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A&P II - Exam 1 > Shoulder and Upper Arm > Flashcards

Shoulder and Upper Arm Flashcards

1
Q

the brachial salute involves which dermatomes

A

C5 - T1

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2
Q

C5 controls

A

abduction of the arm at the glenohumeral joint

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3
Q

C6 controls

A

flexion of the forearm at the elbow

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4
Q

C7 controls

A

extension of the forearm at the elbow joint

extension of wrist

extension of the fingers

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5
Q

C8 controls

A

flexion of the fingers

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6
Q

T1 controls

A

abduction/adduction of the index, middle, and ring fingers

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7
Q

post cord C5-T1 is innervated by the

A

axillary. n

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8
Q

lateral cord C5-C7 is innervated by the

A

musculocutaneous n

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9
Q

post cord C5-T1 is innervated by the

A

radial n

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10
Q

lateral/median cord 5, C6, C8, and T1 is innervated by the

A

median n

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11
Q

medial cord C8 and T1 is innervated by the

A

ulnar n

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12
Q

the coracovlavicular ligament includes what 2 ligaments

A

trapezoid ligament

conoid ligament

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13
Q

when evaluating tears of the acromicoclavicular and coracovlavicular ligaments, what is the most important factor in the physical assessment

A

skin tenting

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14
Q

A/C separations are graded __

through __

A

I-VI

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15
Q

a minor disruption of the AC joint with an intact coracoclavicular ligament is graded a

A

type I

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16
Q

a complete disruption of the AC ligament and the coracoclavicular ligament and the coracoclavicular ligament is classified as

A

type III

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17
Q

a complete tear of the A/C ligament with partial tear of the coracoclavicular ligament is classified as a

A

type II

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18
Q

when assessing clavicular fx, you need to determine if the location is

A

proximal third

middle third

distal third

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19
Q

___ clavicular fx are fraught with injury to structures underneath and may require surgery

A

proximal

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20
Q

2.8% of clavicular fractures are

A

proximal

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21
Q

proximal clavicular fx’s are group ___

A

III

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22
Q

list 2 causes of proximal third clavicular fx’s

A
  1. acute: multisystem trauma (MVC)
  2. stress fx: repetitive stress (ex rowing)
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23
Q

where on the humerus do fx’s usually occur

A

surgical neck

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24
Q

it is virtually impossible for fx’s to occur on which part of the humerus

A

anatomic neck

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25
Q

where is the suprascapular notch located

A

superior border of the scapula

just medial to the base of the coracoid process

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26
Q

what is the clinical significance of the suprascapular notch

A

it is a common site of entrapment of the suprascapular n

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27
Q

what muscles of the shoulder does the axillary nerve innervate

A

deltoid

triceps

teres minor

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28
Q

what 3 muscles originate at the coracoid process

A
  1. coracobrachialis m
  2. pectoralis minor m
  3. short head of biceps m
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29
Q

the greater tubercle (tuberosity) is the origin of what 3 muscles

A
  1. supraspinatus
  2. infraspinatus
  3. teres minor

SIT → rotator cuff

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30
Q

the bicipital groove is the origin of what 3 muscles

A
  1. pectoralis major m
  2. latissmus dorsi m → the miss between 2 majors
  3. teres major m
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31
Q

the coracobrachialis m AND the short head of the biceps are innervated by which nerves

