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week 1 - Shoulder and Elbow > Shoulder and Brachial Plexus Anatomy > Flashcards

Shoulder and Brachial Plexus Anatomy Flashcards

1
Q

what movements can the shoulder perform?

A

-flexion and extension
-abduction/adduction
-interal/external rotation
-circumduction

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2
Q

what movements can the elbow perform?

A

-flexion/extension
-pronation and supination

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3
Q

what movements can the wrist perform?

A

-flexion/extension
-abduction/adduction

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4
Q

what is circumduction?

A

circular movement a ball and socket joint

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5
Q

what is pronation/supination?

A

rotating the forearm
-moves palm from ant to post facing or vice versa
-not medial rotation, requires arm to be Half flexed

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6
Q

what is aposition?

A

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

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7
Q

what are the possible movements of digits?

A

-flex
-extend
-abduct
-adduct
-circumduct

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8
Q

what is the pectoral girdle?

A

the scapula and humerus working around the shoulder

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9
Q

what is the shoulder joint?

A

glenohumeral joint

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10
Q

where is the clavicle located?

A

from the manubrium to the acromion
sits just above humerus

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11
Q

what classifies the clavicle?

A

-has slight sigmoid curves
-conccave lat convex med
-has space for vessels and nerves
-transmits weight
-acts as strut (holds limb out and transfers weight)
-strong ligaments of SC joint (bone is more likely to break rather than muscles or tendons)

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12
Q

what is the scapula?

A

-large flat triangular bone

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13
Q

what ribs does the scapula overlap?

A

2-7

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14
Q

what is the spine of the scapula?

A

the sharp ridge that goes laterally across, supraspinous fossa and infraspinous fossa

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15
Q

what is the acromion process?

A

lateral, high point of the shoulder, articulates with the clavicle

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16
Q

what is the coracoid process?

A

lateral & anterior, where muscles attach

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17
Q

what is the glenoid cavity?

A

laterally, inferior to acromion, articulates with humerus

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18
Q

where does the scapula have a joint connection to the axial skeleton?

A

it does not.

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19
Q

which muscles hold the scapula in place?

A

-trapezius
-levator scapulae
-rhomboid major and minor
-serratus anterior
-pectoralis minor

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20
Q

what happens when the scapula moves?

A

moves around AC and SC joints, generated by muscles that attach scapula to trunk
-indirectly also muscles trunk to humerus when shoulder fixed

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21
Q

what is protraction/retraction?

A

pushing and retracting

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22
Q

what happens when there is a lateral rotation/abduction of the scapula?

A

tilts the glenoid cavity upwards

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23
Q

what happens when there is a medial rotation/ adduction of the scapula?

A

brings arm back down

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24
Q

what is the floor of the axilla?

A

upward arching sheet skin

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24
Q

what is the apex of the axilla?

A

points up and medially, continuous with neck root

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25
Q

what is the anterior wall of the axilla?

A

pectoral muscles

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26
Q

what is the posterior wall of the axilla?

A

subscapularis, tires major and lat dorsi

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27
Q

what is the medial wall of the axilla?

A

chest wall and serrates ant

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28
Q

what is the lateral wall of the axilla?

A

the humerus and muscles

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29
Q

what is the pectoralis major?

A

fan shaped superficial muscle

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30
Q

what are the attachments of the pectoralis major?

A

has 2 heads
-medial clavicle
-sternum and upper 6 costal cartilages, aponeurosis of external obliques
-humerus (crest of greater tubercle & lat lip of inter tubercle groove
lower fibres trust to form U shaped tendon

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31
Q

what are the actions of the pectoralis major?

A

both heads together
-protracts and depresses scapula
-adducts & medial rotation humerus
-clav head - flexes humerus
-sternocostal - extends humerus

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32
Q

what nerve innervates pectoralis major?

A

medial and lateral pectoral nerves

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32
Q

what is the pectoralis minor?

A

a triangular muscle, deep to major

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33
Q

what are the attatchments of the pectoralis minor?

A

3-5th ribs
coracoid process of scapula

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34
Q

what are the actions of the pectoralis minor?

A

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

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35
Q

what nerve innervates the pectoralis minor?

A

medial pectoral nerve

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36
Q

what is the brachial plexus?

A

nerve supply to the upper limb

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36
Q

what makes up the brachial plexus?

A

ventral rami of nerves from C5-T1 spinal nerve roots
has some minor contributions from C4 and T2
extends inferiorally and lateral through the neck/axilla and into arm

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37
Q

what does the brachial plexus do?

A

provides sensory, motor and sympathetic nerve supply to the pectoral girdle and upper limb except for trapezius.
the complex re-routing gives back up mechanism

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38
Q

what comes off from the lateral cord?

A

musculo cutaneous nerve and the axillary nerve

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38
Q

what comes off the posterior cord?

A

axillary nerve and radial nerve

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39
Q

what makes up the median cord?

A

fibres from the lateral and medial cord

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40
Q

where does the ulnar nerve come off?

