
Lymph nodes draining:
- Upper limb
- Mammary tissue
Adipose
87
Q

What does the basilic vein drain?

A

Posteromedial hand and foreaem

88
Q

When does the basilic vein become the axillary vein?

A

Lower margin teres major

89
Q

Which is more anterior in the axilla; the axillary artery or vein?

A

Vein

90
Q

When does the axillary vein become the subclavian vein?

A

Lateral border rib 1

91
Q

What veins join the axillary vein?

A

Brachial veins

Cephalis vein

92
Q

How do the basilic and cephalic veins communicate?

A

Median cubital vein

93
Q

Where does the axillary artery run from and to?

A

From lateral margin rib 1

To inferior margin teres major

94
Q

Where is part 1 of the axillary artery?

A

Proximal to pectoralis minor

95
Q

Where is part 2 of the axillary artery?

A

Posterior to pectoralis minor

96
Q

Where is part 3 of the axillary artery?

A

Distal to pectoralis minor

97
Q

What are the branch(es) of the first part of the axillary artery?

A

Superior thoracic artery

98
Q

What are the branch(es) of the second part of the axillary artery?

A

Thoracoacromial artery

Lateral thoracic artery

99
Q

What are the branch(es) of the third part of the axillary artery?

A

Subscapular artery
Anterior circumflex humeral artery
Posterior circumflex humeral artery

100
Q

Where does the humeral group of axillary lymph nodes lie?

A

Posterior to axillary vein

101
Q

Where does the pectoral group of axillary lymph nodes lie?

A

Inferior margin pectoralis minor

102
Q

Where does the subscapular group of axillary lymph nodes lie?

A

Posterior axillary wall

103
Q

Where does the central group of axillary lymph nodes lie?

A

Axillary fat

104
Q

Where does the apical group of axillary lymph nodes lie?

A

Superior margin pectoralis minor

105
Q

What does the humeral group of axillary lymph nodes drain?

A

Upper limb

106
Q

What does the pectoral group of axillary lymph nodes drain?

A

Thorax

Mammary tissue

107
Q

What does the subscapular group of axillary lymph nodes drain?

A

Back
Shoulder
Neck

108
Q

What does the central group of axillary lymph nodes drain?

A

Communicates with other nodes

109
Q

What does the apical group of axillary lymph nodes drain?

A

Mammary tissue

Other node groups

110
Q

What do the grey rami communicantes that go to the brachial plexus roots carry?

A

Post-ganglionic SNS fibres

111
Q

Where are the roots and trunks of the brachial plexus located?

A

Posterior triangle of neck

Pass between anterior and middle scalene muscles

112
Q

What root(s) contribute to the superior trunk of the brachial plexus?

A

C5 and C6

113
Q

What root(s) contribute to the middle trunk of the brachial plexus?

A

C7

114
Q

What root(s) contribute to the inferior trunk of the brachial plexus?

A

C8 and T1

115
Q

What is the route of the roots and trunks of the brachial plexus to enter the axilla?

A

Pass over rib 1

116
Q

What do branches of the C5 root contribute to?

A 
Phrenic nerve (C3-C5) -> Diaphragm
Dorsal scapular nerve (C5) -> Rhomboids
117
Q

What do branches of C5-C7 roots contribute to?

A

Long thoracic nerve (C5-C7) -> Serratus anterior

118
Q

What do branches of the superior trunk only contribute to?

A 
Suprascapular nerve (C5+C6) -> Infraspinatus
Nerve to subclavius (C5+C6) -> Subclavius
119
Q

In general terms, what do the 3 anterior divisions of each trunk of the brachial plexus supply and via what nerves?

A

Anterior compartments of arm and forearm

Via musculocutaneous and median nerves

120
Q

In general terms, what do the 3 posterior divisions of each trunk of the brachial plexus supply and via what nerves?

A

Posterior compartments of arm and forearm

Via radial nerve

121
Q

What are the peripheral branches of the divisions in the brachial plexus?

A

There are none

122
Q

How are the cords of the brachial plexus named?

A

By their relation to the axillary artery

123
Q

What divisions form the lateral cord?

A

Anterior divisions of superior and middle trunks

124
Q

What are the roots values for the lateral cord?

A

C5-C7

125
Q

What are the peripheral branch(es) of the lateral cord?

A

Lateral pectoral nerve (C5-C7)

126
Q

What divisions form the posterior cord?

A

All posterior divisions

127
Q

What are the root values for the posterior cord?

A

C5-T1

128
Q

What are the peripheral branch(es) of the posterior cord?

A 
Subscapular nerves (Upper and lower - C5+C6)
Thoracodorsal nerve (C6-C8)
129
Q

What divisions form the medial cord?

A

Continuation of the anterior division of inferior trunk

130
Q

What are the root values for the medial cord?

A

C8+T1

131
Q

What are the peripheral branch(es) of the medial cord?

A

Medial pectoral nerve (C8+T1)

Cutaneous nerves

132
Q

What are the terminal nerve branches of the lateral cord?

A

(Lateral pectoral nerve)
Musculocutaneous nerve (C5-C7)
Lateral root of median nerve

133
Q

What are the terminal nerve branches of the posterior cord?

A 
(Subscapular nerves)
(Thoracodorsal nerve)
Axillary nerve (C5+C6)
Radial nerve (C5-T1)
134
Q

What are the terminal nerve branches of the medial cord?

A

(Medial pectoral nerve)
(Medial cutaneous nerves of arm and forearm)
Ulnar nerve (C8+T1)
Medial root of median nerve

135
Q

What is the general function of the muscles in the anterior arm compartment?

