Shoulder and arm Flashcards
Types of joints
Fibrous, cartilagenous, and synovial
Types of fibrous joints and characteristics
Types: sutures, syndesmoses, and gomphoses
Characteristics: solid, not very movable
Types of cartilaginous joints and characteristics
Types: synchondroses and symphyses
Characteristics: solid, can change degree of mobility over time, ex. female pelvis
Synovial joint characteristics
most movable, most common, joint capsule consists of inner synovial membrane and outer fibrous capsule, has hyaline cartilage lining, some have articular disc.
Ligament connects ____ to_____, while tendons connect _____ to _____.
Ligament: bone, bone
Tendons: muscles, bone
Synarthrosis vs. amphiarthrosis vs. diarthrosis
no movement, little movement, and a lot of movement
Acromioclavicular joint
Bones: acromial process of scapula and clavicle
Type: synovial, plane
Functional type: diarrhetic, gliding and rotation of scapula on clavicle
Glenohumeral Joint/Shoulder
Bones: scapula and humerus
Type: synovial, ball + socket/cup+saucer
Functional type: diarrhetic, multiaxial, flexion + extension + adduction + abduction + circumduction + rotation of humerus and arm
Elbow Joint
Bones: Ulna + radius with humerus
Type: synovial, hindge
Functional type: diarrhetic, uniaxial, flexion + extension of forearm
Proximal Radioulnar Joint
Bones: radius and ulna
Type: synovial, pivot
Functional type: diarrhetic, uniaxial, rotation of radius around long axis of forearm to allow pronation and supination
Distal Radioulnar Joint
Bones: radius and ulna
Type: synovial, pivot w/ articular disc
Functional type: diarrhetic, uniaxial, rotation of convex head of ulna in ulnar notch of radius
Sternoclavicular Joint
Bones: sternum and clavicle
Type: synovial, shallow saddle with articular disc
Functional type: diarrhetic, multiaxial
Types of shoulder muscles
Axioappendicular: connect thorax to upper limbs. Hypaxial.
Scapulahumeral: connects scapula to humerus
Bursa
Pillows of synovial fluid that allow for smooth movement. Synovial sheaths are like long bursa.
Ligaments of shoulder region
Coracoclavicular (trapezoid + conoid), coracoacromial, glenohumeral (superior, middle, and inferior {at axillary recess})
Transverse ligament of humerus around biceps.
Tendons of shoulder
infraspinatus, teres minor, supra spinatus and subscapularis
Bursas of shoulder
Subacromial, subdeltoid, subcoracoid, and subscapular (only one that communicates with synovial cavity of joint)
Impingement syndrome involves which tendons?
Supraspinatus (tendonitis) and/or subacromial (bursitis)
Scapulahumeral muscles are innervated by ____
brachial plexus
Scapulahumeral muscles
Deltoid, teres major + minor, subscapularis, supraspinatus, infraspinatus.
Rotator cuff muscles
teres minor, subscapularis, supraspinatus, and infraspinatus.
Deltoid attachments
Proximal: lateral 1/3 of clavicle, acromion and spine of scapula
Distal: deltoid tuberosity of humerus
Actions of deltoid
flexes, medially rotates, abducts, extends, and laterally rotates humerus
Innervation of deltoid
axillary nerve
Attachments of teres major
Proximal: posterior surface of inferior angle of scapula
Distal: medial lip of inter tubercular (bicipital) groove of humerus
Actions of teres major
adducts and medially rotates humerus aka internal rotation
Innervation of teres major
lower subscapular nerve
Attachments of supraspinatus
Proximal: supraspinous fossa of scapula
Distal: superior facet of greater tubercle of humerus
Actions of supraspinatus
works with deltoid in abduction of humerus, acts with other rotator cuff muscles in stabilizing shoulder joint
Innervation of supraspinatus
suprascapular nerve
Attachments of subscapularis
Proximal: subscapular fossa (anterior surface of scapula)
Distal: lesser tubercle of humerus
Actions of subscapularis
medially rotates and adducts humerus, helps hold humeral head in place
Innervation of subscapularis
upper+lower sub scapular nerves
Characteristics of subscapularis
Common sports injury in pitchers = rotator cuff tendonitis
Injuries here can lead to bicipital tendon instability and biceps tendonitis.
Longest and strongest of the rotator cuff muscles.