A

medial cord

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40
Q

what are the roots of the brachial plexus?

A

5 of them, vetral rami of C5-T1 spinal nerves, unite in a pattern to form 3 trunks
-emerge between scalene anterior and medius muscles

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41
Q

what are the trunks of the brachial plexus?

A

3 of them, each trunk divides to give an anterior and posterior division
located within the neck

42
Q

what are the divisions of the brachial plexus?

A

6 of them, regroup and restructure to give cords
-pass deep to middle 1/3 of clavicle
-into apex of axilla and regroup to form cords

43
Q

what are the cords of the brachial plexus?

A

3 of these, give rise to 5 terminal branches
-lie posteriorly to axillary artery

44
Q

what do the anterior divisions of the brachial plexus do?

A

supply FLEXOR muscles &skin on FRONT OF UL

45
Q

what do the posterior divisions of the brachial plexus supply?

A

EXTENSORS and skin on BACK of UL

46
Q

where does the brachial plexus end?

A

lower border pectoralis minor by dividing into nerves

47
Q

what does the lateral cord consist of?

A

-musculocutaneous nerve, pierces coracobrachialis muscle
-supplies it, biceps brachia and brachialis
-lateral root of median nerve supplies forearm flexors & thenar eminence
-continues as lateral cut of forearm

48
Q

what makes up the medial chord?

A

-medial root of median nerve, forearm flexors and thenar eminence
-ulnar nerve intrinsic muscles of the hand
-also continues as 3 sensory cutaneous nerves

49
Q

what comes from the posterior cord?

A

-radial nerve, largest and innervates all extensor muscles in arm and forearm
-axillary nerve - innervates teres minor and deltoid

50
Q

what are the main supraclavicular branches?

A

dorsal scapular
long thoracic
supra scapular

51
Q

where is the dorsal scapular?

A

from ramus of C5, supplies rhomboids

52
Q

where is the long thoracic nerve?

A

from the ventral rami of C5-C7, supplies serratus anterior

53
Q

where is the supra scapular nerve?

A

from the superior trunk, supplies suprasinatus & infraspinatus

54
Q

what are the main infraclavicular branches of the brachius plexus?

A

-medial and lateral pectoral
-upper and lower subscapular
-thoracodorsal

55
Q

where do the upper and lower sub scapular nerves come from?

A

come from posterior cord, sub scapular and tires major

56
Q

where does the thoracodorsal nerve come from?

A

lattismus dorsi

57
Q

what is crutch palsy?

A

prolonged use of crutches, compression to radial nerve, affects extensor muscles

57
Q

what happens when there is damage to the radial nerve?

A

drop wrist, can’t extend hand it is caused by intramuscular injections into the deltoid and hits radial nerve

58
Q

what is carpal tunnel syndrome?

A

median nerve damage
compression of the nerve
can cause numbness, tingling and pain in palm and fingers
caused by repetitive wrist flexion

59
Q

where is the axillary nerve?

A

comes from the posterior cord C5-C6

60
Q

what muscles does the axillary nerve innervate?

A

teres minor - laterally rotates arm
deltoid - abducts arm
(cutaneous (sensory) innervation to inferior lateral shoulder)

61
Q

where is the ulnar nerve?

A

comes off the medial cord, C8-T1

62
Q

what does the ulnar nerve do?

A

-flex and adduct wrist
-flex fingers
-adducts thumb
-controls hypothenar muscles
-flexes metocarpalphalangeal joints and extends interphalangeal joints
-abducts and adducts fingers

63
Q

where is the median nerve?

A

comes from the median and lateral cords, C5-T1

64
Q

what does the medial nerve do?

A

-pronates forearm and hand
-flexes and abducts wrist
-flexes fingers
-controls thumb muscle
controls thenar muscle
-flexes metacarpophalangeal joints and extends interphalangeal joints

65
Q

what are the joints of the pectoral girdle?

A

sternoclavicular joint
acromioclavicular joint

66
Q

what is the sternoclavicular joint?

A

-notch of manubrium and medial clavicle
-acts like ball and socket
-accompanies scapula joint
-highly strengthened by ligaments
-synovial joint

67
Q

why is the sternoclavicular joint so strong?

A

-caspule thickened ant and post by sternoclavicular ligaments
-intraclavicular ligament - med end of clavicle, connects them along the middle
-joint extends superiorly to 1st costal cartilage
-costoclavicular ligament strengthens inferior aspect of this joint.

68
Q

what is the acromioclavicular joint/

A

-from the lateral clavicle to the acromion process
-sliding synovial joint

69
Q

what strenghtens the AC joint?

A

ligaments
-coracoclavicular
-acromioclavicular
-corocoacromial

70
Q

what kind of joint is the gelnohumeral joint?

A

synovial multiracial ball and socket joint
limited stability due to poor bony fit and loose capsule and ligaments

71
Q

what stabilises the glenohumeral joint?

