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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
what are the two functions of the rotator cuff muscles?
- Hold the humerus in the glenoid cavity | - Depress the humeral head to minimise risk of dislocation
26
what does anterior dislocation of the humerus lead to?
Tearing of the glenoid labrum
27
what is the result of compression of the axillary nerve?
Limited abduction due to reduced function of the deltoid muscle
28
what are the rotator cuff muscles?
Supraspinatus Infraspinatus teres minor subscapularis
29
what is the scapulothoracic joint?
This is a virtual joint between the scapula, and the thoracic wall immediately anterior to it.
30
what are the possible movements of the ST joint?
- 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
31
what spinal nerves make up the somatic brachial plexus?
C5-T1.
32
what is the brachial plexus responsible for?
innervation of the entire upper limb except trapezius
33
what is the sensory innervation provided by the brachial plexus?
sensory innervation to joints and skin and motor innervation to the muscles. As well as providing sympathetic fibres to the vessels for vasoconstriction.
34
structures of the brachial plexus
Roots, trunks, divisions, cords, branches.
35
``` roots of peripheral nerves : Musculoskeletal Axillary nerve Ulnar nerve Radial nerve Median nerve ```
``` Musculoskeletal (C5, C6) Axillary nerve (C5, C6) Ulnar nerve (C8, T1) Radial nerve (C5 – T1) Median nerve (C6 – T1) ```
36
what does the musculocutaneous nerve supply?
Supplies the anterior compartment of the arm Lies close to the subscapularis tendon Continues as the lateral cutaneous nerve
37
roots of musculocutaneous nerve
C5, C6
38
what does the axillary nerve supply? course of the nerve
Supplies the deltoid and teres minor muscle Emerges from the posterior cord of the brachial plexus alongside the radial nerve
39
what are the roots of the axillary nerve?
C5, C6
40
What does the ulnar nerve supply? course of the nerve
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
41
what does the radial nerve supply? course of the nerve
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
42
what are the roots of the ulnar nerve?
C8, T1
43
what does the radial nerve divide into, above the elbow?
Superficial radial nerve | Posterior interosseous nerve
44
what are the roots of the radial nerve?
C5-T1
45
what does the medial nerve supply? course of the nerve
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
46
what are the roots of the median nerve?
C6-T1
47
what are the intrinsic shoulder muscles?
Deltoid | Teres Major
48
what are the four rotator cuff muscles?
Supraspinatus Infraspinatus Subscapularis Teres Minor
49
what are the muscles of the anterior compartment of the arm?
Biceps brachii Brachialis Coracobrachialis
50
what are the muscles of the posterior compartment of the arm?
Triceps | Anconeus
51
what are the anterior pectoral muscles?
Pectoralis Major Pectoralis Minor Subclavius Serratus Anterior
52
what are the posterior pectoral muscles?
Levator Scapulae Rhomboids Major and Minor Trapezius Latissimus Dorsi
53
what is the proximal attachment of pec major?
Medial 1/3 clavicle Sternum Costal cartilages I – VII
54
what is the distal attachment of pec major?
Lateral lip of the intertubercular groove
55
what is the function of pec major?
Flexion Adduction Internal rotation at GHJ
56
what is the innervation to the pec major?
Lateral and medial pectoral nerves
57
what is the proximal attachment of pec minor?
Ribs III – VI
58
what is the distal attachment of pec minor?
Coracoid process of the scapula
59
what is the function of pec minor?
protraction of STJ
60
what is the innervation to pec minor?
Medial pectoral nerve only
61
what is the function of subclavian?
Anchors the clavicle | Stabilises the sternoclavicular joint
62
what is the proximal attachment of serratus anterior?
Lateral surface of ribs I - VIII
63
what is the distal(insertion) attachment of serratus anterior?
Medial border to the scapula
64
what is the function of the serratus anterior?
Protraction at STJ Rotation: Can elevate the glenoid fossa responsible for centring the scapula on the thoracic wall
65
what is the innervation to the serratus anterior?
Long thoracic nerve (C5-C7)
66
what does injury to long thoracic nerve lead to?
scapular winging occurs
67
in what procedure may the thoracodorsal nerve be damaged?
mastectomies when looking for lymph nodes
68
what is the proximal attachment of the trapezius?
The ligamentum nuchae and the thoracic spine Technically: External occipital protuberance, ligamentum nuchae, vertebra C1-T12
69
what is the distal attachment of the trapezius?
Posterior 1/3 clavicle Acromion Scapular spine
70
what is the function of the trapezius?