A

musculocutaneous n

C 5, 6, 7

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32
Q

the pectoralis minor m is innervated by what nerves

A

medial pectoral n

C8

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33
Q

the supraspinatus AND infraspinatus m are innervated by which nerves

A

upper scapular n

C5

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34
Q

teres minor is innervated by what nerves

A

axillary

C 5, 6

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35
Q

pectoralis minor is innervated by what nerves

A

medial and lateral pectoral n

C5-T1

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36
Q

latissmus dorsi m is innervated by which nerves

A

thoracodorsal

C 6-8

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37
Q

teres major m is innervated by which nerves

subscapularis n

thoracodorsal n

C 5-8

A
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38
Q

irritation of the diaphragm is referred by which nerve

A

phrenic nerve

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39
Q

gallbladder pain is referred to via the __

__

A

C4

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40
Q

pleurisy of the lower lobes is referred via the __

to __

A

phrenic n

C4

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41
Q

what are some examples of deep pain in relation to the shoulder

A

tear of supraspinatus tendon

subdeltoid/subacromial bursitis

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42
Q

myositis, tendonitis, and bursitis do generally not cause pain with __ movement

A

passive

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43
Q

why might axillary neuritis occur

A

deep pain 2/2 to an abscess

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44
Q

what condition might you have if you have pain with an uppercut movement

A

tenosynovitis of long head of biceps

normally flexion of the arm only uses the short head of the biceps

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45
Q

what are the 4 muscles of the rotator cuff

A
  1. supraspinatus
  2. infraspinatus
  3. teres minor
  4. subscapularis

SITS

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46
Q

supraspinatus:

O:

I:

A:

A

O: supraspinatus fossa of scapula

I: greater tuberosity of humerus

A: abduction of humerus; stabilizes head of humerus

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47
Q

subscapularis:

O:

I:

A:

A

O: front surface of scapula in subscapular fossa

I: lesser tuberosity of humerus

A: internally rotates humerus; stabilizes head of humerus

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48
Q

infraspinatus:

O:

I:

A:

A

O: infraspinatus fossa of scapula

I: greater tuberosity of humerus

A: externally rotates shoulder

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49
Q

teres minor:

O:

I:

A:

A

O: upper part of lateral border of scapula

I: back and lower part of greater tuberosity of humerus

A: externally rotates humerus; stabilizes head of humerus

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50
Q

which muscle is the (0-30) 0-15 degree muscle

A

supraspinatus m

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51
Q

which nerve is called the 0-30 (0-15) degree n

A

suprascapular n

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52
Q

the suprascapular nerve innervates the

A

supraspinatus and infraspinatus muscles

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53
Q

impingement of the suprascapular n can cause

A

paralysis of the supraspinatus and infraspinatus muscles

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54
Q

which tubercle is the SIT tubercle

A

greater tubercle

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55
Q

the rotator cuff muscles include the __ muscles

plus the __

A

subscapularis m → inserts on the lesser tubercle

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56
Q

which nerve is also called the (30-90) or 15+ nerve

A

axillary n

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57
Q

which muscle is the (30-90) 15 + degree muscle

A

deltoid m

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58
Q

which muscle is the major abductor of the arm

A

deltoid m

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59
Q

which section of the deltoid muscle is the main abductor

A

medial

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60
Q

which section of the deltoid do you use to bench press

A

anterior

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61
Q

which section of the deltoid do you use for bend over lateral raises

A

posterior

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62
Q

what is shoulder impingement syndrome

A

when the acromiom rubs against or impinges the rotator cuff beneath it

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63
Q

shoulder impingement syndrome can cause a torn

A

supraspinatus tendon

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64
Q

chronic rotator cuff tears can cause loss of space between

A

the humeral head and the acromion

65
Q

which structure accounts for 50% of the area of the shoulder socket joint

A

glenoid labrum

66
Q

why might you feel deep pain and hear a click with shoulder movement

A

torn glenoid labrum

67
Q

what are the 3 adductors of the humerus

A
  1. pectoralis majaor
  2. teres major
  3. latissmus dorsi

the miss between 2 majors

68
Q

the muscle that inserts into the lesser tubercle/tuberosity ___ rotates the humerus

A

internally

69
Q

the muscle that inserts into the greater tubercle/tuberosity __ rotates the humerus

A

externally

70
Q

what are the 4 passive stabilizing structures of the shoulder

A
  1. glenoid fossa
  2. capsular structures
  3. glenoid labrum
  4. osseous structures
71
Q

name 2 characteristics of the glenoid fossa that help to stabilize the shoulder

A
  1. it is very shallow
  2. vacuum effect of the joint
72
Q

what are the 4 stabilizing ligaments of the glenoid fossa

A
  1. superior glenohumeral ligament
  2. middle glenohumeral ligament
  3. inferior glenohumeral ligament
  4. coracohumeral ligament
73
Q

what are the 2 stabilizing osseous structures of the shoulder

A
  1. acromion
  2. coracoid process
74
Q

what is the most important stabilizing structure of the shoulder

A

inferior glenohumeral ligament

75
Q

the glenohumeral joint is a ___ type of joint

and it is inherently ___

A

ball and socket

unstable

76
Q

what causes recurrent shoulder dislocations

A

glenohumeral instability

77
Q

which ligament of the glenohumeral joint is most vulnerable to damage in an anterior shoulder dislocation

