Shoulder

Question 1

What inserts into the infraglenoid tubercle?

Answer 1

Long head of triceps brachii

Question 2

What inserts into the supraglenoid tubercle?

Answer 2

long head of biceps brachii

Question 3

What underlies the sub scapular fossa?

Answer 3

Subscapularis muscle, moves freely under thoracic wall

Question 4

What are the joints that make up the shoulder?

Answer 4

Sternoclavicular
Acromioclavicular
Glenohumeral joint
*Scapulothoracic

Question 5

Which muscles insert into the intertubercular sulcus?

Answer 5

Lateral lip: pectoralis major
Floor: Latissimus dorsi
Medial lip: Teres major

Question 6

What are the names of the facets on the greater tubercle of the humerus (lateral) and which muscle tendons insert here?

Answer 6

Three of the rotator cuff muscles
Superior facets: Supraspinatus
Middle facet: Infraspinatus
Inferior facet: Teres minor

Question 7

What inserts on the deltoid tuberosity?

Answer 7

Deltoid muscle

Question 8

Why is a fracture of the surgical neck important clinically?

Answer 8

The axillary nerve and posterior circumflex humeral artery pass posteriorly to the surgical neck.

Question 9

Which ligaments are located at the sternoclavicular joint and what type of joint is it?

Answer 9

Anterior and posterior sternoclavicular ligament, Interclavicular ligament and Costoclavicular ligament.
It is a synovial, saddle shaped joint.

Question 10

Which ligaments reinforce the acromioclavicular joint?

Answer 10

Acromioclavicular ligament

Coracoclavicular ligament: trapezoid ligament and conoid ligament - weight bearing component

Question 11

How is stability of the glenohumeral joint provided?

Answer 11

Rotator cuff muscles and long head of biceps brachii

Question 12

What is the glenoid labrum?

Answer 12

It is a ring of fibrocartilage and deepened the glenoid cavity, increasing the surface of the ‘ball and socket’ shoulder joint.

Question 13

What surrounds the shoulder joint?

Answer 13

The synovial membrane attaches to the articular surface but is redundant inferiorly so abduction can take place.
The coracohumeral ligament.
Superior, middle and inferior glenohumeral ligaments.
Transverse humeral ligament. (Holds the long head of biceps brachii in the inter tubercular sulcus)

Question 14

Which muscles make up the rotator cuff muscles and which is most likely to be impinged in injury?

Answer 14

Subscapularis
Supraspinatus*
Infraspinatus
Teres minor

Question 15

What is the vascular supply to the glenohumeral joint?

Answer 15

Anterior and posterior circumflex humeral arteries

Suprascapular artery

Question 16

Name the origin and insertion of the trapezius muscle, innervation and action

Answer 16

Origin: External occipital protuberance, spinous processes of C7 to T12
Insertion: Superior edge of spine of scapula, acromion, posterior lateral 1/3rd of clavicle
Innervation: Accessory nerve (CNXI), sensory C3, C4
Action: elevates scapula and helps when abducting arm. Middle fibres help in retraction. Lower fibres depress the scapula.

Question 17

Name the origin and insertion of the deltoid muscle, innervation and action

Answer 17

Origin: Inferior edge of spine of scapula, lateral margin of acromion, anterior edge of lateral 1/3rd of clavicle
Insertion: Deltoid tuberosity of humerus
Innervation: Axillary nerve C5, C6
Action: Abduction after 15 degrees, flexion and extension

Question 18

Name the origin and insertion of levator scapulae, innervation and action

Answer 18

Origin: transverse process of C1-C4
Insertion: Medial border of scapula between spine of scapula and superior angle
Innervation: Dorsoscapular nerve C5 and anterior rami of C3, C4
Action: elevates scapula

Question 19

Name the origin and insertion of rhomboid minor, innervation and action

Answer 19

Origin: spinous processes of C7-T1
Insertion: medial border of scapula superior to spine of scapula
Innervation: dorsoscapular nerve (C4, C5)
Action: Elevates and retracts scapula

Question 20

Name the origin and insertion of rhomboid major, innervation and action

Answer 20

Origin: Spinous processes of T2-T5
Insertion: medial border of scapula inferior to spine of scapula
Innervation: Dorsoscapular nerve (C4, C5)
Action: elevates and retracts scapula

Question 21

What innervates the rotator cuff muscles?