A

Flexors of arm and elbow

136
Q

What nerve supplies the anterior arm compartment?

A

Musculocutaneous nerve

137
Q

What are the muscles of the anterior arm compartment?

A

Biceps brachii
Coracobrachialis
Brachialis

138
Q

What are the origins of the biceps brachii?

A

Long head - Supraglenoid tubercle of scapula

Short head - Coracoid process

139
Q

What are the insertions of the biceps brachii?

A

Radial tuberosity

Cubital fascia via bicipital aponeurosis

140
Q

What are the functions of both heads of biceps brachii?

A

Supination
Flexion of elbow (when supine)
Weak flexion of arm

141
Q

What is the function of the short head of biceps brachii?

A

Resists dislocation of shoulder

142
Q

What is the function of the long head of biceps brachii?

A

Prevents head of humerus moving superiorly

143
Q

What is the innervation to the biceps brachii?

A

Musculocutaneous nerve (C5+C6)

144
Q

What is the origin of the coracobrachialis?

A

Coracoid process of scapula

145
Q

What is the insertion of coracobrachialis?

A

Middle 1/3 of medial shaft of humerus

146
Q

What are the functions of coracobrachialis?

A

Flexion of arm

Assists in adduction of arm

147
Q

What pierces coracobrachialis?

A

Musculocutaneous nerve

148
Q

What nerve innervates coracobrachialis?

A

Musculocutaneous nerve (C5-C7)

149
Q

What is the origin of brachialis?

A

Distal half of anterior surface of humerus

150
Q

What are the insertions of brachialis?

A

Ulnar tuberosity

Coronoid process of ulna

151
Q

Where is brachialis found?

A

Deep to biceps brachii

152
Q

What is the function of brachialis?

A

Flexes elbow (in all positions)

153
Q

What is the innervation to brachialis?

A 
Musculocutaneous nerve (C5+C6)
Some lateral fibres from radial nerve (C7)
154
Q

What are the origins of triceps brachii?

A

Long head - Infraglenoid tubercle of scapula
Lateral head - Post. surface humerus, sup. to radial groove
Medial head - Post. surface humerus, inf. to radial groove

155
Q

What are the insertions of triceps brachii?

A

Proximal olecranon of ulna

Fascia of forearm

156
Q

What are the functions of triceps brachii?

A

All parts - Extension of elbow

Long head - Resists dislocation of humerus (important in adduction)

157
Q

What is the innervation to triceps brachii?

A

Radial nerve (C6-C8)

158
Q

What is the most superior branch of the brachial artery?

A

Profunda brachii

159
Q

What are the branches off of the medial aspect of the brachial artery?

A

Superior ulnar collateral

Inferior ulnar collateral

160
Q

What does the profunda brachii artery branch into at the lateral aspect of the arm?

A

Middle collateral artery

Radial collateral artery

161
Q

After the bifurcation of the brachial artery, what branch is given off of the radial artery?

A

Radial recurrent artery

162
Q

After the bifurcation of the brachial artery, what are the branches off of the ulnar artery?

A

Anterior ulnar recurrent artery
Posterior ulnar recurrent artery
Common interosseous artery

163
Q

What are the branches of the common interosseous artery?

A 
Anterior interosseous
Posterior interosseous (gives off interosseous recurrent)
164
Q

What does the middle collateral artery anastomose with?

A

Interosseous recurrent

165
Q

What does the superior ulnar collateral artery anastomose with?

A

Posterior ulnar recurrent

166
Q

What does the inferior ulnar collateral artery anastomose with?

A

Anterior ulnar recurrent

167
Q

What does the radial recurrent artery anastomose with?

A

Radial collateral

168
Q

What does the lateral intermuscular septum extend from?

A

Greater tubercle of humerus

169
Q

What does the lateral intermuscular septum run along?

A

Lateral supracondylar ridge to the lateral epicondyle

170
Q

What perforates the lateral intermuscular septum?

A

Radial neve

Profunda brachii artery

171
Q

What does the medial intermuscular septum extend from?

A

Lesser tubercle of humerus

172
Q

What does the medial intermuscular septum run along?

A

Medial supracondylar ridge to the medial epicondyle

173
Q

What perforates the medial intermuscular septum?

A

Ulnar nerve
(Superior ulnar collateral artery)
(Posterior branch of the inferior ulnar collateral artery)

174
Q

What are the 3 parts of the medial collateral ligament?

A

Anterior
Posterior
Oblique

175
Q

What does the medial collateral ligament of the elbow do?

A

Prevents abduction

176
Q

How many bands does the lateral collateral ligament of the elbow have?

A

1

177
Q

What does the lateral collateral ligament blend with?

A

Annular ligament

178
Q

What does the lateral collateral ligament do?

A

Prevents adduction of the elbow

179
Q

Where is the annular ligament?

A

Around neck of the radius

180
Q

What does the annular ligament allow?

A

Pronation and supination

181
Q

What bursae are present in the elbow joint?

A

Subcutaneous olecranon bursa

Subtendinous bursa of triceps brachii

182
Q

What are the boundaries of the cubital fossa? (Lateral, medial, roof and floor)

A 
Lateral = Brachioradialis
Medial = Pronator teres
Roof = Skin, fascia and bicipital aponeurosis
Floor = Brachialis
183
Q

Where do the superficial veins run in the cubital fossa?

A

In the superficial fascia above the bicipital aponeurosis

184
Q

What are the contents of the cubital fossa from medial to lateral?

A

Median nerve
Bifurcation of brachial artery (into ulnar and radial)
Biceps tendon
Radial nerve

Regional Gross Anatomy (14 decks)

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