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limbs and back anatomy > shoulder and brachial plexus > Flashcards

shoulder and brachial plexus Flashcards

1
Q

upper limb attachment to axial skeleton

A

anterior - sternoclavicular joint

posterior - muscles to vertebral column

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2
Q

shoulder movements

A

flexion and extension
abduction and adduction
internal and external rotation
circumduction

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3
Q

elbow movements

A

flexion and extension

pronation and supination

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4
Q

wrist movements

A

flexion and extension

abduction and adduction

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5
Q

pronation and supination of the upper limb

A

rotating the forearm
moves palm from anterior to posterior facing = pronation or vice versa = supination
not medial rotation - requires arm to be half flexed

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6
Q

apposition of upper limb

A

gripping between fingers and thumb
reposition = release
opposition of thumb = thumb meets 5th digit

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7
Q

movements of digits (fingers)

A 
flex
extend
abduct
adduct
circumduction
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8
Q

pectoral girdle

A

set of bones in the appendicular skeleton that connects arm on each side
clavicle and scapula

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9
Q

where does the clavicle start and finish

A

manubrium to acromion

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10
Q

describe the parts of the scapula

A

spine - separates supraspinous and infraspinous fossa
acromion process - lateral, high point of shoulder - joins with clavicle
coracoid process - lateral and anterior - muscles attach
medial border - attachment of muscles
glenoid cavity - laterally, inferior to acromion - articulates with humerus

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11
Q

how is the scapula attached to the axial skeleton

A

joined by muscles

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12
Q

muscles holding scapula in place

A 
trapezius
levator scapulae
rhomboid major and minor
serratus anterior
pectoralis minor
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13
Q

scapula movements

A

protraction and retraction
lateral rotation (abduction) and medial rotation (adduction)
elevation and depression

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14
Q

what is the axilla

A

pyramidal space containing brachial plexus, lymph nodes and axillary vessels

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15
Q

axilla landmarks

A

apex
floor - where you spray deodorant
anterior wall - pectoral muscles
posterior wall - subscapularis, teres major, latissimus dorsi
medial wall - chest wall and serratus anterior
lateral wall - humerus and muscles

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16
Q

pectoralis major attachments

A

2 heads - medial clavicle - sternum and upper 6 costal cartilages, aponeuosis of external obliques
humerus - crest of greater tubercle and lateral lip of intertubercle groove

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17
Q

actions of pectoralis major

A

both heads together - protract and depress scapula and adduct and medially rotate humerus
clavicle head flexes humerus
sternocostal head extends humerus

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18
Q

innervation of pectoralis major

A

medial and lateral pectoral nerves

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19
Q

attachments of pectoralis minor

A

3rd to 5th ribs

coracoid process scapula

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20
Q

actions of pectoralis minor

A

depresses shoulder
pulls scapula and shoulder forward
raises ribs when scapula fixed (inspiration)

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21
Q

innervation of pectoralis minor

A

medial pectoral nerve

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22
Q

muscles of the pectoral region

A

pectoralis major and minor
subclavius
serratus anterior

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23
Q

dorsal root

A

afferent sensory fibres

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24
Q

ventral root

A

efferent motor fibres

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25
Q

dorsal rami location

A

deep muscles, skin on dorsum

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26
Q

ventral rami location

A

limbs, lateral and ventral trunk skin

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27
Q

rami

A

mixture of afferent and efferent fibres

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28
Q

brachial plexus

A

ventral rami of c5-t1 spinal nerve roots

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29
Q

where does the brachial plexus innervate

A

sensory, motor and sympathetic nerve supply to pectoral girdle and upper limb - except trapezius

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30
Q

5 terminal nerves from brachial plexus

A 
musculo-cutaneous nerve 
axillary nerve
median nerve
radial nerve
ulnar nerve
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31
Q

different sections of the brachial plexus

A

roots from vertebrae -> trunks -> divisions -> cords -> terminal nerves

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32
Q

where do the brachial plexus roots emerge

A

emerge between scalene anterior and medius muscles

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33
Q

3 trunks and their origin (brachial plexus)

A

upper/superior - C5, C6
middle - C7
lower/inferior - C8, T1
trunks are in the neck

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34
Q

divisions of the BP and where they supply

A

anterior - flexor muscles and skin on front of upper limb

posterior - extensors and skin on back of UL

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35
Q

how are the 3 cords of the BP named

A

according to position to axillary artery

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36
Q

cords of BP

A

lateral - anterior divisions of superior and middle trunk
posterior - uniting posterior divisions of all 3 trunks
medial - anterior division of inferior trunk

37
Q

from lateral cord:

A

musculocutaneous nerve and median nerve

38
Q

from medial cord:

A

median nerve and ulnar nerve

39
Q

musculocutaneous nerve supplies

A

coracobrachialis muscle, biceps brachii, brachialis

40
Q

median nerve supplies

A

forearm flexors and thenar eminence

41
Q

from posterior cord:

A

radial nerve and axillary nerve

42
Q

radial nerve supplies

A

all extensors

43
Q

axillary nerve supplies

A

teres minor - laterally rotates arm

deltoid - abducts arm

44
Q

quandrangular space

A

gap between teres major, minor, humerus and long head of triceps where axillary nerve travels

45
Q

ulnar nerve supplies

A

intrinsic muscles of the hand

46
Q

main supraclavicular branches of the BP

A

dorsal scapular - supplies rhomboids
long thoracic - supplies serratus anterior
suprascapular - supplies supraspinatus and infraspinatus

