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S&F 1 > Shoulder > Flashcards

Shoulder Flashcards

1
Q

this is palpable along its entire length of the upper anterior part of the shoulder?

A

Clavicle

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2
Q

On the anterior view of the clavicle, what can you see that differentiates it from the posterior view?

A

The coracoid process.

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3
Q

The spine of the scapula is seen from which view?

A

Posterior view

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4
Q

Glenoid cavity is between which two structures?

A

Humerus and scapula

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5
Q

The coracoid and acromion process are part of which structure.

A

Scapula

Coracoid = seen anteriorly

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6
Q

Which part of the scapula is connected to the clavicle?

A

Acromion process (also considered the point of the shoulder) continuation of the scapular of the spine

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7
Q

Which portion of the clavicle is closer to the vertebra?

A

Medial end

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8
Q

T/F the anatomical head of the humerus is the point that always breaks.

A

False

It is the surgical neck that always breaks

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9
Q

Which tuberosity on the humerus is more lateral?

A

The Greater tuberosity

The lesser tuberosity is more medial

Intertubercular groove in-between the two

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10
Q

A fracture of the humerus surgical neck affects which nerve?

A

Axillary nerve

This is also the most common fracture

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11
Q

What is the sternoclavicular joint?

A

Between the clavicle and the manubrium of the sternum

Initiates all the movement of the shoulder

Indirect movement of the arm

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12
Q

What are the parts of the sternum?

A

Manubrium

Body

Xiphoid process

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13
Q

What is the sternal angle?

A

It is the prominence between the manubrium and the body at the level of the second rib

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14
Q

What are the three joints/ligaments between the scapula and the clavicle?

A

Acromioclavicular joint (not really mobile, just to attach the scapula)

Caracoclavicular ligament (contains two - trapezoid and conoid)

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15
Q

Slide 8

A

?

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16
Q

Slide 9

A

?

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17
Q

What is a grade 1 shoulder separation?

A

Simple sprain of the AC joint capsule

AC and CC space widths are in normal range

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18
Q

Subluxation of the AC joint, what is this?

A

Grade 2 shoulder separation

AC joint capsule significantly damage; AC space width at least 50% greater than normal CC space width in normal range

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19
Q

When the AC and CC space widths both are at least 50% greater than normal this is know as a?

A

Grade III shoulder separation (acromioclavicular dislocation)

Dislocation of the AC joint capsule and CC ligament significantly damaged

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20
Q

Patient comes to you with a bruise over the right acromioclavicular joint? What do you suspect is going on?

A

Grade II Shoulder location

Scapula is inferolaterally displaced from the lateral end of the clavicle and the coracoclavicular space is within normal range

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21
Q

What muscle is between the clavicle and the superior portion of humerus?

A

Superspinatis muscle

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22
Q

What are the cartilages that line the glenoid cavity?

A

Glenoid Labrum (small)

Hyaline Cartilage covering the head of the humerus and the glenoid cavity

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23
Q

Whats is the most mobile bone in the body?

A

Humerus

180 degrees Abduction or elevation retained from primates

This movement is dependent on 4 muscle -> supraspinatus, deltoid, trapezius, and serratus anteriror

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24
Q

Why are sports injuries with the humerus so common?

A

Because the humerus is hyper-mobile

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25
Q

How do you identify a shoulder dislocation?

A

when the More lateral point is the acromion

Head of the humerus goes anterior and medially (no longer the most lateral portion).

Also more elevated Glenoid cavity & becomes more lateral

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26
Q

What is an anterior shoulder dislocation?

A

The head of the humerus has come to rest in a subarachnoid position (humeral head lies inferior to the coracoid process)

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27
Q

Which nerve is more exposed with a shoulder dislocation?

A

Axillary nerve (it goes more medial)

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28
Q

What is the shoulder joint also called?

A

Glenoid joint

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29
Q

What is cleidocranial dysostosis?

A

A hereditary condition characterized by defective ossification of cranial bones and clavicle

“Person has no clavicle”

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30
Q

T/F Clavicle has nothing to do with the shoulder really, it has more to do with the head?

A

True

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31
Q

T/F all mammals have clavicles

A

False

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32
Q

80% of all clavicular fractures occur where?

A

In the middle third of the clavicle. Does not typically cause major vascular or nerve injury

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33
Q

Which vessels/nerves does the clavicle overlie?

A

Subclavian artery

Subclavian vein

Part of brachial plexus

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34
Q

What are the three parts of the clavicle. ?

A

Proximal third

Middle third

Distal third

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35
Q

The shoulder movements are characterized by?