Multiple movements of the STJ | Elevation/rotation/retraction/depression
71
what is the function of the rhomboids?
Rotation | Retraction
72
what is the function of the levator scapula?
Elevation
73
what is the innervation to the rhomboids and lev scapulae?
dorsal scapular nerve
74
proximal attachment of lat dorsi
Vertebral column from T7 to ileum
75
distal attachment of lat dorsi
Floor of intertubercular groove of humerus
76
what is the function of lat dorsi?
Adduction (same as pec major) Medial rotation (same as pec major) Extension (opposite to pec major)
77
what is the innervation to the lat dorsi?
thoracodorsal nerve
78
proximal attachment of deltoid
Posterior 1/3 clavicle Acromion Scapular spine (same as the distal attachments for the trapezius)
79
distal attachment of deltoid
Deltoid tuberosity of the humerus
80
function of deltoid
Abduction beyond 15⁰ (GHJ)
81
innervation to deltoid
axillary nerve
82
proximal attachment of teres major?
Inferior angle of the scapula
83
distal attachment of teres major?
Medial lip of intertubercular groove
84
function of teres major
Medial rotation Adduction Extension (tiny bit)
85
innervation to teres major
Inferior subscapular
86
proximal attachment of supraspinatus
Supraspinous fossa
87
function of supraspinatus
Abduction to 15⁰
88
innervation of supraspinatus
Suprascapular
89
proximal attachment of infraspinatus
Infraspinous fossa
90
function of infraspinatus
Lateral rotation
91
innervation to infraspinatus
Suprascapular
92
proximal attachment of teres minor
Infraspinous fossa
93
function of teres minor
Lateral rotation
94
innervation to teres minor
Axillary
95
proximal attachment of scapularis
Medial border of scapula
96
distal attachment of scapularis
Lesser tubercule
97
function of subscapularis
Medial rotation
98
innervation to subscapularis
Upper and lower subscapular nerves
99
distal attachment of rotator cuff muscles
onto the greater tubercule except for subscapularis (lesser tubercle) causes medial rotation
100
how do you test muscles e.g. at GH?
oppose the movement
101
which muscles cause flexion at GHJ?
Pectoralis Major Anterior fibres of Deltoid Coracobrachialis Biceps Brachii also helps.
102
which muscles cause extension at GHJ?
Latissimus Dorsi | Posterior fibres of Deltoid
103
which muscles cause abduction at GHJ?
First 15 degree – Supraspinatus Later – Central fibres of Deltoid
104
which muscles cause adduction at GHJ?
Pectoralis Major Latissimus Dorsi Teres Major
105
which muscles cause external rotation at GHJ?
Infraspinatus | Teres Minor
106
which muscles cause internal rotation at GHJ?
Subscapularis
107
which muscles help resist dislocation?
Deltoid, Rotator Cuff, tendon of long head of biceps, short head of biceps, coracobrachialis
108
what are the boundaries of the axilla?
- 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
what connect the humerus to the deep fascia of the arm on either side?
Medial and lateral intermuscular septa
110
what is the anterior compartment of the arm innervated by?
musculocutaneous nerve
111
what is the posterior compartment of the arm innervated by?
radial nerve
112
when does the axillary artery become the brachial artery?
inferior border of the teres major
113
what is near the brachial artery?
median nerve (artery is lateral to it)
114
what branch comes of the brachial artery and what nerve runs nearby?
The profunda brachii- runs alongside the radial nerve
115
what happens to the brachial artery at the elbow?
Brachial artery divides at the elbow into the radial and ulnar arteries
116
what does the profunda brachii supply?
Supplies blood to the posterior compartment of the arm.
117
what is the superficial venous drainage for the arm?
Basilic – draining medial part | Cephalic – draining lateral part
118
what is the deep venous drainage of the arm?
The venae comitantes of the profunda brachii (VCPB)
119
when does the basili vein become deep? what does it join and where?
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
what is the superificial lymphatic drainage of the arm?
Cubital lymph nodes | Delto-pectoral lymph nodes
121
what is the deep lymphatic drainage of the arm?
Lymph nodes running alongside the deep veins
122
where do the breast drain?
axillary lymph nodes, | where the arm systems also drain
123
what are the 5 groups of axillary lymph nodes?
``` Central Humeral Apical Pectoral Subscapular ``` [CHAPS]
124
where do the axillary lymph nodes drain?
subclavian lymphatic trunk
125
what nerves can be damaged during surgery near the axillary lymph nodes?
Long thoracic and thoracodorsal | Results in winging of the scapula

Anatomy Upper Limbs (3 decks)

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