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shoulder and arm Flashcards

1
Q

DIAGRAM bones of pectoral girlde and arm

A

scapula, clavicle, and humerus

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2
Q

DIAGRAM scapula

A

spine separates supra and infraspinous fossa- note coracoid process (crows beak), acromion, glenoid cavity (socket for humerus) and subscapular fossa

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3
Q

DIAGRAM clavicle

A

sternal facet articulates with manubrium, acromila end (flattened end) joins with acromium inferior end is rough, superior end is smooth

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4
Q

DIAGRAM humerus

A

at proximal end is greater and lesser tubercle, inter-tubercular groove, as well as surgical and anatomical neck in shaft is radial groove and deltoid tuberosity at distal end is lateral and medial epicondyle, and condyles (capitulum /trochlea)

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5
Q

surgical vs anatomical neck

A

surgical more easily damaged

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6
Q

muscular anatomy compartments

A

anterior pectoral girdle muscles, posterior ‘’ ‘’, intrinsic shoulder muscles, anterior compartment of upper arm, posterior ‘’ ‘’

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7
Q

anterior pectoral girdle muscles

A

pec major/minor, subclavius, serratus anterior (between anterior and posterior)

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8
Q

DIAGRAM pec major- attachments and heads and functions+ innervation

A

proximally attached to clavicle, sterum and CC’s- distal attachment to lateral part of intertubucular sulcus/groove has 3 heads adduction, internal rotation and flexion lateral and median pectoral nerves

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9
Q

DIAGRAM pec minor- attachments and function

A

proximally to coracoid process, distally to 2-5th ribs pulls scapula forward

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10
Q

DIAGRAM subclavius

A

proximally 1st rib (costochondral joint), distally inferior part of clavicle stabilises clavicle

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11
Q

DIAGRAM serratus anterior- attachments, nerve and function

A

medial part of scapula, running anterior over thoracic cage, attaching to ribs 1-9 long thoracic nerve stabilises scapula and protracts it

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12
Q

posterior pectoral girdle muscles

A

traps, lats, rhomboids and levator scapulae

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13
Q

DIAGRAM traps, attachments, parts, nerve and function

A

attaches to nuchal line of skull, cervical and thoracic vertebrae (up to T12)- curls round to front to attach to acromium and clavicle 3 parts- descending, middle and ascending accessory nerve actions on scapula- elevation, retraction, rotation, depression

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14
Q

DIAGRAM lats- attachments and function and nerve

A

continuous with thoracolumbar fascia- attaches to iliac crest, up to T8, to floor of intertuburcular sulcus adducts, extends and rotates humerus thoracodorsal

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15
Q

DIAGRAM rhomboids

A

rhomboid minor and major- attaches to medial border of scaula, and spinous processes retracts, rotates and stabilises scapula

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16
Q

DIAGRAM levator scapulae

A

attaches to superior angle of scapula+ C1-4 transverse processes elevates+ rotates scapula

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17
Q

nerve supply of rhomboids and levator scapulae

A

dorsal scapular nerve

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18
Q

intrinsic shoulder muscles

A

deltoid, teres major, rotator cuff muscles (supraspinatus, infraspinatus, teres minor and subscapularis)

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19
Q

DIAGRAM deltoid

A

attaches to spine of scapula, acromium and lateral part of clavicle, as well as DELTOID TUBEROSITY axillary nerve abducts arm beyond 15 degress

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20
Q

DIAGRAM rotator cuff

A

proximal attachments on scapula (covers scapula)- supraspinatus in supraspinous fossa, infra in infraspinous fossa attach at head of humerous- all attach at greater tuberous EXCEPT subscapularis (lesser tubercle)

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21
Q

overall function of rotator cuff

A

holds head of humerous into glenoid fossa (stabilisation)- also depresses humerous head to lower risk of dislocation

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22
Q

role of supraspinatus

A

initiates abduction of arm in first 15 degrees (after that deltoid)- feel muscle above spine of scapula

23
Q

role of infraspinatus

A

external rotation- feel muscle below spine of scapula

24
Q

DIAGRAM teres major

A

attaches to shaft of humerous at intertubercular sulcus (NOT head)- proximally at inferior angle of scapula adducts and rotates arm

