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GAR > Shoulder and Deltoid Pg 60-71 > Flashcards

Shoulder and Deltoid Pg 60-71 Flashcards

1
Q

What is the shoulder?

A

articulation of the head of humerus and the glenoid cavity of scapula

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2
Q

What is the main function of the shoulder?

A

To place the hand in a position to grasp efficiently

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3
Q

Where does the clavicle attach?

A

attaches to the sternum medially and the acromion process of the scapula laterally

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4
Q

The clavicle is located above and anterior to which rib ?

A

first rib

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5
Q

What are two functions of the clavicle?

A

acts as a strut to hold the scapula and shoulder in place laterally
protects the subclavian vessels and the brachial plexus and azxillary vessels as they enter arm

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6
Q

Where is the most frequent break in the clavicle located and what does this look like?

A

Between the middle and lateral third of the clavicle
Shoulder droops

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7
Q

Why does the shoulder droop when the clavicle breaks between the middle and lateral third of the clavicle?

A

Sternocleidomastoid muscle pulls the medial fragment upwards
Trapezius cannot hold up the lateral fragment due to the weight of the upper limb
Deltoid muscle and gravity pulls lateral fragment down and medially

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8
Q

What can happen if the broken pieces of the clavicle have jagged edges?

A

The jagged edges of the clavicle can damage the subclavian artery and the brachial plexus running deep to it

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9
Q

WHAT IS IMPORTANT TO KNOW ABOUT THE SUPRASCAPULAR NOTCH?

A

the suprascapular notch is enclosed by the superior transverse ligament (aka suprascapular ligmant)

THE SUPRASCAPULAR ARTERY RUNS OVER THE SUPERIOR TRANSVERSE LIGAMENT

THE SUPRASCAPULAR NERVE RUNS UNDER THE SUPERIOR TRANSVERSE LIGAMENT

*The army goes over the bridge. The navy goes under the bridge

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10
Q

What is the function of the glenoid labrum?

A

fibrocartilaginous ring that deepens the shoulder socket to provide more stability

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11
Q

Which part of the humerus is most likely to fracture or thin?

A

Surgical neck (because it is the narrowest part of the humerus)

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12
Q

WHAT STRUCTURES CAN GET DAMAGED IF THE SURGICAL NECK OF THE HUMERUS IS FRACTURED?

A

AXILLARY NERVE AND THE POSTERIOR HUMERAL CIRCUMFLEX ARTERY

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13
Q

WHAT SYMPTOMS WILL THE PATIENT EXHIBIT IF THE AXILLARY NERVE IS DAMAGED?

A

WEAKNESS/LOSS OF ABDUCTION OF ARM AND SENSORY LOSS OVER LATERAL SHOULDER (NUMBNESS)

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14
Q

What does the axillary nerve innervate?

A

Supplies sensory innervation to the skin of the lateral arm

Supplies motor innervation to the deltoid and teres minor muscles

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15
Q

WHAT NERVE MAY GET DAMAGED WITH A FRACTURE OF THE HUMERAL SHAFT?

A

RADIAL NERVE

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16
Q

WHAT HAPPENS IF YOU DAMAGE THE DEEP BRANCH OF THE RADIAL NERVE?

A

CANNOT EXTEND WRIST (WRIST DROP), THUMB, AND METAPHALANGEAL JOINT

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17
Q

WHAT HAPPENS IF YOU DAMAGE THE SUPERFICIAL BRANCH OF THE RADIAL NERVE?

A

LOSS OF SENSATION OVER RADIAL DISTRIBUTION OF THE HAND

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18
Q

WHAT HAPPENS IF YOU DAMAGE THE ORIGIN OF THE RADIAL NERVE?

A

GET BOTH DEEP AND SUPERFICIAL DAMAGE IN ADDITION TO LOSS OF ARM EXTENSION AND LOSS OF SENSATION OVER POSTERIOR ARM AND FOREARM

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19
Q

The greater tubercle of the humerus is the site of insertion for which muscles?