Attachments of infraspinatus
Proximal: infraspinous fossa of scapula
Distal: middle facet of greater tubercle of humerus
Actions of infraspinatus
laterally rotates humerus, helps hold humeral head in place
Innervation of infraspinatus
suprascapular nerve
Attachments of teres minor
Proximal: middle part of lateral border of scapula
Distal: inferior facet of greater tubercle of humerus
Actions of teres minor
laterally rotation of humerus, helps hold humeral head in place
Innervation of teres minor
axillary nerve
Which muscle’s tendon is compressed at angles greater than or equal to 90 degrees and a common injury in the elderly?
Supraspinatus, injured with receptive overhead activities
Muscles, artery, and innervation of quadrangular space
Muscles: teres minor + major, lateral + long head of triceps brachii
Artery: posterior circumflex humeral
Innervation: axillary nerve
Triangular Space
Teres minor and major, circumflex scapular artery, long head of triceps brachii = lateral border
Triangular interval
Lateral and long head of triceps brachii with teres major at superior border, deep brachial artery, and radial nerve
Brachium =
Antebrachium =
Arm
Forearm
Elbow joints
Humeroradial at capitulum
Humeroulnar at trochlear notch and trochlea
Proximal radioulnar at pivot of radius and ulna
Dermatomes of Brachial Plexus
C5-8, T1
Divisions of Brachial Artery
Originates from axillary artery.
1) Profunda brachii (deep brachial artery)
a. posterior descending branch = middle collateral
b. anterior descending branch = radial collateral
2) Superior ulnar collateral
3) Inferior ulnar collateral
Anterior compartment of arm
Flexors Biceps brachii (short + long head), brachial, and coracobrachialis
Attachments of biceps brachii
Proximal: long head - supraglenoid tubercle of scapula
short head - coracoid process of scapula
Distal: radial tuberosity and fascia of forearm via bicipital aponeurosis
Actions of biceps brachii
supinates forearm, when supine will flex forearm
short head - resists dislocation of shoulder
Blood supply and innervation of biceps brachii
Blood supply: brachial artery
Innervation: musculocutaneous nerve
Attachments of coracobrachialis
Proximal: coracoid process of scapula
Distal: middle 1/3 of medial humeral surface
Actions of coracobrachialis
flexes and adducts arm at shoulder joint
resists dislocation of shoulder joint
Blood supply and innervation of coracobrachialis
Blood supply: brachial artery
Innervation: musculocutaneous nerve
Attachments of Brachialis
Proximal: distal 1/2 of anterior surface of humerus
Distal: coronoid process and tuberosity of ulna
Actions of Brachialis
Flexes forearm at elbow joint
Innervation and blood supply of Brachialis
Blood supply: brachial artery
Innervation: musculocutaneous nerve
Posterior compartment of arm
Extensor
Triceps brachii (long head {most medial}, lateral head, and medial head), anconeus (stabilizes elbow joint)
Innervated by radial nerve
Attachments of anconeus
Proximal: lateral epicondyle of humerus
Distal: lateral surface of olecranon, superior part of surface of ulna
Actions of anconeus
Assists triceps in extension of forearm and stabilizes elbow joint, also abducts ulna during pronation
Blood supply and innervation of anconeus
Blood supply: deep brachial artery
Innervation: radial nerve
Attachments of triceps brachii
Proximal: long - infraglenoid tubercle
lateral - posterior surface of humerus
medial - posterior surface of humerus, inferior to radial groove (spiral groove)
Distal: proximal end of olecranon and fascia of forearm
Actions of triceps brachii
extends forearm at elbow joint, long head - resists dislocation of shoulder joint
Blood supply and innervation of triceps brachii
Blood supply: deep brachial artery
Innervation: radial nerve
Veins of cubital fossa
cephalic, medial cubital, medial antebrachial, and basilic
Boundaries of cubital fossa
Lateral: brachioradialis
Medial: pronator teres
Superior: imaginary line between medial and lateral humeral epicondyles
Roof: skin, superficial & deep fascia, bicipital aponeurosis
Floor: supinator and brachialis
Contents of cubital fossa
Medial nerve, bifurcation of radial+ulnar arteries, brachial veins, tendon of biceps brachii+bicipital aponeurosis, and radial nerve (deep at supinator + superficial at brachial radialis)
What makes up the funny bone?
very superficial ulnar nerve running posterior to medial epicondyle of humerus
Contents of posterior cubital region/elbow region
Triceps and olecranon process, anconeus, ulnar nerve, and posterior ulnar recurrent artery
Cubital anastomosis
Brachial artery-ulnar artery:
Superior ulnar collateral-posterior ulnar recurrent
Inferior ulnar collateral-anterior ulnar recurrent
Deep Brachial Artery-Radial and Interosseous Arteries: Radial collateral artery-radial recurrent artery
Middle collateral artery- interosseous recurrent artery