25
anterior compartment of arm+ innervation
biceps, brachialis and coracobrachialis musculocutaneous
26
DIAGRAM biceps- attachment
short head (medial) attaches to coracoid process, long head crosses over shoulder joint attaching to supraglenoid tubercle heads merge distally, crossing elbow joint, and tendon attaches to radial tuberosity- also forms biceps aponeuroisis, so distally has 2 attachments
27
DIAGRAM brachialis- attachment and function
attaches to CORONOID process and shaft of humerus flexes elbow
28
DIAGRAM coracobrachialis
from coracoid process and shaft of humerus- adducts humerous
29
posterior compartment of arm and nerve
triceps+anconeus radial nerve
30
DIAGRAM triceps brachii- attachments
lateral, medial and long head attached to shaft of humerous- long head crosses shoulder joint to attach to infraglenoid tubercle of scapula distally, heads mervge to attach to olecranon process of ulna
31
DIAGRAM anconeus-attachments+ function
lateral epicondyle and posterior ulna stabilises elbow joint, but also extends arm
32
DIAGRAM joints of region
sterno-clavicular, acromio-clavicular and gleno-humeral (shoulder) joint scapula-thoracic joint (virtual joint) and elbow joint
33
DIAGRAM gleno-humoral joint
glenoid fossa (socket) is quite shallow, so not stable and needs rotator cuff muscles for stability- glenoid labrum however does deepen fossa slightly for more stability
34
DIAGRAM axilla- what is it and what it contains
transition between shoulder+arm- contains axillary artery/vein and branches, lymph nodes+ brachial plexus- borders form a pyramid
35
arteries of whole region
subclavian artery- passes underneath clavicle, and after first rib becomes axillary artery- after teres major becomes brachial artery (gives of profundal brachii branch)- divides into ulnar/radial arteries at elbow
36
DIAGRAM superificial and deep veins of region
superficial- dorsal venous netwrok in hand, forming cephalic and basilic- cephalic goes up lateral border of arm in delto-pectoral groove, basilic up medial border of arm deep- basilic vein joins venae comitantes to form axillary vein- cephalic vein joins axillary vein, which becomes subclavian vein
37
DIAGRAM lymphatic drainage of area
superficial -cubital lymph node and delto-pectoral lymph nodes, which drain itnto axillary lymph nodes- important for breast cancer, thus removal can called lymphoedma of arm region
38
DIAGRAM regions of plexus
roots (anterior rami-pass under clavicle), trunks, divisions, cords, then terminal branches (peripheral nerves)
39
largest nerves of brachial plexus
axillary musculocutaneuous, ulnar, median and radial
40
DIAGRAM common sites of nerve damage
at elbow, shoulder joint (dislocation compresses nerve), and shaft of humerus
41
DIAGRAM overview muscles attached to scapula
ef
42
DIAGRAM sternoclavicular joint- stabilisation, what is it+ importance
separated by an articular disk- stabilised by clavicular and costoclavicular ligaments allows movement of pectoral girdle
43
DIAGRAM acromio-clavicular joint- what is it, stabilisation+ injury
joint between clavicle, acromion+ coracoid process- stabilised by acromioclavicular+ coracoclavicular ligaments falls onto outstretched hand can tear acromio-clavicular (minor) or coracoclavicular (minor)
44
DIAGRAM glenohumeral joint- capsule and relation to biceps
capsules cups the head of humerous- it extends above the head to form a SUBACROMIAL BURSA tendon of long head of bicep goes through joint
45
DIAGRAM glenohumeral joint- pathology and ligaments of capsule
impingement of shoulder can occur (trapping of a tendon leading to pain when raising arm) inflammation of joint leads to frozen shoulder ligaments of CAPSULE are 3 glenohumeral, coraco-humeral and transverse-humeral
46
movements of glenohumeral joint
abduction/adduction, flexion/extension, internal/external roation, circumduction (combination)
47
anterior dislocation of humerus effect
compression of axillary nerve= less abduction (deltoid)
48
DIAGRAM scapulothoracic joint- why joint and movements
virtual joint- called joint as they move relative to each other elevation/depression of scapula, protraction/retraction, rotation of scapula
49
injury of serratus anterior
when removing lymph nodes, thoracodorsal and long thoracic nerve affected, which causes scapular winging, as muscles CENTRES scapula on thoracic wall
50
movements at glenohumeral joint and testing for them
test by opposing it's movement flexion- pec major, anterior deltoid, coracobrachialis, biceps extension- lats, posterior deltoid abduction- supraspinatus, then deltoid adduction- lats, teres major, pec major external rotation- infraspinatus+ teres minor internal rotation- subscapularis
51
DIAGRAM boundaries of axilla
apex (rib 1), anterior wall (pec major), posterior wall (subscapularis, lats) medial wall- ribs 1-4+ serratus anterior lateral wall- intertubercular sulcus base- skin
52
brachial artery branches
branches to profundal brachii, which supplies blood to posterior part of arm, going through radial groove also gives off nutrient artery to humerus
53
axillary lymph nodes+ damage to what nerves
CHAPS- central, humeral, apical, pectoral and subscapular nodes- close to long thoracic+ thoracodorsal- can lead to scapular winging during surgery if nerves damaged

limbs anatomy (8 decks)

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