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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
dorsal rami location
deep muscles, skin on dorsum
26
ventral rami location
limbs, lateral and ventral trunk skin
27
rami
mixture of afferent and efferent fibres
28
brachial plexus
ventral rami of c5-t1 spinal nerve roots
29
where does the brachial plexus innervate
sensory, motor and sympathetic nerve supply to pectoral girdle and upper limb - except trapezius
30
5 terminal nerves from brachial plexus
``` musculo-cutaneous nerve axillary nerve median nerve radial nerve ulnar nerve ```
31
different sections of the brachial plexus
roots from vertebrae -> trunks -> divisions -> cords -> terminal nerves
32
where do the brachial plexus roots emerge
emerge between scalene anterior and medius muscles
33
3 trunks and their origin (brachial plexus)
upper/superior - C5, C6 middle - C7 lower/inferior - C8, T1 trunks are in the neck
34
divisions of the BP and where they supply
anterior - flexor muscles and skin on front of upper limb | posterior - extensors and skin on back of UL
35
how are the 3 cords of the BP named
according to position to axillary artery
36
cords of BP
lateral - anterior divisions of superior and middle trunk posterior - uniting posterior divisions of all 3 trunks medial - anterior division of inferior trunk
37
from lateral cord:
musculocutaneous nerve and median nerve
38
from medial cord:
median nerve and ulnar nerve
39
musculocutaneous nerve supplies
coracobrachialis muscle, biceps brachii, brachialis
40
median nerve supplies
forearm flexors and thenar eminence
41
from posterior cord:
radial nerve and axillary nerve
42
radial nerve supplies
all extensors
43
axillary nerve supplies
teres minor - laterally rotates arm | deltoid - abducts arm
44
quandrangular space
gap between teres major, minor, humerus and long head of triceps where axillary nerve travels
45
ulnar nerve supplies
intrinsic muscles of the hand
46
main supraclavicular branches of the BP
dorsal scapular - supplies rhomboids long thoracic - supplies serratus anterior suprascapular - supplies supraspinatus and infraspinatus
47
main infraclavicular branches
medial and lateral pectoral upper and lower subscapular thoracodorsal
48
crutch palsy cause and effects
prolonged use of crutches | commonly affects radial nerve, affects extensors
49
what does do radial nerve damage and how does it happen
drop wrist, cant extend hand | caused by intramuscular injections into deltoid
50
carpal tunnel syndrome cause and effects
medial nerve damage | results in numbness, tingling and pain in palm and fingers
51
roots of axillary nerve
c5-c6
52
area the axillary nerve supplies
sensory innervation to inferior lateral shoulder
53
roots of ulnar nerve
C8-T1
54
area the ulnar nerve supplies
sensory innervation to the medial third of the hand, little finger and medial half of the ring finger
55
roots of median nerve
fibres from C6-T1
56
area that the median nerve supplies
sensory innervation to lateral 2/3 palm, thumb, index and middle finger, lateral half of ring finger and dorsal tips of these fingers
57
roots of radial nerve
C5-T1
58
area that the radial nerve supplies
sensory innervation to posterior surface of arm and forearm, lateral 2/3 of dorsum of hand
59
roots of musculocutaneous nerve
C5-C7
60
area that the musculocutaneous nerve supplies
sensory innervation to lateral surface of forearm
61
joints of pectoral girdle
sternoclavicular | acromioclavicular
62
describe the sternoclavicular joint
notch of manubrium and medial clavicle acts like a ball and socket joint synovial joint only joint connecting UL to axis
63
describe the sternoclavicular ligaments
joint capsule thickened anteriorly and posteriorly by sternoclavicular ligaments interclavicular ligament - medial end of clavicle costoclavicular ligament - first rib to clavicle
64
describe the acromioclavicular joint
lateral clavicle to acromion of scapula gliding synovial joint strengthened by ligaments
65
acromioclavicular joint ligaments
acromioclavicular corocoacromial coracoclavicular - strongest but not strictly AC joint
66
shoulder joint
glenohumeral joint
67
describe the glenohumeral joint
head of humerus and glenoid cavity scapula synovial multiaxial ball and socket joint limited stability - poor bony fit and loose capsule and ligaments
68
how is the glenohumeral joint stabilised
rotator cuff muscles stabilise without limiting movement as ligaments would
69
describe the bones in the glenohumeral joint
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
describe the synovial capsule at the glenohumeral joint
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
describe the synovial membrane
lines non-articular surfaces articular surfaces lined by articular cartilage lines bursae
72
bursae
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
bursae at glenohumeral joint
subacromial, subscapular, subdeltoid and subcoracoid bursae
74
flexion at GH joint
muscles passing anterior to joint pectoralis major anterior fibres of deltoid - assisted by short head of biceps brachii and coracobrachialis
75
extension at GH joint
limited from anatomical position - posterior fibres of deltoid and latissimus dorsi returning to anatomical position - latissimus dorsi, teres major, pectoralis major
76
abduction at GH joint
first 15-30 degrees by supraspinatus then deltoid takes over | limb to over head requires lateral rotation of scapula - serratus anterior and trapezius
77
adduction at GH joint
gravity latissimus dorsi lowest sternocostal fibres of pectoralis major until arm horizontal
78
medial rotation by GH joint
muscles from trunk to anterior humerus - pectoralis major and latissimus dorsi muscles from scapula to anterior humerus - subscapularis and teres major
79
lateral rotation by GH joint
muscles from scapula to post humerus - infraspinatus, deltoid and teres minor
80
muscles attaching humerus to scapula
``` 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
rotator cuff muscles and their function
``` supraspinatus infraspinatus teres minor subscapularis join humerus to scapula ```
82
function of the tendons at the rotator cuff
encircle the joint fuse with the articular capsule unique to animals who reach overhead
83
describe teres minor
scapula to posterior greater tubercle of humerus lateral rotation and stabilisation axillary nerve
84
describe infraspinatus
scapula to posterior/superior greater tubercle of humerus lateral rotation and stabilisation suprascapular nerve
85
describe supraspinatus
scapula to superior greater tubercle humerus abduction and stabilisation suprascapular nerve
86
describe subscapularis
scapula to lesser tubercle humerus medial rotation and stabilisation subscapular nerve
87
dislocation of shoulder
most frequent joint dislocated | tears ligaments and articular cartilage
88
rotator cuff injuries
common injury when using limb above horizontal eg. swimming, throwing tear supraspinatus tendon frozen shoulder - stiffness, irritation and inflammation of tendons
89
axillary nerve injury
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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