Session 2 Lecture Notes Flashcards
What is the shoulder girdle?
What is it’s function?
The clavicle and scapula
Connects the arm to the skeleton
Name the 4 joints within the shoulder girdle
- Sternoclavicular
- Acromioclavicular
- Scapulothoracic
- Glenohumeral
Which bone is FIRST to start ossifying but LAST to complete?
The clavicle
What part of the humerus used to be the growth plate?
The anatomical neck
Where to the rotator cuff muscles attach to?
The greater and lesser tubercles
What tubercle of the humerus appears more laterally?
The greater tubercle
the lesser tubercle is more medial
What is the most commonly dislocated joint?
The glenohumeral joint
What is the glenoid labrum?
A ring of fibrocartilage that deepens the glenoid cavity and allows the humeral head a more secure fit
What are the 3 glenohumeral ligaments?
- Superior
- Middle
- Inferior
What are the 3 extracapsular ligaments?
Where do they all attach to?
- Coracoacromial
- Coracoclavicular
- Coracohumeral
All attach to the coracoid process
Name the 4 rotator cuff muscles
Where do they all insert?
SITS: 1. Supraspinatus 2. Infraspinatus 3. Teres minor 4. Subscapularis All insert at the proximal humerus
What innervates infraspinatus and supraspinatus?
The suprascapular nerve
What innervates teres minor?
The axillary nerve
What innervates subscapularis?
The upper and lower subscapularis nerves
At the shoulder joint - what does subscapularis do?
Medially rotates the shoulder
At the shoulder joint - what do supraspinatus do?
Abduction of shoulder (0-15 degrees)
At the shoulder joint what does infraspinatus and teres minor do?
Laterally rotates the shoulder
The space between the acromion and head of humerus is 1-1.5 cm. What is within this space?
- Subacromial bursa
- Rotator cuff tendons
- Capsule
- Long head of biceps
Abduction is an action that requires 2 joints - what are they?
- Glenohumeral - 0-90 degrees
2. Scapulo-thoracic - over 90 degrees
What muscles abduct the arm above 90 degrees at the scapula-thoracic joint?
- Trapezius
2. Serratus anterior
What innervates the deltoid?
Axillary nerve
What innervates pectoralis major?
The medial and lateral pectoral nerves
What innervates latissimus dorsi?
Thoracodorsal nerve
What innervates teres major?
Thoracodorsal nerve
What innervates coracobrachialis?
Musculocutaneous nerve
What innervates biceps brachii?
Musculocutaneous nerve
The brachiocephalic trunk passes into the subclavian artery on which side?
Only the left side
The right side starts with the right subclavian artery
What 2 arteries branch from the axillary artery into the proximal humerus?
- Anterior circumflex artery
2. Posterior circumflex artery
When might the anterior and posterior circumflex arteries be damaged?
Following a dislocated shoulder
Although rare, breaks to clavicle could damage brachial plexus - why?
The roots and trunks of brachial plexus are behind the clavicle
Which 2 nerves come from the posterior cord of the brachial plexus?
Which one wraps around the humerus?
Radial nerve Axillary nerve (which wraps around humerus)
Which nerve of the brachial plexus is most at risk following a shoulder fracture or dislocation?
Where would you lose sensation?
The axillary nerve
The regimental badge area
Where does the radial groove insert?
Give an example of when this could be damaged
The radial groove
In a mid shaft fracture - the radial nerve could be damaged
In an anterior dislocation of shoulder, what will be sticking out?
The acromion process
In a posterior dislocation of shoulder - how will the patient be holding their shoulder?
How does this dislocation occur?
Holding in internal rotation
Can happen following electric shock or seizure when the muscles move so forcibly it moves the shoulder too
What is calcification tendinitis?
Deposit of calcium hydroxyapatite in the subacromial space
What is acute calcific tendinitis?
When the build up of calcium hydroxyapatite deposit in the subacromial space bursts
With a popeye muscle appearance - what tendon has ruptured and what is the treatment?
The long head of biceps brachii has ruptured
As short head is functioning no treatment
What is impingement?
Give 2 ways in which this may be caused
When the subacromial space is reduced either because:
- Disease in tendon and tendon has become swollen
- Inflammation in bursa
What are full thickness large rotator cuff tears?
Can treat with allograft - what is this?
Tears that involve the rotator cuff muscles eg tear across the head of the humerus
The rotator cuff muscles can become shrunken and need allograft repair
This is using tissue from another person
When does rotator cuff arthropathy typically occur?
What happens?
In the elderly
The humeral head rubs against bone and wears away the acromion
