Scapula and Deltoid Regions

Question 1

Skeletal Elements of Pectoral Girdle

Answer 1

Scapula, Clavicle, *Humerus not considered part*

Question 2

Joints of the Shoulder Region: Ligament Reinforced

Answer 2

Coracoclavicular: A: Trapezoid B: Conoid Coracoacromial Superior Glenohumeral Middle Glenohumeral Inferior Glenohumeral

Question 3

Scapular Motion

Answer 3

Elavation/Depression Protraction/Retraction Upward/Downward Rotation

Question 4

Deltoid

Answer 4

Origin: lateral 1/3 of clavicle, acromion, spine of scapula Insertion: deltoid tuberosity of humerus Axns: At humerus Flex Medially Rotate Abduct Extend Laterally Rotate Blood Supply: deltoid branch of thoracoacromial arterial trunk Innervation: Axillary nerve (C5-6)

Question 5

Teres Major

Answer 5

Origin: Post. surface of inf. angle of scapula Insertion: med. lip of intertubercular groove of humerus Axns: at humerus Adduct Medially Rotate Blood Supply: circumflex scapular artery Innervation: lower subscapular nerve (C5-6)

Question 6

Serratus Anterior

Answer 6

Origin: Ext. surface of lateral part of ribs 1-9 Insertion: Ant. surface of medial border of scapula Axns: Protracts scapula Holds scapula to thoracic wall Rotates scapula Blood Supply: Lateral Thoracic Artery Innervation: Long Thoracic Nerve (C5-7)

Question 7

Muscles of the Rotator Cuff

Answer 7

Supraspinatus Infraspinatus Subscapularis Teres Minor

Question 8

Supraspinatus

Answer 8

Origin: Supraspinous fossa of scapula

Insertion: sup. facet of greater tubercle of humerus

Axns: Abduction of humerus

Stabilize shoulder joint

Blood supply: Suprascapular artery

Innervation: Suprascapular nerve (C4-7)

Question 9

Shoulder Impingement

Answer 9

Supraspinatus tendonitis

Greater than 90º angle compresses SS tendon

can involve subacromial bursa

SS can also tear

Question 10

Subscapularis

Answer 10

Origin: subscapular fossa (ant. surface)

Insertion: lesser tubercle of humerus

Axns: medially rotates humerus

adducts humerus

hold humeral head in place

Blood Supply: subscapular artery

Innervation: upper & lower subscapular nerves (C5-7)

Question 11

Subscapularis

Answer 11

Largest Rotator Cuff Muscle: tears are rare: tendonitis common

Injury leads to bicipital tendon instability/tendonitis

Passes over biceps tendon

Origin: Infraspinous fosssa

Insertion: middle facet of greater tubercle of humerus

Axns: laterally rotates humerus

holds humeral head in place

Blood Supply: suprascapular artery

Innervation: suprascapular nerve (C5-6)

Question 12

Teres Minor

Answer 12

Origin: Middle part of lateral border of scapula

Insertion: Inf. facet of greater tubercle of humerus

Axns: lat. rotate humerus

hold humeral head in place

Blood: circumflex scapular artery

Nerve: axillary nerve (C5-6)

Initiates abduction to 15º

Question 13

Circulation: Subclavian Artery

Answer 13

Origin:

Right: brachiocephalic trunk

Left: Aortic arch

arises posterior to sternoclavicular joint

3 divisions in relation to ant. scalene muscle

Part 1: medial to it

Part 2: posterior to it

Part 3: lateral to it

Question 14

Medial Part of Subclavian Artery

Answer 14

Branches:

Internal thoracic (mammary) a.

Vertebral a.

Thyrocervical arterial trunk

Question 15

Thyrocervical Arterial Trunk:

Answer 15

Consists of:

Tranverse Cervical artery: superficial and deep branch

deep branch is dorsal scapular artery

Inferior thyroid artery

ascending cervical artery

suprascapular artery

Question 16

Posterior Part of Subclavian Artery Branches

Answer 16

Costocervical arterial trunk

supreme intercostal artery

deep cervical artery

Question 17

Lateral Part of Subclavian Artery: No branches

Answer 17

Dorsal Scapular may arise from it

Subclavian becomes axillary at lateral border of 1st rib

Question 18

Scapular Anastomoses

Answer 18

Suprascapular artery

Dorsal Scapular artery

Posterior Intercostal arteries

Circumflex Scapular artery

Thoracodorsal artery

Question 19

Dorsal Scapular Artery Note

Answer 19

Can arise from subclavian

Can arise from transverse cervical (30% of time)

called deep branch of transverse cervical

Runs along vertebral border of scapular

Question 20

Be able to draw venous drainage and arteries

Question 21

Relationships and Spaces

Answer 21

Traingle of Auscultation

Quadrangular Space: axillary nerve & post. circumflex humeral artery

Triangular Space: circumflex scapular artery

Triangular Interval: deep brachial artery and radial nerve