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Anatomy Exam 3 > Shoulder > Flashcards

Shoulder Flashcards

1
Q

What are the Muscles of the Pectoral Region (Shoulder: Anterior View)

A
  • Originate on the anterior aspect of the axial skeleton
  • General innervation: C6-8

1) Pec major
2) Pec minor
3) Serratus anterior

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2
Q

Describe Pectoralis major

A
  • Pectoralis major (clavicular and sternocostal heads)
  • Origin: clavicle, sternum, costal cartilages of superior ribs
  • Insertion: anteromedial aspect of proximal humerus
  • Actions: adduction, flexion, & medial rotation of glenohumeral joint (GHJ)
  • Innervation: medial and lateral pectoral nerves
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3
Q

Describe Pectoralis minor

A
  • Origin: ribs 3-5
  • Insertion: coracoid process of scapula
  • Actions: protraction and depression of scapula (stabilizes scapula)
  • Innervation: medial pectoral nerve

-Note: ‘medial pectoral does more’ may help you remember that the medial pectoral nerve innervates both pectoralis major and minor (vs. the lateral pectoral nerve, which innervates pectoralis major only)

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4
Q

Describe Serratus anterior

A
  • Origin: lateral aspect of ribs 1-8
  • Insertion: anterior surface of medial border of scapula
  • Actions: protraction and upward rotation of scapula, fixes scapula on thoracic wall
  • Innervation: long thoracic nerve

-Note: Lesion of the long thoracic nerve (common due to its superficial location) paralyzes the serratus anterior muscle, resulting in a winged scapula, as the scapula is no longer fixed on the thoracic wall

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5
Q

Describe Blood Supply of the Pectoral Region

A

Axillary artery (continuation of subclavian artery) gives rise to:

1) Thoracoacromial artery
- Supplies pectoral muscles and deltoid
2) Lateral thoracic artery
- Courses with the long thoracic nerve
- Supplies serratus anterior and pectoral muscles

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6
Q

What are the Extrinsic Muscles of the Back (Shoulder: Posterior View)

A
  • Originate on the posterior aspect of the axial skeleton
  • General innervation: C5-7, CN XI

1) Trapezius
2) Levator scapulae
3) Rhomboid minor and Rhomboid major
4) Latissimus dorsi

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7
Q

Describe Trapezius

A
  • Origin: occipital bone, nuchal ligament, thoracic spinous processes
  • Insertion: clavicle, acromion, spine of scapula
  • Actions:
    1) Superior portion: elevation and upward rotation of scapula
    2) Middle portion: retraction of scapula
    3) Inferior portion: depression and upward rotation of scapula
  • Innervation: spinal accessory nerve (CN XI)

Note: the spinal accessory nerve (CN XI) can be tested by asking the patient to shrug their shoulders against resistance.

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8
Q

Describe Levator scapulae

A
  • Origin: cervical transverse processes
  • Insertion: superior angle of scapula
  • Actions: elevation and downward rotation of scapula
  • Innervation: dorsal scapular nerve
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9
Q

Describe Rhomboid minor and Rhomboid major

A

-Origin: nuchal ligament, thoracic spinous processes
-Insertion: medial border of scapula
-Actions: retraction and downward rotation of scapula
(also fixes scapula on body wall)
-Innervation: dorsal scapular nerve

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10
Q

Describe Latissimus dorsi

A
  • Origin: thoracolumbar fascia, iliac crest, ribs
  • Insertion: anteromedial aspect of proximal humerus
  • Actions: extension, adduction, and medial rotation of GHJ
  • Innervation: thoracodorsal nerve
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11
Q

What are the Intrinsic Muscles of the Shoulder?

A
  • Originate on the scapula and insert on the humerus
  • General innervation: C5-6

1) Deltoid
2) Teres major
3) Rotator cuff muscles

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12
Q

Describe the Deltoid

A
  • Origin: clavicle, acromion and spine of scapula
  • Insertion: deltoid tuberosity of humerus
  • Actions:
    1) Anterior portion: flexion and medial rotation of GHJ
    2) Middle portion: abduction of GHJ (after initial 15º)
    3) Posterior portion: extension and lateral rotation of GHJ
  • Innervation: axillary nerve

Note: Lesion of the axillary nerve can be tested by palpation of the deltoid muscle while abducting against resistance (after initial 15º) & by loss of skin sensation (pain, temperature, touch) on lateral aspect of shoulder

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13
Q

Describe Teres major

A
  • Origin: inferior angle of scapula
  • Insertion: anteromedial aspect of proximal humerus
  • Actions: medial rotation and adduction of GHJ
  • Innervation: lower subscapular nerve
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14
Q

Describe the Rotator cuff muscles

A

Rotator cuff muscles create a supportive musculotendinous cuff around the glenohumeral joint (stabilizing this joint); ‘SITS’:

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15
Q

What are the different parts of the Rotator cuff muscles?

A

“SITS”

S=Supraspinatus
I=Infraspinatus
T=Teres minor
S=Subscapularis

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16
Q

Describe the S=Supraspinatus part of the rotator cuff

A
  • Origin: supraspinous fossa of scapula
  • Insertion: greater tubercle of humerus
  • Actions: abduction of GHJ (initial 15º), stabilize GHJ
  • Innervation: suprascapular nerve
17
Q

Describe the I=Infraspinatus part of the rotator cuff

A
  • Origin: infraspinous fossa of scapula
  • Insertion: greater tubercle of humerus
  • Actions: lateral rotation of GHJ, stabilize GHJ
  • Innervation: suprascapular nerve
18
Q

Describe the T=Teres minor part of the rotator cuff

A
  • Origin: lateral border of scapula
  • Insertion: greater tubercle of humerus
  • Actions: lateral rotation of GHJ, stabilize GHJ
  • Innervation: axillary nerve
19
Q

Describe the S=Subscapularis part of the rotator cuff

A
  • Origin: subscapular fossa of scapula
  • Insertion: lesser tubercle of humerus
  • Actions: medial rotation and adduction of GHJ, stabilize GHJ
  • Innervation: upper and lower subscapular nerves
20
Q

Describe the Blood Supply of the Posterior Shoulder

A

-Subclavian artery gives rise to:
Thyrocervical trunk and that gives rise to
1) Transverse cervical artery
2) Suprascapular artery

21
Q

Describe the Transverse cervical artery

A
  • Superficial branch supplies trapezius
  • Deep branch (= dorsal scapular artery) supplies rhomboids and levator scapulae.
  • Note: This branch may arise separately from the subclavian artery.
22
Q

Describe the Suprascapular artery

A

-Supplies supraspinatus and infraspinatus
-Contributes to collateral circulation of the shoulder
-This Artery courses over the superior transverse scapular ligament while the suprascapular Nerve passes under the superior transverse scapular ligament
“Army over Navy”

23
Q

Describe the Veins of the Posterior Shoulder

A
  • Note: The veins parallel the arteries and share the same names (exception: there is no thyrocervical vein). It is not unusual for a single artery to have a pair of associated veins.
  • Drainage of posterior shoulder is to the transverse cervical vein and suprascapular vein. These drain to the external jugular, which drains to the subclavian.

Anatomy Exam 3 (6 decks)

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