Shoulder

Question 1

Three areas of transition in the UE

Answer 1

axilla
cubital fossa
carpal tunnel
all nerves and vessels of the arm pass through here

Question 2

superior thoracic aperture

Answer 2

thoracic inlet, formed by first rib, posterior clavicle, superior margin scapula, medial coracoid process

Question 3

thoracic inlet syndrome

Answer 3

first rib and clavicle compress nerves passing through superior thoracic aperture

Question 4

What nerve roots form the brachial plexus?

Answer 4

C5-T1
terminal branches musculocutaneous, axillary, median, radial, ulnar nerves
only UE muscle not innervated by brachial plexus in trapezius, CN 11

Question 5

Brachial plexus mnemonic

Answer 5

real truckers drink cold beer
roots trunks divisions cords branches

Question 6

what does the radial nerve innervate?

Answer 6

posterior arm and forearm
elbow and wrist extensors

Question 7

What does the ulnar nerve innervate?

Answer 7

intrinsic hand muscles and medial wrist flexors in forearm

Question 8

what does the axillary nerve innervate?

Answer 8

deltoid and teres minor

Question 9

what nerves could be impaired in humeral surgical neck fracture?

Answer 9

radial, ulnar, axillary

Question 10

sternoclavicular joint bones and ligaments

Answer 10

clavicle, manubrium, cartilage of rib 1
posterior/anterior sternoclavicular, interclavicular, and costoclavicular ligaments

Question 11

acromioclavicular joint bones and ligaments

Answer 11

acromion of scapula snd clavicle are a synovial joint
2 ligaments acrmioclavicular and coracoclavicular
coracoacromial ligament present but has no role in stabilizing the Ac joint

Question 12

function of the coracoacromial ligament

Answer 12

superior arch over the humerus preventing superior displacement

Question 13

glenohumeral joint

what kind of joint and where does it’s stability come from

Answer 13

ball and socket joint with high mobility
stability comes from glenoid labrum, rotator cuff muscles, extracapsular ligaments, long head of biceps tendon

Question 14

function of the glenoid labrum

Answer 14

deepens ball and socket joint by 50%, main shoulder stabiltiy

Question 15

What structures prevent downward displacement of the humerus?

Answer 15

supraspinatus pulls up, upper capsule, and coracohumeral ligament all pull the bone up

Question 16

how does the rotator cuff increase shoulder stability

Answer 16

They pull the humeral head into the glenoid cavity

Question 17

what structures prevent upward displacement of the humerus?

Answer 17

coracoacromial arch, long head of biceps

Question 18

two most common rotator cuff disorders

Answer 18

tendinopathy and impingement
most commonly supraspinatus because it passes through the small joint space between the acromion and acromioclavicular ligament with limited blood supply

Question 19

trapezius

Answer 19

origin: superior nuchal line, occipital protuberance, C7-T12 spinous processes
insertion: clavicle, acromion, scapular spine
innervation: CN 11
action: scapular elevation, retraction, depression

Question 20

deltoid

Answer 20

origin: inferior scapular spine, lateral acromion, lateral clavicle
insertion: deltoid tuberosity
innervation: axillary
action: abduction, extension, flexion, IR, ER

starts same places trap inserts!

Question 21

levator scapulae

Answer 21

origin: C1-C4 transverse processes
insertion: superior angle of scapula
innervation: dorsal scapular n
action: elevate and upward rotate scapula

Question 22

rhomboid minor

Answer 22

origin: C7-T1 transverse processes
insertion: medial border above scapular spine
innervation: dorsal scapular n
action: retraction

Question 23

rhomboid major

Answer 23

origin: T2-T5 transverse processes
insertion: medial border below scapular spine
innervation: dorsal scapular n
action: retract

Question 24

supraspinatus

Answer 24

origin: supraspinous fossa
insertion: greater tubercle
innervation: suprascapular n
action: abduction

Question 25

infraspinatus

Answer 25

origin: infraspinous fossa of scapula
insertion: greater tubercle
innervation: suprascapular
action: ER

Question 26

teres minor

Answer 26

origin: lateral border of scapula
insertion: greater tubercle humerus
innervation: axillary
action: ER

Question 27

teres major

Answer 27

origin: inferior angle of scapula
insertion: intertubercular groove of humerus
innervation: lower subscapular
action: extension, abduction, IR

wraps around the medial side of humerus to intertubercular groove

Question 28

long head of triceps

Answer 28

origin: inflaglenoid tubercle of scapula
insertion: olecranon of ulna
innervation: radial n
action: extension of elbow, extend shoulder, adduct shoulder

Question 29

pectoralis minor

Answer 29

origin: ribs 3-5
insertion: coracoid process of scapula
innervation: medial pectoral
action: elevate ribs, pull scapula down and medial

Question 29

pectoralis major

Answer 29

origin: clavicular head from anteiror clavicle, sternocostal from anterior sternum and first 7 costal ribs
insertion: lateral lip of the intertubercular groove
innervation: medial and lateral pectoral n
action: adduct, IR, flex shoulder

Question 30

subclavius

Answer 30

origin: first rib, costal cartilage
insertion: mid 1/3 clavicle
innervation: nerve to subclavius
action: depress clavicle down and forward

Question 31

serratus anterior

Answer 31

origin: 1-9 ribs
insertion: costal surface of medial scapula border
innervation: long thoracic
action: protract and rotate scapula upwards

Question 32

subscapularis

Answer 32

origin: subscapular fossa
insertion: lesser tubercle
innervation: upper and lower subscpaular nn
action: IR, adduct

Question 33

latissimus dorsi

Answer 33

origin: spinous process T7-L1, thoracolumbar fascia, iliac crest, inferior 3-4 ribs
insertion: intertubercular groove, inferior angle scapula
innervation: thoracodorsal
action: adduct, extend, IR humerus

Question 34

what is the major blood supply to the upper arm? What does it become down the arm?

major branches? What’s the landmark for the transition of this artery?

Answer 34

axillary artery, becomes brachial artery once inferior to inferior border of teres minor
6 branches: thoracoacromial, lateral thoracic, subscapular, anterior circumflex, posterior circumflex