Shoulder Flashcards
1
Q
scapula
- appearance
- surfaces
A
large flat triangular bone
surfaces
-costal (anterior or ventral) surface
-dorsal surface
2
Q
scapula dorsal surface
- divided into _____ and _____ by _____
- acromion has a _____ for atriculation with _____
A
divided into supraspinous and infraspinous fossae by spine
acromion has a facet for articulation with the clavicle
3
Q
spinoglenoid notch
- other name
- location
A
great scapular notch
lateral extent of dorsal surface of scapula before acromion
4
Q
scapular spine
- where does it begin?
- what is the acromial angle?
A
from lateral end a forward projecting acromion (his words)
acromial angle is where the spine bends at the spinoglenoid notch
5
Q
scapula borders
-locations
A
lateral border -from inferior angle to glenoid cavity medial border (vertebral) -from inferior angle to superior angle superior border -superior angle to suprascapular notch
6
Q
infraglenoid tubercle
- location
- what is it
A
on lateral border of scapula
widening as you move superiorly on the lateral border
7
Q
suprascapular notch purpose
A
traveling path for suprascapular artery and nerve
8
Q
scapula angles
-location of each
A
inferior angle -overlies 7th intercostal space (rib) superior angle -medial to superior border lateral angle (head) medial angle -sometimes described along the medial border at the end of the spine
9
Q
lateral angle of the scapula
-contains…
A
glenoid cavity glenohumeral joint supraglenoid tubercle infraglenoid tubercle anatomical neck (constriction around the glenoid cavity) surgical neck that is ill-defined
10
Q
coracoid process
-location
A
from top of head of scapula (lateral to suprascapular notch)
points laterally and anteriorly
11
Q
clavicle
- articulates with…
- parts and description of each
A
articulates with the manubrium of the sternum and the acromion of the scapula
acromial end
-flattened for articulation with acromion
sternal end
-enlarged for articulation with the manubrium of sternum and 1st costal cartilage
shaft
-medial 2/3 convex anteriorly
-lateral 1/3 concave anteriorly
12
Q
jugular notch
- other name
- location
A
suprasternal notch
location
-midsagitally
-between the paired articulation of the clavicles
13
Q
parts of the humerus
A
head body trochlea capitulum coronoid fossa olecranon fossa supracondylar ridges
14
Q
head of the humerus
- articuates with…
- creates what joint
- two ridges called…
- ridges separated by…
A
articulates with the glenoid cavity of the scapula
creates glenohumeral joint
ridges
-greater and lesser tubercles
separated by intertubercular groove (sulcus; also known as bicipital groove)
15
Q
body of the humerus
- name of distal expansions of the bone
- 2 landmarks and purpose
A
expansions are medial and lateral epicondyles
deltoid tuberosity
-anterolateral “bump” indicating insertion of deltoid muscle
radial groove
-spiral groove
-posterior aspect
-position of the radial nerve
16
Q
trochlea
- articulates with…
- lateral to trochlea is…
- -purpose
A
articulates with ulna
lateral to trochlea is a deep groove (sulcus for ulnar nerve)
-“funny bone”
17
Q
capitulum
-articulates with…
A
radius
18
Q
joints of the shoulder
A
acromioclavicular joint
shoulder (glenohumeral) joint
19
Q
acromioclavicular joint
-ligaments
A
acromioclavicular ligament
coracoclavicular ligament
20
Q
coracoclavicular ligament
-what are the parts?
A
conoid (more medial) ligament
trapezoid ligament
21
Q
glenohumeral joint
- ligaments and capsules supported by…
- glenoid cavity enlarged/deepened by…
- where is the weakest part of the articular capsule and why?
A
ligaments and capsules supported by rotator cuff
-supraspinatus, infraspinatus, teres minor, subscapularis
glenoid cavity enlarged by fibrocartilaginous labrum (may be dense CT instead)
weakest part of articular capsule is posterior part because it is not supported by any ligaments
22
Q
glenohumeral joint ligaments
A
intrinsic ligaments of the capsule glenohumeral ligaments transverse humeral ligament coracohumeral ligament coracoacromial arch
23
Q
glenohumeral ligaments
- names
- where do they travel?