A

Supraspinatous, Infraspinatous, and Teres minor

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20
Q

Lesser tubercle of the humerus is the site of insertion for which muscle?

A

subscapularis

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21
Q

What two structures run along the spiral (radial) groove which is found on the posterior shaft of the humerus?

A

Radial nerve

Profunda brachii artery

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22
Q

Function of sternoclavicular joint

A

allows for elevation, depression, protraction, retraction, and circumduction of shoulder

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23
Q

What is the function of the acromioclavicular joint?

A

resists the upward motion of the head of humerus

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24
Q

What happens if the acromioclavicular ligament is ruptured?

A

Separation of shoulder

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25
Q

List the four ligaments found in the glenohumeral joint

A

Coracohumeral
Glenohumeral
Transverse humeral
Coracoacromial

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26
Q

List the muscles that make up the rotator cuff?

A

Supraspinatous, Infraspinatous, Teres minor, and Subscapularis

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27
Q

The glenohumeral joint is innervated by what nerves?

A

Axillary nerve
Suprascapular nerve
Lateral Pectoral nerve

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28
Q

What arteries supply the glenohumeral joint?

A

Suprascapular artery
Anterior humeral circumflex artery
Posterior humeral circumflex artery

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29
Q

What are the 3 joints of the shoulder?

A

Sternoclavicular joint
Acromioclavicular joint
Glenohumeral joint

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30
Q

What two veins merge to form the axillary vein?

A

Brachial vein and superficial basilic vein

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31
Q

Where are superficial veins in the upper extremity found and where do they drain?

A

They are found in the subcutaneous tissues and drain into the deep veins

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32
Q

Which veins are used for drawing blood, parenteral injections and starting IVs?

A

Superficial veins are the primary veins used and most commonly the:
Basilic vein
Cephalic vein
Median cubital vein

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33
Q

What is the course of the basilic vein?

A

The basilic vein runs medially and eventully joins the brachial vein to form axillary vein

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34
Q

What is the course of the cephalic vein?

A

The cephalic vein runs laterally and enters the clavipectoral triangle to join the axillary vein

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35
Q

What vein is found in the cubital fossa and connects the cephalic and basilic vein?

A

Median cubital vein

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36
Q

What structures run under the median cubital vein?

A

biceps tendon
brachial artery
median nerve

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37
Q

Why are superficial veins important during exercise?

A

Physical activity cause increase in arterial blood pressure which increases pressure within the muscle fascia leading to improper function of deep veins. The body compensates by utilizing superficial veins to carry blood back to the heart upon muscle exertion since the superficial veins are not next to arterial vessels or in fascial sheaths

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38
Q

Peripheral cutaneous nerves that branch off of axillary nerve innervate ?

A

skin over the deltoid

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39
Q

Peripheral cutaneous nerves supply what?

A

They provide sensory information to specific areas of skin

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40
Q

Palmar cutaneous branches of the radial nerve innervate?

A

thumb

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41
Q

Palmar cutaneous branches of the median nerve innervate?

A

skin over middle fingers

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42
Q

Palmar cutaneous branches of the ulnar nerve innervate?

A

innervates skin over the little finger

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43
Q

What branches from the musculocutaneous nerve after the musculocutaneous nerve has innervated the biceps brachii, brachialis, and coracobrachialis muscles?

A

Lateral cutaneous nerve

44
Q

What does the lateral cutaneous nerve (that branches from the musculocutaneous nerve) innervate?

A

lateral aspect of the forearm

45
Q

What is the course of the radial nerve?

A

The radial nerve runs along radial groove (aka spiral groove) of humerus and past the triangular interval

46
Q

What does the radial nerve innervate?

A

triceps brachii, extensors in forearm, and skin on posterior aspect of arm and forearm

47
Q

What artery runs alongside radial nerve?

A

profunda brachii artery

48
Q

A fracture that involves the shaft of the humerus often damages what nerve?

A

Radial nerve

49
Q

What nerve runs along the surgical neck of humerus?

