Shoulder Flashcards

1
Q

What inserts into the infraglenoid tubercle?

A

Long head of triceps brachii

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2
Q

What inserts into the supraglenoid tubercle?

A

long head of biceps brachii

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3
Q

What underlies the sub scapular fossa?

A

Subscapularis muscle, moves freely under thoracic wall

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4
Q

What are the joints that make up the shoulder?

A

Sternoclavicular
Acromioclavicular
Glenohumeral joint
*Scapulothoracic

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5
Q

Which muscles insert into the intertubercular sulcus?

A

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

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6
Q

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

A

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

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7
Q

What inserts on the deltoid tuberosity?

A

Deltoid muscle

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8
Q

Why is a fracture of the surgical neck important clinically?

A

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

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9
Q

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

A

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

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10
Q

Which ligaments reinforce the acromioclavicular joint?

A

Acromioclavicular ligament

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

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11
Q

How is stability of the glenohumeral joint provided?

A

Rotator cuff muscles and long head of biceps brachii

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12
Q

What is the glenoid labrum?

A

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

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13
Q

What surrounds the shoulder joint?

A

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)

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14
Q

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

A

Subscapularis
Supraspinatus*
Infraspinatus
Teres minor

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15
Q

What is the vascular supply to the glenohumeral joint?

A

Anterior and posterior circumflex humeral arteries

Suprascapular artery

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16
Q

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

A

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.

17
Q

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

A

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

18
Q

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

A

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

19
Q

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

A

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

20
Q

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

A

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

21
Q

What innervates the rotator cuff muscles?

A
Suprascapular nerve (C5, C6): supraspinatus and infraspinatus
Axillary nerve: Teres minor
22
Q

What is the function of teres major and infraspinatus?

A

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

23
Q

What does the axillary nerve innervate?

A

Deltoid and teres minor muscles

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

24
Q

What are the borders of the axilla?

A

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

25
Q

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

A

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

26
Q

Name the origin and insertion of subclavius, innervation and action

A

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

27
Q

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

A

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

28
Q

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

A

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

29
Q

What is ‘winging of the scapula’?

A

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.

30
Q

Where does the axillary artery become the brachial artery?

A

As it crosses the inferior margin of teres major muscles.

31
Q

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

A

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

32
Q

Name the origin and insertion of brachialis, innervation and action

A

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

33
Q

Name the origin and insertion of coracobrachialis, innervation and action

A

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

34
Q

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

A

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)

35
Q

What are the branches of the axilla?

A
  1. Superior thoracic artery
  2. Thoraco-acromila artery and lateral thoracic
  3. Subscapular artery, anterior circumflex, posterior circumflex
36
Q

Where are the basilic and cephalic veins located?

A

Basilic: drains posteromedial
Cephalic: drains posterolateral

37
Q

What are the trunks of the brachial plexus?

A

Anterior rami of C5-T1

38
Q

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

A
Medial pectoral nerve
Medial cutaneous nerve of the arm
Medial cutaneous nerve of the forearm
Medial root of median nerve
Ulnar nerve
39
Q

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

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