A

Movements of the point of the shoulder ( Acromion)

36
Q

how do the shoulder muscles raise or shrug the shoulder?

A

By pulling the clavicle and scapula upward at the sternoclavicular joint

“Elevation”

37
Q

How do the muscles lower the shoulder

A

by pulling the clavicle and scapula downward at the sternoclavicular joint

“Depression”

38
Q

What are the six movements of the shoulder?

A
  1. Raise the shoulder (elevate)
  2. Lower the shoulder (depression)
  3. Protraction (going anteriorly)
  4. Retraction (going posteriorly)
  5. Abduction (away from midline) - lateral rotation
  6. Adduction (towards midline) - medial rotation
39
Q

What is articulating the 6 movements of the shoulder?

A

Sternoclavicular joint

40
Q

By pulling the clavicle and scapula forward at the sternoclavicular joint the shoulder muscles are able to do what?

A

Protaction

41
Q

How do the muscles retract the shoulder?

A

By pulling the clavicle and scapula backwoods at the sternoclavicular joint

42
Q

For every two degrees of abduction what is happening?

A

The shoulder moves one degree and the sternoclavicular joint moves one degree

43
Q

During abduction what is happening to the scapular?

A

It is rotating. Point of reference is the inferior angle (moving laterally)

44
Q

What are the movements of the arm at the shoulder joint?

A

Flexion

Extension

Internal rotation

external rotation

Humerus is moving not the scapula.

45
Q

What is happening to the arm when the scapula is rotating medially?

A

Adduction of the arm

46
Q

Do you only move the shoulder joint in the six movements of the shoulder/arm?

A

No. During adduction and abduction you move the sternoclavicular joint

47
Q

Trapezius

Invervation

Orign

Insertion

Function

A

innervation: Accessory nerve (Cranial nerve 11) - motor innervation and contains 3 parts C3 and C4 - sensory innervation

Orgin: Skull (extrnal ocipital protuberance) and vertebra (lower part) middle part of the trapezius comes from the nuchal ligament

Insertion: upper part goes to the acromion, middle and lower part to the spine of the scapula (this is the part that really moves when the muscle contracts)

Function: raise/lower the shoulder “Cranial muscle” not a true back muscle. prime movers for lateral rotation of the scapula and the prime mover for retraction of the shoulder.

48
Q

T/F The trapezius contains three parts and they all have to contract together

A

False! You can contract one part alone

49
Q

What is the purpose of the nuchal ligament?

A

Prevents head from bending down to far

50
Q

Levator Scapulae

Innervation

Origin

Insertion

Function

A

Innervation: dorsal scapular nerve (C5) and C3 and C4 nerve fibers, and branch of brachial plexus

Origin: tranvserse process of C1 and C2

Insert: Superior angle and medial border of scapula

Funciton: Raise and medially rotate the scapula

51
Q

Rhomboid Major & Minor

Inervation

Insertion

Origin

Funtion

A

Innervation: dorsal scapular nerve (C5)

Origin: Vertebra

Insertion: Medial border of scapula

Function: retract the shoulder (i.e aduction, completely moving the scapula) and medially rotate the scapula

52
Q

The upper part of the trapezius does what to the scapula?

A

Elevating and lateral rotation the scapula

53
Q

indirect abduction to the humerus is done by what?

54
Q

If the trapezius moves the scapula 20 degrees, how many degrees is the humerus abducting the arm?

A

40 degrees

55
Q

The middle part of the trapezius does what to the scapula?

A

retraction of the scapula

56
Q

If you contract the trapezius as a whole, all three heads at the same time, what is happening to the scapula?

A

retraction and lateral rotation of the scapula

Upper and lower part functions will cancel out leaving the function of the middle part.

57
Q

The third part of the trapezius does what to the scapula?

A

depresses the scapula

58
Q

These three muscles are all innervated by the dorsal scapular nerve Which is medial to the scapula)?

A

Rhomboid major

Rhomboid minor

Levator scapular nerve

All medial (intermediate layer of back) muscles

59
Q

Suprascapular nerve is located where?

A

Above the scapula

60
Q

The subscapular nerves are located where?

A

below the scapula

61
Q

What are the nerves that go from medial to the posterior scapula?

A

Dorsal scapular (medial to scapula)

Suprascapula nerve

Subscapular nerve

Axillary nerve (lateral to scapula)

62
Q

What is the common function of the levator scapula muscle, rhomboid minor muscle , and the rhomboid major muscle?