A

Axillary nerve

50
Q

A fractured surgical neck of the humerus may lead to what type of nerve damage?

A

Axillary nerve damage

51
Q

The axillary nerve passes through what space?

A

quadrangular space

52
Q

The axillary nerve innervates ?

A

teres minor, deltoid, and the skin over the deltoid (lateral shoulder)

53
Q

Which artery runs alongside axillary nerve?

A

Posterior humeral circumflex artery

54
Q

What two structures are associated with the suprascapular notch?

A

Suprascapular ligament runs along top of the suprascapular notch to create the suprascapular foramen

Suprascapular nerve runs under the suprascapular ligament

Suprascapular artery runs above the suprascapular ligament

55
Q

Suprascapular nerve innervates?

A

Supraspinatous and Infraspinatous

56
Q

What artery supplies supraspinatous?

A

Suprascapular artery

57
Q

What artery supplies infraspinatous?

A

Suprascapular artery
Circumflex scapular artery

58
Q

What artery supplies teres minor?

A

Suprascapular artery
Dorsal scapular artery

59
Q

What artery supplies teres major?

A

Posterior circumflex humeral artery
Thoracodorsal branch of subscapular

60
Q

What artery supplies deltoid?

A

Thoracoacromial artery
Subscapular artery
Circumflex humeral artery
Deep brachial artery

61
Q

What artery supplies subscapularis?

A

Suprascapular artery
Axillary artery
Subscapular artery

62
Q

What muscles make up rotator cuff?

A

Supraspinatous
Infraspinatous
Teres minor
Subscapularis

63
Q

What is function of rotator cuff?

A

Move humerus
Hold head of humerus in glenoid fossa
Prevent shoulder subluxation with movement
MAINTAINS THE STABILITY OF SHOULDER

64
Q

If any muscle of the rotator cuff is damaged or paralyzed, what results?

A

Sublaxation of head humerus from glenoid cavity

65
Q

What two structures run along spiral groove of posterior side of humerus and are thus in jeopardy with fracture of humeral shaft?

A

Radial nerve
Profunda brachii artery

66
Q

WHAT STRUCTURES RUN OUT OF THE QUADRANGULAR SPACE (UPPER EXTREMITY)?

A

AXILLARY NERVE

POSTERIOR CIRCUMFLEX HUMERAL ARTERY

67
Q

WHAT ARE BOUNDARIES OF QUADRANGULAR SPACE?

A

TERES MINOR
TERES MAJOR
LONG HEAD OF TRICEPS (MEDIALLY)
SURGICAL NECK OF HUMERUS (LATERAL)

68
Q

What structures run through the triangular space (upper extremity)?

A

Circumflex scapular artery and veins
(no nerve)

69
Q

What are boundaries of triangular space?

A

Teres minor
Teres major
Long head of triceps (lateral)

70
Q

What structures run through the triangular interval (upper extremity)?

A

Radial nerve
Profunda brachii artery

71
Q

What are boundaries of triangular interval (upper extremity)?

A

Teres major
Long head of triceps (Medial)
Lateral head of triceps (Lateral)

72
Q

Mild Shoulder Separation-what is affected?

A

Acromioclavicular ligament severed

73
Q

Severe Shoulder Separation-what is affected?

A

Both acromioclavicular ligament and coracoclavicular ligaments severed

74
Q

What happens in Shoulder Dislocation?

A

Humeral head out of socket

75
Q

What should you test if you suspect shoulder dislocation?

A

Test nerve sensation of axillary nerves and musculocutaneous nerves

76
Q

Which direction is the humerus most commonly displaced out of glenoid cavity?

A

Anterior (95%)

77
Q

What causes shoulder dislocation?

A

Aggressive abduction and lateral rotation that damages or stretches rotator cuff
*baseball

78
Q

What things can get damaged in shoulder dislocation and why?

A

Damage to axillary nerve can occur due to close relation to inferior part of the joint capsule

Can also damage axillary artery and vein and brachial plexus

79
Q

Anterior shoulder dislocation appears?