A

the rotator cuff muscles

72
Q

where does the radius articulate with the humerus?

A

the capitulum

73
Q

where does the ulna articulate with the humerus?

A

trochlea

74
Q

where does the synovial capsule of the glenohumeral joint attatch?

A

proximally
-scapula beyond supraglenoid tubercle
-margin of labrum
distally
-anatomical neck of humerus

75
Q

what are bursae?

A

fluid filled sac lined by synovial membrane
-found around most major joints
-reduce friction

75
Q

what muscles help flex the arm?

A

pectoralis major
anterior fibres of deltoid
assisted by short head of biceps and coracobrachialis

76
Q

what are the bursae of the glenohumeral joint?

A

-subacromial
-subscapular
-subdeltoid
-subcoracoid bursae

77
Q

what muscles would be involved in extension of the arm?

A

from anatomical position
-posterior fibres of deltoid and lat dorsi
extension to return to anatomical position
-lat dorsi, tires major, pectoralis major

77
Q

what muscles control abduction of arm?

A

first 15-30 bu supraspinatous
after it is deltoid
over head requires lat rotation of scapula (serious anterior and trap)

78
Q

what muscles control adduction of arm?

A

lat dorsi and lowers sternocostal fibres of pectoralis major

79
Q

what muscles control medial rotation of the arm?

A

TRUNK TO ANT HUMERUS
pectoralis major
lat dorsi
SCAPULA TO ANT HUMERUS
subscapularis
teres major

80
Q

what muscles are involved in the lateral rotation of the arm?

A

infraspinatus
deltoid
teres minor

81
Q

what muscles attach some distance from the shoulder?

A

(considerable mechanical effect on shoulder)
deltoid
terms major
short head biceps Brachi

82
Q

which muscles lie close to the shoulder?

A

(smaller mechanical effect on shoulder)
-stabilise joint
-act as main ligaments
long head biceps
-triceps brachii
-rotator cuff

83
Q

what are the rotator cuff muscles?

A

-supraspinatus
-infraspinatus
-teres minor
-subscapularis

84
Q

what do the rotator cuff muscles do?

A

contract together, major stabilising force shoulder
contract individually to cause movement
join scapula to humerus

85
Q

what does the infraspinatus muscle do?

A

-scapula -post/sup greater tubercle humerus
-lat rotation and stabilisiation
-innervated by subscapular nerve

85
Q

what does teres minor do?

A

-scapula (lat margin)- post greater tubercle humerus
-lateral rotation and stabilisation
-innervated by axillary nerve

86
Q

what is the supraspinatus muscle?

A

-from scapula to sup greater tubercle humerus
-abduction and stabilisation
-innervated by supra scapular nerve

87
Q

what is the subscapularis muscle?

A

-from scapula to lesser tubercle humerus
-medial rotation and stabilisation
-innervated by subscapular nerve

88
Q

what is dislocation?

A

most frequently in shoulder
humeral head pushes against weakest part of capsule
tears ligaments and articular capsules

89
Q

what are rotator cuff injuries?

A

common if limb was above head
tear supraspinous tendon
frozen shoulder

90
Q

what is the axillary nerve injury?

A

may be injured with dislocations by the head of the humerus
-paralysis of deltoid and loss of sensation in small area of skin over deltoid

91
Q

which muscle is located immediately deep to the trapezius and connects vertebral spinous processes to the medial margins of the scapulae?

A

rhomboids

92
Q

What is the name of the fascial layer that envelops the muscles which are part of the erector spinae?

A

thoraco-lumbar fascia

93
Q

What actions does the latissimus dorsi muscle effect on the shoulder joint?

A

Adduction, extension, and medial rotation

94
Q

Which muscle is needed for starting arm abduction from the anatomical position?

A

supraspinatus

95
Q

Where on the scapula does the levator scapulae attach?

A

superior angle

96
Q

What part of the trapezius has a role in rotating (tilting) the scapula so that the inferior angle swings laterally, and, what is it needed for?

A

The superior (descending) part and this is needed to allow full elevation of the arm

97
Q

What is the name of the gap located between teres major and minor, humerus, and long head of the triceps, through which the axillary nerve travels?

A

quadrangular space

98
Q

Which nerve travels close to the shaft of the humerus between the lateral and medial heads of the triceps?

A

radial

99
Q

what makes up the borders of the quadrangular space?

A

teres minor
teres major
long head of triceps
surgical neck of the humerus

100
Q

which part of the scapula is closest to the ribs?

A

sub scapular fossa

101
Q

which muscle is responsible for external/lateral rotation of the glenohumeral joint?

A

infraspinatus

102
Q

what cords of the brachial plexus contribute to the median nerve?

A

medial and lateral cords

103
Q

what rotator cuff muscle is essential for the initiation of shoulder abduction?

A

supraspinatus

104
Q

which part of the brachial plexus gives off the long thoracic nerve?

A

roots of C6, C7 and C5

week 1 - Shoulder and Elbow (9 decks)

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