A
names -superior -middle -inferior supraglenoid tubercle of scapule to neck and lesser tubercle of humeruss
24
Q
transverse humeral ligament
-location
A
covers intertubercular groove
25
coracohumeral ligament
| -function
strengthens superior part of capsule
26
coracoacromial arch
- what is it formed by
- function
```
formed by
-coracoid process
-coracoacromial ligament
-acromion
prevents superior displacement of humerus
```
27
triangles and spaces
| -what are their names (4)
triangular space
quadrangular space
triangular interval
triangle of auscultation
28
triangular space
- what is the lateral border
- space contains...
lateral border
-tendon of the long head of the triceps as it separates the bellies of the teres minor (and subscapularis) and teres major lateral to their muscular origin on the lateral border of the scapula
contains the circumflex scapular arteries
29
quadrangular space
- medial and lateral borders
- contains...
```
medial border
-long head of the triceps separating the lateral extension of the teres minor (and subscap) and teres major muscles
lateral border
-humerus
contains
-posterior circumflex humeral vessels
-axillary nerve
```
30
triangular interval
- continuous inferiorly from...
- what is it bordered by (3)?
- deep in the groove you can identify...
continuous inferiorly from the quadrangular space
borders
-between long and lateral head of the triceps
-below teres major
deep in the groove
-posterior shaft of humerus
-lying on the bone are the deep brachial artery and radial nerve
31
the deep brachial artery and the radial nerve lie in the...
radial groove
32
triangle of auscultation
| -borders
borders
- inferolateral edge of trapezius (lower fibers)
- dorsomedial edge of lat
- medial border of scapula (or medial edge of rhomboid major)
33
triangle of auscultation
- what enlarges this area
- enlarging the area causes what to occur
crossing the arm in front of the body enlarges the area
as a result, the underlying intercostal spaces 6 and 7 become subcutaneous
this allows for a relatively unobstructed access to respiratory sounds
34
what arteries form the anastomotic blood supply to the scapular region and muscles on the anterior body wall
subclavian artery
-all bronches
axillary artery
-continuation of subclavian past first rib
35
subclavian artery
- where does it originate?
- what are it's 3 parts
origination
-right: brachiocephalic trunk
-left: aortic arch
parts
-from origin to medial border of anterior scalene muscle
-portion situated behind anterior scalene
-from anterior scalene's lateral border to outer border of the 1st rib
36
subclavian artery branches
vertebral artery
internal thoracic artery (mammary artery)
thyrocervical trunk
dorsal scapular artery
37
vertebral artery
- function
- where is it located after branching from subclavian?
- where is it identified?
blood supply to CNS
located in the transverse foraminae of cervical vertebrae
identified in the floor of the suboccipital triangle
38
internal thoracic artery
| -functions
blood to the diaphragm
| anastomosis with intercostal arteries
39
thyrocervical trunk
- location
- branches into...
```
usually from 1st part of the subclavian
branches
-inferior thyroid artery
-suprascapular artery
-transverse cervical artery
-superficial scapular artery
```
40
dorsal scapular artery
- arises from...
- may also arise from
arises from the 3rd (sometimes 2nd) part of the subclavian
| may also arise from brance of the thyrocervical trunk
41
what is the dorsal scapular artery called if it arises from the thyrocervical trunk
transverse cervical artery
42
axillary artery
- lateral extension of...
- parts...
lateral extension of subclavian artery past lateral border of 1st rib
parts
-lateral border of 1st rib to medial boder of pectoralis minor
-portion situated posterior to pectoralis minor
-pectoralis minor's lateral border to inferior border of teres major (becomes brachial artery)
43
axillary artery main branches
```
troracoacromial artery (trunk)
lateral thoracic artery
subscapular artery
anterior circumflex humeral artery
posterior circumflex humeral artery
```
44
thoracoacromial artery (trunk)
- location
- branches
```
from 2nd part of axillary artery
branches
-pectoral
-acromial
-clavicular
-deltoid
```
45
lateral thoracic artery
| -why is it larger in females?
runs with lateral mammary branches to mammary gland
46
subscapular artery
- arises from...
