Shoulder and axilla

Question 1

The lower limb is adapted for what?

Answer 1

to be a stable platform for locomotion; limited ROM, larger joints/ligaments; robust bones

Question 2

The upper limb sacrifices stability for what?

Answer 2

mobility and manipulation; joints have increased ROM, decreased body attachments; smaller bones and muscles; delicate features

Question 3

What dermatome is predominant along the posterior arm and forearm?

Answer 3

C7 - C6 on its thumside and C8 on pinky side

Question 4

Where do breaks in the humerus most often occur?

Answer 4

surgical neck

Question 5

Flexors of the forearm arise from what attachment?

Answer 5

medial epicondyle of humerus

Question 6

Extensors of the forarm arise from what?

Answer 6

lateral epicondyle of humerus

Question 7

What bone and process articulates with the humerus?

Answer 7

ulna - olecranon process

Question 8

Sine the olecranon and the head of the radius don’t move, how is the forearm pronated and supinated?

Answer 8

the radius is rotated over the top of the ulna (to pronate)

Question 9

What is the only bony articulation of the scapula to the body?

Answer 9

through the clavicle at the acromioclavicular joint

Question 10

What is the only bony attachment of the clavicle to the body?

Answer 10

sternoclavicular joint

Question 11

Where does the tendon of the long head of biceps brachii attach?

Answer 11

it goes through the intertubercular groove to attach to the supraglenoid tubercle

Question 12

What is the most commonly fx bone in the body?

Answer 12

middle 1/3 of the clavicle

Question 13

If the fx is fragmented, what is it called?

Answer 13

comminuted fx

Question 14

Where is the shoulder joint the weakest?

Answer 14

inferior aspect

Question 15

Where do most shoulder dislocations occur?

Answer 15

anterior inferior - b/c rotator cuff muscles are in front, on top and in back, but not inferior

Question 16

origin / insertion of pec major

Answer 16

clavicle, sternum and ribs to the humerus

Question 17

origin / insertion of pec minor

Answer 17

ribs to the coracoid process

Question 18

deltoid origin / insertion

Answer 18

clavicle, aromion, scapular spine to humerus

Question 19

What does the deltoid do?

Answer 19

flex and extends shoulder, abducts the arm but nothing over 90 degrees

Question 20

What innervates the deltoid?

Answer 20

axillary n

Question 21

What are the rotator cuff muscles?

Answer 21

supraspinatous
infraspinatous
teres minor
subscapularis

SITS

Question 22

What is the most commonly injured rotator cuff muscle?

Answer 22

supraspinatus - also most commonly involved in rotator cuff tendonitis

Question 23

How do you test for rotator cuff injury?

Answer 23

empty can test

Question 24

brachial plexus trunks are found where?

Answer 24

b/w anterior and middle scalenes

Question 25

roots of brachial plexus are what?

Answer 25

VPR

Question 26

When does the subclavian a turn into the axillary?

Answer 26

once it passes the first rib

Question 27

When does the axillary turn into the brachial a.?

Answer 27

once it passes teres major

Question 28

What are the main branches of the axillary a.?

Answer 28

superior thoracic; thoracoacromial; lateral thoracic; subscapular; cirumflex humeral

Question 29

What a. wraps around the head of humerus to supply the glenohumeral joint?

Answer 29

anterior and posterior cirumflex humeral arteries

Question 30

What a. runs down the thoracic wall to supply serratus anterior?

Answer 30

lateral thoracic

Question 31

thoracoacromial branch of axillary a gives off what 4 branches?

Answer 31

clavicular, pectoral, deltoid and acromial

Question 32

What is the largest branch of the axillary a?

Answer 32

subscapular a.; gives off circumflex scapular and thoracodoral (lat)

Question 33

What is the anastamosis of the scapula?

Answer 33

suprascapular a. joins circumflex scapular a. and transverse cervical a. joins thoracodorsal

Question 34

If an injury occurs around the axillary or subclavian a. - what arteries are the border of the anastomoses meaning there could still be blood supply?