Answer 21

Suprascapular nerve (C5, C6): supraspinatus and infraspinatus
Axillary nerve: Teres minor

Question 22

What is the function of teres major and infraspinatus?

Answer 22

Teres major: Medial rotation and extension of the arm at the glenohumeral joint
Infraspinatus: Lateral rotation of the arm at the glenohumeral joint

Question 23

What does the axillary nerve innervate?

Answer 23

Deltoid and teres minor muscles

Has a superior lateral cutaneous branch which innervates the inferior part of deltoid “regimental badge area”

Question 24

What are the borders of the axilla?

Answer 24

Medial border: thoracic wall, serrated anterior
Superior border: lateral border of rib 1, clavicle
Floor: skin of armpit
Lateral border: inter tubercular sulcus of humerus
Posterior border: subscapularis, terms major, latissimus doors, long head of triceps
Anterior wall: pectoralis major and minor, subclavius, fascia

Question 25

Name the origin and insertion of pectoralis major, innervation and action

Answer 25

Origin: medial half of clavicle, first seven costal cartilages, Insertion: lateral lip of intertubercular sulcus Innervation: Medial and lateral pectoral nerves Action: Flexion, adduction, medial rotation, at sternoclavicular head extension

Question 26

Name the origin and insertion of subclavius, innervation and action

Answer 26

Origin: first rib Insertion: inferior surface of medial third of clavicle Innervation: Nerve to subclavius Action: pulls tip of shoulder down and medially

Question 27

Name the origin and insertion of pectoralis minor, innervation and action

Answer 27

Origin: Anterior surface of ribs 3-5 Insertion: Coracoid process of scapula Innervation: Medial pectoral nerve Action: Pulls tip of shoulder down, protracts scapula

Question 28

Name the origin and insertion of serratus anterior, innervation and action

Answer 28

Origin: Lateral surfaces of ribs 1-9 Insertion: Costal surface of medial border of scapula Innervation: Long thoracic nerve (c5, c6, c7) Action: Protraction and rotation of scapula, keeps it attached anteriorly to the thoracic wall

Question 29

What is 'winging of the scapula'?

Answer 29

This occurs when there is damage to the long thoracic nerve, normal elevation of the arm is not possible. The serratus anterior usually keeps the medial border and inferior angle of the scapula on the thoracic wall.

Question 30

Where does the axillary artery become the brachial artery?

Answer 30

As it crosses the inferior margin of teres major muscles.

Question 31

Name the origin and insertion of biceps brachialis, innervation and action

Answer 31

Origin: Short head from coracoid process Long head from supraglenoid tubercle Insertion: Radial tuberosity Innervation: Musculocutaneous nerve (C5-7) Action: Flexor of the forearm and supinator

Question 32

Name the origin and insertion of brachialis, innervation and action

Answer 32

Origin: Anterior surface of distal half of humerus Insertion: Coronid process and tuberosity of ulna Innervation: Musculocutaneous nerve Action: Flexor of forearm

Question 33

Name the origin and insertion of coracobrachialis, innervation and action

Answer 33

Origin: Coracoid process Insertion: linear roughening on midshaft of humerus Innervation: Musculocutaneous nerve Action: Flexor of arm at glenohumeral joint

Question 34

Name the origin and insertion of triceps brachii, innervation and action

Answer 34

Origin: Infraglenoid tubercle, posterior surface of humerus (medial and lateral heads) Insertion: olecranon Innervation: Radial nerve Action: Extension of the forearm (also can adduct the arm at the shoulder joint)

Question 35

What are the branches of the axilla?

Answer 35

1. Superior thoracic artery 2. Thoraco-acromila artery and lateral thoracic 3. Subscapular artery, anterior circumflex, posterior circumflex

Question 36

Where are the basilic and cephalic veins located?

Answer 36

Basilic: drains posteromedial Cephalic: drains posterolateral

Question 37

What are the trunks of the brachial plexus?

Answer 37

Anterior rami of C5-T1

Question 38

Which nerves arise from the medial cord of the brachial plexus?

Answer 38

``` Medial pectoral nerve Medial cutaneous nerve of the arm Medial cutaneous nerve of the forearm Medial root of median nerve Ulnar nerve ```

Question 39

Which nerves arise from the posterior cord of the brachial plexus?

Answer 39

``` Superior sub scapular nerve Thoracodorsal nerve Inferior sub scapular nerve Axillary nerve Radial nerve ```