A

medially rotate the scapula

63
Q

Supraspinatus & Infraspinatus

Innervation

Origin

Insertion

Function

A

Innservation: Suprascapular nerve

function: Lateral rotation of the humerus (both)

Origin: Scapula (Spine of scapula separates them)

Insertion: Head of humerus

64
Q

A muscle being parallel to the bone is good for what?

A

flexion and extension

65
Q

If a muscle wants to abduct or adduct in what position should it be relative to the bone?

A

oblique/parallel

66
Q

If a muscle wants to rotate a bone what position should it be in?

A

perpendicular to bone

67
Q

What is the special function of the supraspinatus?

A

Abduction

Only in primates and humans because of movement of 190 degrees good for the first 27 degrees and then deltoid comes in to assist?

68
Q

What is need for first 27 degrees of abduction?

A

The supraspinatus muscle after that the deltoid can help compensate

69
Q

The deltoid (touches clavicle, scapula and humerus) and the teres minor are innervated by what nerve?

A

Axillary nerve

70
Q

What it the importances of the deltoid muscle?

A

Abduction after 27 degrees

71
Q

The subscapular nerve innervates which muscle?

A

contains 3 parts

Teres major (lower subscapular n.)

Latissimus dorsi (middle subscapular/thoracodorsal nerve)

Subscapularis (upper and lower subscapular n.)

72
Q

Subscapularis

Innervation

Insertion

Origin

Function

A

Innervation: Upper and lower subscapular nerve

Origin - scapula

insertion - anterior part of humerus

Funciton: medial rotation of the arm. Perpendicular to the bone

73
Q

Teres Major
Innervation

Origin

Insertion

Function

A

Innervation: Lower subscapular nerve (C5 & C6)

insertion - anterior part of the humerus

origin - inferior angle of scapula

Funciton: (internally) Medial Rotation and adduction. This muscle is oblique to the bone

74
Q

Latissimus Dorsi

Innervation

Origin

Insertion

Function

A

insertion - anterior part of the humerus

origin - thoracic vertebra

Function: (internally) medial rotation and extension, adduct

innervation: Thoracodorsal nerve

75
Q

This muscle is the most powerful protractor of the shoulder and one of the two prime movers for lateral rotation of the scapula

A

Serratus anterior

76
Q

Loss of serratus Anterior actions weakens the ability to do what?

A

Raise the arm above the shoulder

77
Q

Serratus anterior

Innervation

Origin

Insertion

A

Innervation: Long Thoracic Nerve

Funciton: Protraction of the shoulder and lateral rotation of the scapula (puling scapula anteriorlly). Abduction of the arm indirectily

Origin: Ribs

Insertion: Lateral border of scapula

78
Q

What happens when someone has isolated seraatus anterior palsy?

A

Pronounced flaring of the inferior angle of the scapula

When outstretched arm is thrust forward this pronounced flaring is frequently referred to as winging of the scapula

79
Q

Pectoralis Minor

Innervation

Function

Origin

Insertion

A

Function: Lower and protract the shoulder

Innervation: medial pectoral nerve

Origin: ribs

Insertion: Coracoid process of the scapula

80
Q

Subclavius

Innervation

Origin

Insertion

Function

A

Innervation: Subclavius nerve

Function: Lower the shoulder

Insertion: Clavicle

Orgin: 1st rib

81
Q

What are the muscles of the rotator cuff?

A

Subscapularis

Supraspinatus

Infraspinatus

Teres minor

All innervated by C6 nerve fibers only

82
Q

Teres Minor

Innervation

Origin

Insertion

A

Innervation: Axillary Nerve (C5 & C6)

Function: Lateral rotation of the arm (part of rotator cuff)

83
Q

Which 3 muscles make up the posterior portion of the scapula?

A

Supraspinatus

Infraspinatus

Teres Minor

84
Q

Which two muscles are the most powerful external rotators of the arm at hte shoulder joint?

A

Infraspinatus and Teres minor

85
Q

Deltoid

Innervation

Origin

Insertion

Function

A

Innervation: Axillary nerve (C5 & C8)

Function: Prime mover for abduction of the arm at the shoulder joint; Flexes, internally rotates, extend, and externally rotate arm

86
Q

Pectoralis Major

Innervation

Insertion

Origin

Function

A

Innervation: Medial and lateral pectoral nerve

Function: Adduct, flex. and internally (medial) rotate the arm

Origin: clavicle, sternum, ribs

Insertion: anterior part of the posterior humerus

“Opposite to Latissimus Dorsi in many way”

87
Q

Cephalic vein runs where?

A

In the delto-pectoral triangle

S&F 1 (25 decks)

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