- size
- branches into ____ via...
- continues as _____ after that point
arises from 2nd part of axillary
largest branch of axillary
branches into circumflex scaplar artery through triangular space
continues as thoracodorsal artery
47
anterior circumflex humeral artery
| -location
from lateral side of axillary
| -2nd to 3rd part
48
posterior circumflex humeral artery
| -location
from 3rd part posteriorly
goes around the posterior side of humerus through quadrangular space to anastomose with anterior circumflex humeral artery
49
from where do the intercostal arteries arise?
segmental branches off of the descending aorta
50
what are the anastomoses of the scapula and humerus called?
scapular anastomosis
| anastomosis around the head of the humerus
51
scapular anastomosis
| -involved arteries
```
dorsal scapular
suprascapular
subscapular
circumflex scapular (branch of subscapular)
intercostal branches
```
52
head of humerus anastomosis
| -involved arteries
anterior and posterior circumflex humeral arteries
53
lymphatic drainage
- location
- lymph from UE, back, and anterior surface of thorax and abdomen drain to...
location
-parallels venous drainage through the axilla
lymph travels down to the umbilicus
54
lymphatic drainage
- how are the nodes divided?
- how do these nodes drain?
- how does this drainage enter the venous system?
divided into groups
-brachial (lateral)
-subscapular (posterior)
-pectoral (anterior)
these groups drain into a set of central nodes
-central nodes drain through an apical group of nodes
drainage enters venous system through thoracic duct
55
lymphatic drainage
- constant or variable
- pectoral nodes continuous with...
- result of blockage of a node or lymph vessel
```
variable
-lymph from the breast does not have to enter the anterior group prior to getting into the central or apical group
pectoral nerves continuous with
-supraclavicular nodes
-cervical nodes
blockage of node
-can alter flow pattern
-spread of metastatic cells takes place in this fashion
```
56
nerve supply for shoulder
| -formed from
formed from branches of the brachial plexus
57
brachial plexus
- organization
- innervates which muscles outside of shoulder?
similar to the lumbar and sacral plexuses
nerves are formed by a mixing of primary ventral rami of lower cervical and first thoracic spinal nerves
innervates
-trapezius
-sternocleidomastoid
-these also receive from spinal accessory nerve
58
why are ventral rami of the brachial plexus involved in trap and SCM innervation?
provide sensory innervation for the purpose of transmitting proprioceptive information about the muscle back to the CNS
required since CN 11 does not have a sensory component
59
winged scapula
- due to...
- results in..
```
due to
-damage to long thoracic nerve
OR
-ventral rami that eventually form long thoracic
result
-paralysis of serratus anterior
```
60
serratus anterior
- function
- what happens if it is paralyzed due to long thoracic damage?
function
-assists in fixing scapula to thoracic wall
-upward rotation
result
-patient unable to abduct arm above horizontal
-patient unable to push with the arm since scapula is limited in superior rotation
61
axillary nerve damage
| -leads to...
atrophy of deltoid muscle
weakness in shoulder abduction against resistance
absence or roundness of shoulder
62
thoracodorsal nerve damage
- inability to...
- what becomes paralyzed?
- how does this lead to the inability
inability to do "chin-ups"
paralyzes latissimus dorsi
lat extends humerus
in a closed chain with humerus fixes (as in during chin-ups), the lat pulls the body towards the humerus
63
rotator cuff
- function
- what muscles reinforce the superior, posterior, and anterior aspects of the joint?
```
main dynamic stability of glenohumeral joint
superior
-supraspinatus
posterior
-teres minor
-infraspinatus
anterior
-subscapularis
```
64
GH joint
- what structures provide static stabilization
- where is the weakest support dynamically and why?
```
static
-ligaments supporting the articular capsule
weakest dynamic support
-inferiorly
-lack of supporting tendons
```