A

Arm typically held in external rotation and slight abduction

80
Q

Posterior shoulder dislocation appears?

A

Arm typically held in adduction and internally rotated

81
Q

Fractures of the surgical neck of humerus are common in what population?

A

elderly with osteoporosis

82
Q

INJURY TO SURGICAL NECK OF HUMERUS USUALLY RESULTS IN DAMAGE TO?

A

AXILLARY NERVE

83
Q

Damage to the surgical neck of humerus that results in damage to axillary nerve results in ?

A

Numbness and loss of sensation over the shoulder and inability to abduct the arm to 90 degrees

84
Q

Transverse fractures of humerus are usually classified as?

A

Spiral fractures

85
Q

FRACTURE AT THE HUMERAL SHAFT MAY DAMAGE WHAT NERVE?

A

RADIAL NERVE

86
Q

What is the main symptom of radial nerve damage?

A

Wrist drop

87
Q

When drawing blood from medial cubital vein, must be careful to not puncture?

A

biceps tendon, brachial artery, median nerve
*if use cephalic or basilic vein instead-no worries, only muscle underneath

88
Q

INJURY TO DISTAL HUMERUS MAY DAMAGE WHAT NERVE?

A

MEDIAN NERVE

89
Q

INJURY TO MEDIAL EPICONDYLE OF HUMERUS MAY DAMAGE WHAT NERVE?

A

ULNAR NERVE

90
Q

WHAT CAN CAUSE WINGED SCAPULA?

A

THE LONG THORACIC NERVE ARISES FROM C5, C6, C7 NERVE ROOTS. IF THE ROOTS OR THE LONG THORACIC NERVE ITSELF IS DAMAGED, THE SERRATUS ANTERIOR WILL BE PARALYZED

91
Q

WHAT ARE THE SIGNS OF WINGED SCAPULA?

A

ARM CAN’T BE ABDUCTED ABOVE 90 DEGREES

SCAPULA MOVES LATERALLY AND POSTERIORLY

92
Q

Rotator cuff syndrome results in?

A

Shoulder pain induced by movement of the humerus that steadily worsens over time

Instability in the glenohumeral joint

Degenerative tendinitis and/or rupture of the supraspinatus tendon (most common injury)

93
Q

Why should you never push down on a broken clavicle?

A

Axillary artery/vein and cords of brachial plexus run underneath the clavicle

94
Q

WHICH MUSCLES OF THE UPPER EXTREMITY ARE LATERAL ROTATORS

A

POSTERIOR DELTOID
INFRASPINATUS
TERES MINOR

95
Q

WHICH MUSCLES OF THE UPPER EXTREMITY ARE MEDIAL ROTATORS?

A

SUBSCAPULARIS
TERES MAJOR
ANTERIOR DELTOID
PECTORALIS MAJOR
LATISSIMUS DORSI

96
Q

What nerve innervates deltoid?

A

axillary nerve

97
Q

What is the primary action of anterior deltoid?

A

flexes and medially rotates

98
Q

What is the primary action of medial deltoid?

A

Power abductor of arm starting from 15 to 90 degrees

99
Q

What is the primary action of the posterior deltoid

A

extends and laterally rotates

100
Q

What nerve innervates supraspinatous?

A

Suprascapular nerve

101
Q

What is the primary action of supraspinatous

A

initiates abduction of arm up to 15 degrees (then the deltoid kicks in )

102
Q

What is the primary action of teres major and also latissimus dorsi?

A

adducts, extends, and medially rotate

103
Q

What innervates pectoralis major?

A

Lateral and medial pectoral nerve

104
Q

What is the primary action of pectoralis major?

A

adducts, flexes, and medially rotates

105
Q

If a football player gets hit on the side wall of chest, what injury should you worry about?

A

Damage to the long thoracic nerve.

This paralyzes serratus anterior and results in winged scapula since serratus anterior can no longer hold shoulder in

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