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Anatomy Upper Limbs > Shoulder and arm > Flashcards

Shoulder and arm Flashcards

1
Q

bones of the upper limb

A 
- Pectoral girdle: Clavicle;
Scapula
- Arm: Humerus
- Forearm:Radius; Ulna
- Wrist: Scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate
- metacarpals (5)
- phalanges (thumb only has 2)
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2
Q

where does the supraspinatus sit?

A

supraspinous fossa

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3
Q

where does the infraspinatus sit?

A

infraspinous fossa

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4
Q

where do the teres major and minor muscles sit?

A

lateral border of scapula

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5
Q

where does the subscapularis sit?

A

subscapular fossa

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6
Q

where does the short head of the biceps, coracobrachilias and pec major originate from?

A

corocaid process

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7
Q

where does the long head of the biceps originate from?

A

supraglenoud tubercle

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8
Q

where does the long head of the triceps originate from?

A

infraglenoid tubercle

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9
Q

structures to identify on humerus

A 
Deltoid tuberosity
Radial groove
Medial and lateral epiondyles
Olecranon fossae
Trochlea, capitulum
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10
Q

what are the joints of the pectoral girdle

A

Sternoclavicular joint
Acromioclavicular joint
Glenohumeral joint
Scapulothoracic joint

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11
Q

what separates the sternum and the clavicle?

A

articular disk

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12
Q

what stabilises the sternoclavicular joint?

A

stern-clavicular and costoclavicular ligaments

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13
Q

what does the sternoclavicular joint enable?

A

movement of the pectoral girdle

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14
Q

what is the acromio-clavicular joint?

A

Synovial joint between the clavicle, acromion and coracoid process

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15
Q

what are the important ligaments of the acromio-clavicular joint?

A
  • Acromioclavicular
  • Coracoclavicular (Composed of the conoid and trapezoid ligaments)
  • Coracoacromial
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16
Q

what can be torn in the acromio-clavicular joint in a dislocation?

A

Commonly injured by falls onto outstretched hand and can tear the ligaments
Minor: Tearing of the acromio-clavicular
Major: Tearing of the coraco-clavicular

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17
Q

what is the glenohumeral joint?

A

Joint between the glenoid process of the scapula and head of the humerus

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18
Q

what deepens the glenoid socket?

A

glenoid labrum

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19
Q

Subacromial bursa

A

capsule extends above the humeral head to form a bursa

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20
Q

what tendon passes through the glenohumeral joint?

A

tendon of the long head of the biceps

comes from under the transverse humeral ligament

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21
Q

what is the common site for pathology for impingement of the shoulder?

A

The acromion, coracoid and acromio-coracoid ligament form an arch above the joint and this is the site

This is trapping of a tendon (usually supraspinatus) when raising the arm resulting in pain

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22
Q

which ligaments make the capsule that surrounds the GH joint?

A

Gleno-humeral (x3)
Coraco-humeral
Transverse-humeral

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23
Q

what does inflammation of the GH joint lead to?

A

frozen shoulder

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24
Q

what are the movement facilitated by the GH joint?

A

Flexion and extension

  • Abduction and adduction
  • Internal and external rotation
  • Circumduction (combination of movements)
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25
Q

what are the two functions of the rotator cuff muscles?

A
  • Hold the humerus in the glenoid cavity

- Depress the humeral head to minimise risk of dislocation

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26
Q

what does anterior dislocation of the humerus lead to?

A

Tearing of the glenoid labrum

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27
Q

what is the result of compression of the axillary nerve?

A

Limited abduction due to reduced function of the deltoid muscle

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28
Q

what are the rotator cuff muscles?

A

Supraspinatus
Infraspinatus
teres minor
subscapularis

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29
Q

what is the scapulothoracic joint?

A

This is a virtual joint between the scapula, and the thoracic wall immediately anterior to it.

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30
Q

what are the possible movements of the ST joint?

A
  • Elevation and depression of the scapula
  • Protraction and retraction
  • Rotation whereby the glenoid cavity either moves upwards or downwards

These movements are separate and independent of movements at the gleno-humeral joint

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31
Q

what spinal nerves make up the somatic brachial plexus?

A

C5-T1.

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32
Q

what is the brachial plexus responsible for?

A

innervation of the entire upper limb except trapezius

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33
Q

what is the sensory innervation provided by the brachial plexus?

A

sensory innervation to joints and skin and motor innervation to the muscles.

As well as providing sympathetic fibres to the vessels for vasoconstriction.

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34
Q

structures of the brachial plexus

A

Roots, trunks, divisions, cords, branches.

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35
Q 
roots of peripheral nerves :
Musculoskeletal 
Axillary nerve 
Ulnar nerve 
Radial nerve
Median nerve
A 
Musculoskeletal (C5, C6)
Axillary nerve (C5, C6)
Ulnar nerve (C8, T1)
Radial nerve (C5 – T1)
Median nerve (C6 – T1)
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36
Q

what does the musculocutaneous nerve supply?