47
Q

main infraclavicular branches

A

medial and lateral pectoral
upper and lower subscapular
thoracodorsal

48
Q

crutch palsy cause and effects

A

prolonged use of crutches

commonly affects radial nerve, affects extensors

49
Q

what does do radial nerve damage and how does it happen

A

drop wrist, cant extend hand

caused by intramuscular injections into deltoid

50
Q

carpal tunnel syndrome cause and effects

A

medial nerve damage

results in numbness, tingling and pain in palm and fingers

51
Q

roots of axillary nerve

A

c5-c6

52
Q

area the axillary nerve supplies

A

sensory innervation to inferior lateral shoulder

53
Q

roots of ulnar nerve

A

C8-T1

54
Q

area the ulnar nerve supplies

A

sensory innervation to the medial third of the hand, little finger and medial half of the ring finger

55
Q

roots of median nerve

A

fibres from C6-T1

56
Q

area that the median nerve supplies

A

sensory innervation to lateral 2/3 palm, thumb, index and middle finger, lateral half of ring finger and dorsal tips of these fingers

57
Q

roots of radial nerve

A

C5-T1

58
Q

area that the radial nerve supplies

A

sensory innervation to posterior surface of arm and forearm, lateral 2/3 of dorsum of hand

59
Q

roots of musculocutaneous nerve

A

C5-C7

60
Q

area that the musculocutaneous nerve supplies

A

sensory innervation to lateral surface of forearm

61
Q

joints of pectoral girdle

A

sternoclavicular

acromioclavicular

62
Q

describe the sternoclavicular joint

A

notch of manubrium and medial clavicle
acts like a ball and socket joint
synovial joint
only joint connecting UL to axis

63
Q

describe the sternoclavicular ligaments

A

joint capsule thickened anteriorly and posteriorly by sternoclavicular ligaments
interclavicular ligament - medial end of clavicle
costoclavicular ligament - first rib to clavicle

64
Q

describe the acromioclavicular joint

A

lateral clavicle to acromion of scapula
gliding synovial joint
strengthened by ligaments

65
Q

acromioclavicular joint ligaments

A

acromioclavicular
corocoacromial
coracoclavicular - strongest but not strictly AC joint

66
Q

shoulder joint

A

glenohumeral joint

67
Q

describe the glenohumeral joint

A

head of humerus and glenoid cavity scapula
synovial multiaxial ball and socket joint
limited stability - poor bony fit and loose capsule and ligaments

68
Q

how is the glenohumeral joint stabilised

A

rotator cuff muscles stabilise without limiting movement as ligaments would

69
Q

describe the bones in the glenohumeral joint

A

head of humerus - 4x too big for glenoid fossa
glenoid fossa of scapula - shallow and only covers about 1/3 of humerus - allows movement
glenoidal labrum deepens the socket - fibrocartilage ring around glenoid cavity

70
Q

describe the synovial capsule at the glenohumeral joint

A

thin loose sac that envelopes joint - dislocation site
proximal attachments - scapula beyond supraglenoid tubercle and margin of labrum
distal attachments - neck of humerus
inner synovial membrane and outer fibrous layer

71
Q

describe the synovial membrane

A

lines non-articular surfaces
articular surfaces lined by articular cartilage
lines bursae

72
Q

bursae

A

fluid filled sac lined by synovial membrane
found around most major joints
reduces friction and provides protection where one structure frequently moves over other

73
Q

bursae at glenohumeral joint

A

subacromial, subscapular, subdeltoid and subcoracoid bursae

74
Q

flexion at GH joint

A

muscles passing anterior to joint
pectoralis major
anterior fibres of deltoid - assisted by short head of biceps brachii and coracobrachialis

75
Q

extension at GH joint

A

limited from anatomical position - posterior fibres of deltoid and latissimus dorsi
returning to anatomical position - latissimus dorsi, teres major, pectoralis major

76
Q

abduction at GH joint

A

first 15-30 degrees by supraspinatus then deltoid takes over

limb to over head requires lateral rotation of scapula - serratus anterior and trapezius

77
Q

adduction at GH joint

A

gravity
latissimus dorsi
lowest sternocostal fibres of pectoralis major until arm horizontal

78
Q

medial rotation by GH joint

A

muscles from trunk to anterior humerus - pectoralis major and latissimus dorsi
muscles from scapula to anterior humerus - subscapularis and teres major

79
Q

lateral rotation by GH joint

A

muscles from scapula to post humerus - infraspinatus, deltoid and teres minor

80
Q

muscles attaching humerus to scapula

A 
muscle attaching distance from shoulder - 
teres major
deltoid 
short head biceps brachii
muscle lying close to shoulder - 
long head biceps brachii
triceps brachii
rotator cuff
81
Q

rotator cuff muscles and their function

A 
supraspinatus
infraspinatus
teres minor
subscapularis 
join humerus to scapula
82
Q

function of the tendons at the rotator cuff

A

encircle the joint
fuse with the articular capsule
unique to animals who reach overhead

83
Q

describe teres minor

A

scapula to posterior greater tubercle of humerus
lateral rotation and stabilisation
axillary nerve

84
Q

describe infraspinatus

A

scapula to posterior/superior greater tubercle of humerus
lateral rotation and stabilisation
suprascapular nerve

85
Q

describe supraspinatus

A

scapula to superior greater tubercle humerus
abduction and stabilisation
suprascapular nerve

86
Q

describe subscapularis

A

scapula to lesser tubercle humerus
medial rotation and stabilisation
subscapular nerve

87
Q

dislocation of shoulder

A

most frequent joint dislocated

tears ligaments and articular cartilage

88
Q

rotator cuff injuries

A

common injury when using limb above horizontal eg. swimming, throwing
tear supraspinatus tendon
frozen shoulder - stiffness, irritation and inflammation of tendons

89
Q

axillary nerve injury

A

may be injured with dislocations with head of humerus

paralysis of deltoid and loss of sensation in small area of skin over deltoid

limbs and back anatomy (2 decks)

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