Answer 34

between the thyrocervical trunk and subscapular a.

Question 35

what structures are present in the suprascapular notch?

Answer 35

the suprascapular nerve goes under the ligament in the notch and the suprascapular a. goes over it

Question 36

quadrangluar space contains what structures?

Answer 36

axillary n and posterior humeral circumflex.

Question 37

A fx of the surgical neck runs the risk of injury to what?

Answer 37

axilary n and posterior humeral circumflex a. (quadrangular space)

Question 38

What is the radial n. located in the arm?

Answer 38

in the spiral groove of the humerus

Question 39

what a. runs with the radial n. in the spinal groove of humerus?

Answer 39

deep brachial / profunda brachii

Question 40

A mid shaft fx would likely injury what structures?

Answer 40

radial n. and depp brachial a.

Question 41

What structure is commonly injured in shoulder dislocations?

Answer 41

axillary n

Question 42

axillary n supples what?

Answer 42

deltoid

Question 43

How do you test for axillary n injury?

Answer 43

chevron sign; ask if pt can feel touch to base of deltoid area

Question 44

What are the dermatomes of the hand?

Answer 44

thumb to pinky: C6 C7 C8 | radial median ulnar

Question 45

musculocutaneous n gives rise to what cutaneous n?

Answer 45

lateral antibrachial cutaneous

Question 46

the medial cord gives rise to what cutaneous nerves?

Answer 46

medial brachial and antibrachial cutaneous nerves

Question 47

radial n gives rise to what cutaneous n?

Answer 47

lower lateral cutaneous

Question 48

axillary n gives rise to what cutaneous n?

Answer 48

upper lateral cutaneous

Question 49

What superfical vein is on the lateral arm?

Answer 49

cephalic

Question 50

Where does the cephalic drain?

Answer 50

drains to the axillary vein through the deltopectoral triangle

Question 51

what superficial vein is medial?

Answer 51

basilic

Question 52

How does the basilic v. drain?

Answer 52

to the medial intermuscular septum to join the brachial veins

Question 53

Which vein is used for long term catheters?

Answer 53

basilic

Question 54

What are the contents of the anterior axilla?

Answer 54

axillary sheath; brachial plexus cords; axillary a and main branches; deep veins of upper limb

Question 55

What innervates the muscles of the anterior wall of the axilla?

Answer 55

medial and lateral cords - medial and lateral pectoral nerves

Question 56

What innervates the medial wall of the axilla (serratus anterior)

Answer 56

long thoracic n. from brachial plexus roots

Question 57

What innervates the posterior wall of axilla? (lat, teres major, subscapularis)

Answer 57

branches from posterior cord (upper and lower supscapular n and thoracodorsal)

Question 58

What does the posterior cord of the brachial plexus supply?

Answer 58

axillary for the shoulder nad radial for the extensor arm / forear

Question 59

musculocutaneous supples?

Answer 59

all flexor ARM muscles

Question 60

median n supplies?

Answer 60

all flexor FOREARM muscles (except for 1 and 1/2)

Question 61

ulnar n supples?

Answer 61

all HAND muscles except 1 and 1/2

Question 62

pec major is inn by?

Answer 62

medal and lateral pec nerves

Question 63

pec minor is inn by?

Answer 63

medial pec n.

Question 64

subclavius is inn by?

Answer 64

n to subclavius of upper trunk

Question 65

serratus anterior (aka medial wall of axilla) fxn and inn

Answer 65

fxn: holds scapula to thoracic wall inn: long thoracic

Question 66

injury of the serratus anterior can lead to what ?

Answer 66

winging of scaula. could be producd by impact injury to the back; vertebral border of scapula will swing out

Question 67

muscles of the posterior axillary fold and their innervations:

Answer 67

``` infraspinatus: suprascapular n. teres minor: axillary n. subscapularis: upper and lower subscapular ns teres major: lower subscapular n lat: thoracodorsal ```