A

Supplies the anterior compartment of the arm

Lies close to the subscapularis tendon
Continues as the lateral cutaneous nerve

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37
Q

roots of musculocutaneous nerve

A

C5, C6

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38
Q

what does the axillary nerve supply?

course of the nerve

A

Supplies the deltoid and teres minor muscle

Emerges from the posterior cord of the brachial plexus alongside the radial nerve

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39
Q

what are the roots of the axillary nerve?

A

C5, C6

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40
Q

What does the ulnar nerve supply?

course of the nerve

A

No branches in the upper arm
Supplies the hand and the anterior compartment of the forearm

  • Upper arm in the anterior compartment initially but pierces the intermuscular septum and distally runs in the posterior compartment
  • Lies posterior to the medial epicondyle and can be damaged
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41
Q

what does the radial nerve supply?

course of the nerve

A

Supplies the posterior compartments of the arm and forearm

It lies on the humerus in the radial groove and can be damaged there by fractures
It descends between the medial and lateral heads of the triceps brachii

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42
Q

what are the roots of the ulnar nerve?

A

C8, T1

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43
Q

what does the radial nerve divide into, above the elbow?

A

Superficial radial nerve

Posterior interosseous nerve

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44
Q

what are the roots of the radial nerve?

A

C5-T1

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45
Q

what does the medial nerve supply?

course of the nerve

A

Supplies the anterior compartments of the arm and forearm

It passes through the upper arm via the anterior compartment.
It begins anterior to the brachial artery
But at the level of the elbow it lies medial to the brachial artery and can be damaged there at any time

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46
Q

what are the roots of the median nerve?

A

C6-T1

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47
Q

what are the intrinsic shoulder muscles?

A

Deltoid

Teres Major

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48
Q

what are the four rotator cuff muscles?

A

Supraspinatus
Infraspinatus
Subscapularis
Teres Minor

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49
Q

what are the muscles of the anterior compartment of the arm?

A

Biceps brachii
Brachialis
Coracobrachialis

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50
Q

what are the muscles of the posterior compartment of the arm?

A

Triceps

Anconeus

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51
Q

what are the anterior pectoral muscles?

A

Pectoralis Major
Pectoralis Minor
Subclavius
Serratus Anterior

52
Q

what are the posterior pectoral muscles?

A

Levator Scapulae
Rhomboids Major and Minor
Trapezius
Latissimus Dorsi

53
Q

what is the proximal attachment of pec major?

A

Medial 1/3 clavicle
Sternum
Costal cartilages I – VII

54
Q

what is the distal attachment of pec major?

A

Lateral lip of the intertubercular groove

55
Q

what is the function of pec major?

A

Flexion
Adduction
Internal rotation
at GHJ

56
Q

what is the innervation to the pec major?

A

Lateral and medial pectoral nerves

57
Q

what is the proximal attachment of pec minor?

A

Ribs III – VI

58
Q

what is the distal attachment of pec minor?

A

Coracoid process of the scapula

59
Q

what is the function of pec minor?

A

protraction of STJ

60
Q

what is the innervation to pec minor?

A

Medial pectoral nerve only

61
Q

what is the function of subclavian?

A

Anchors the clavicle

Stabilises the sternoclavicular joint

62
Q

what is the proximal attachment of serratus anterior?

A

Lateral surface of ribs I - VIII

63
Q

what is the distal(insertion) attachment of serratus anterior?

A

Medial border to the scapula

64
Q

what is the function of the serratus anterior?

A

Protraction at STJ
Rotation: Can elevate the glenoid fossa
responsible for centring the scapula on the thoracic wall

65
Q

what is the innervation to the serratus anterior?

A

Long thoracic nerve (C5-C7)

66
Q

what does injury to long thoracic nerve lead to?

A

scapular winging occurs

67
Q

in what procedure may the thoracodorsal nerve be damaged?

A

mastectomies when looking for lymph nodes

68
Q

what is the proximal attachment of the trapezius?

A

The ligamentum nuchae and the thoracic spine

Technically: External occipital protuberance, ligamentum nuchae, vertebra C1-T12

69
Q

what is the distal attachment of the trapezius?

A

Posterior 1/3 clavicle
Acromion
Scapular spine

70
Q

what is the function of the trapezius?

A

Multiple movements of the STJ

Elevation/rotation/retraction/depression

71
Q

what is the function of the rhomboids?

A

Rotation

Retraction

72
Q

what is the function of the levator scapula?

A

Elevation

73
Q

what is the innervation to the rhomboids and lev scapulae?

A

dorsal scapular nerve

74
Q

proximal attachment of lat dorsi

A

Vertebral column from T7 to ileum

75
Q

distal attachment of lat dorsi

A

Floor of intertubercular groove of humerus

76
Q

what is the function of lat dorsi?

A

Adduction (same as pec major)
Medial rotation (same as pec major)
Extension (opposite to pec major)

77
Q

what is the innervation to the lat dorsi?

A

thoracodorsal nerve

78
Q

proximal attachment of deltoid

A

Posterior 1/3 clavicle
Acromion
Scapular spine

(same as the distal attachments for the trapezius)

79
Q

distal attachment of deltoid

A

Deltoid tuberosity of the humerus

80
Q

function of deltoid

A

Abduction beyond 15⁰ (GHJ)

81
Q

innervation to deltoid

A

axillary nerve

82
Q

proximal attachment of teres major?

A

Inferior angle of the scapula

83
Q

distal attachment of teres major?

A

Medial lip of intertubercular groove

84
Q

function of teres major

A

Medial rotation
Adduction
Extension (tiny bit)

85
Q

innervation to teres major

A

Inferior subscapular

86
Q

proximal attachment of supraspinatus

A

Supraspinous fossa

87
Q

function of supraspinatus

A

Abduction to 15⁰

88
Q

innervation of supraspinatus

A

Suprascapular

89
Q

proximal attachment of infraspinatus

A

Infraspinous fossa

90
Q

function of infraspinatus

A

Lateral rotation

91
Q

innervation to infraspinatus

A

Suprascapular

92
Q

proximal attachment of teres minor

A

Infraspinous fossa

93
Q

function of teres minor

A

Lateral rotation

94
Q

innervation to teres minor

A

Axillary

95
Q

proximal attachment of scapularis

A

Medial border of scapula

96
Q

distal attachment of scapularis

A

Lesser tubercule

97
Q

function of subscapularis

A

Medial rotation

98
Q

innervation to subscapularis

A

Upper and lower subscapular nerves

99
Q

distal attachment of rotator cuff muscles

A

onto the greater tubercule
except for subscapularis (lesser tubercle)

causes medial rotation

100
Q

how do you test muscles e.g. at GH?

A

oppose the movement

101
Q

which muscles cause flexion at GHJ?

A

Pectoralis Major
Anterior fibres of Deltoid
Coracobrachialis
Biceps Brachii also helps.

102
Q

which muscles cause extension at GHJ?

A

Latissimus Dorsi

Posterior fibres of Deltoid

103
Q

which muscles cause abduction at GHJ?

A

First 15 degree – Supraspinatus

Later – Central fibres of Deltoid

104
Q

which muscles cause adduction at GHJ?

A

Pectoralis Major
Latissimus Dorsi
Teres Major

105
Q

which muscles cause external rotation at GHJ?

A

Infraspinatus

Teres Minor

106
Q

which muscles cause internal rotation at GHJ?

A

Subscapularis

107
Q

which muscles help resist dislocation?

A

Deltoid, Rotator Cuff, tendon of long head of biceps, short head of biceps, coracobrachialis

108
Q

what are the boundaries of the axilla?

A
  • Apex: Formed by rib 1
  • Anterior wall: Pectoralis major
  • Posterior wall: subscapularis, teres major and latissimus dorsi
  • Medial wall: Ribs I – IV and serratus anterior
  • Lateral wall: Humerus
  • Base: skin, subcutaneous tissue and fascia
109
Q

what connect the humerus to the deep fascia of the arm on either side?

A

Medial and lateral intermuscular septa

110
Q

what is the anterior compartment of the arm innervated by?

A

musculocutaneous nerve

111
Q

what is the posterior compartment of the arm innervated by?

A

radial nerve

112
Q

when does the axillary artery become the brachial artery?

A

inferior border of the teres major

113
Q

what is near the brachial artery?

A

median nerve (artery is lateral to it)

114
Q

what branch comes of the brachial artery and what nerve runs nearby?

A

The profunda brachii- runs alongside the radial nerve

115
Q

what happens to the brachial artery at the elbow?

A

Brachial artery divides at the elbow into the radial and ulnar arteries

116
Q

what does the profunda brachii supply?

A

Supplies blood to the posterior compartment of the arm.

117
Q

what is the superficial venous drainage for the arm?

A

Basilic – draining medial part

Cephalic – draining lateral part

118
Q

what is the deep venous drainage of the arm?

A

The venae comitantes of the profunda brachii (VCPB)

119
Q

when does the basili vein become deep? what does it join and where?

A

Basilic pierces deep fascia midway up arm to become deep and joins the VCPB to form the axillary vein at the inferior border of the teres major

cephalic vein also joins the axillary vein

120
Q

what is the superificial lymphatic drainage of the arm?

A

Cubital lymph nodes

Delto-pectoral lymph nodes

121
Q

what is the deep lymphatic drainage of the arm?

A

Lymph nodes running alongside the deep veins

122
Q

where do the breast drain?

A

axillary lymph nodes,

where the arm systems also drain

123
Q

what are the 5 groups of axillary lymph nodes?

A 
Central
Humeral
Apical
Pectoral
Subscapular

[CHAPS]

124
Q

where do the axillary lymph nodes drain?

A

subclavian lymphatic trunk

125
Q

what nerves can be damaged during surgery near the axillary lymph nodes?

A

Long thoracic and thoracodorsal

Results in winging of the scapula

Anatomy Upper Limbs (3 decks)

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