A

inferior glenohumeral joint

78
Q

list 3 possible reasons for glenohumeral ligament instability (GHLI)

A
  1. congenital laxity
  2. macrotraumatic → 2/2 to an event
  3. microtraumatic → repetitive injury
79
Q

which type of shoulder dislocation accounts for 90% of cases

80
Q

what is the mechanism of injury for anterior shoulder dislocations

A

ar abducted and externally rotated

81
Q

what ligament fails in anterior shoulder dislocations

A

inferior glenohumeral ligament

82
Q

what % of anterior shoulder dislocations become recurrent

83
Q

what nerve is commonly injured in anterior shoulder dislocations

A

axillary n

84
Q

what 2 injuries can occur with anterior shoulder dislocations

A
  1. bankhard lesions
  2. hill-sachs fx
85
Q

what are bankhard lesions

A

anterior glenoid labral injury and fx of the anteroinferior glenoid

86
Q

what is a hill-sachs fx

A

fracture of the posterior superior humeral head

87
Q

what is a SLAP lesion

A

Superior Labral tear from Anterior to Posterior →

labrum torn from front to back (anterior to posterior)

88
Q

what does the Trough sign on MRI

A

posterior shoulder dislocation

89
Q

what does the Trough sign on MRI

A

posterior shoulder dislocation

90
Q

what is Luxatio Erecta

A

an inferior shoulder dislocation

91
Q

what position is the arm in after an inferior shoulder dislocation

A

arm is abducted, elevated, and fixed

92
Q

in an inferior shoulder dislocation, the humeral head is

A

subcoracoid

93
Q

what fracture usually accompanies an inferior shoulder dislocation

A

greater tuberosity fx

94
Q

what does “Reach To Drink Cold Beer” stand for

A

Roots

Trunks

Division

Cords

Branches (Nerves)

95
Q

map of the brachial plexus

96
Q

what does “Most Alcoholics Must Really Urinate” stand for

A

terminal branches of the brachial plexus:

Musculocutaneous

Axillary

Median

Radial

Ulnar

97
Q

what are the roots of the brachial plexus

98
Q

what are the trunks of the brachial plexus

A

superior/upper

middle

inferior or lower

99
Q

what are the divisions of the brachial plexus

A

anterior

posterior

100
Q

how are the cords of the brachial plexus named

A

by position relating to axillary artery

101
Q

what are the roots of the anterior cord of the brachial plexus

102
Q

what are the roots of the medial cord of the brachial plexus

103
Q

what are the roots of the posterior cord of the brachial plexus

104
Q

the shoulder rami of the brachial plexus are

105
Q

the superior rami of the brachial plexus innervate the

A

proximal muscles of the shoulder

106
Q

the inferior rami of the brachial plexus are

107
Q

the inferior rami of the brachial plexus innervate the

A

hand muscles

108
Q

C5 controls

A

abduction of the arm at the glenohumeral joint

109
Q

C6 controls

A

flexion of the forearm at the elbow

110
Q

C7 controls

A

extension of the forearm at the elbow joint

111
Q

C8 controls

A

flexion of the fingers

112
Q

the posterior branches of the brachial plexus innervate which muscle group

113
Q

the anterior branches of the brachial plexus innervate which muscle grup

114
Q

T1 controls

A

abduction and adduction of the index, middle, and ring fingers

115
Q

the musculocutaneous n innervates

A

all muscles in anterior compartment of the arm

116
Q

the median n innervates

A

most flexors in the forearm

thenar muscles in the hand

117
Q

the radial n innervates

A

all muscles in posterior compartment of arm and forearm

118
Q

the ulnar n innervates

A

most intrinsic m in hand

flexor carpi ulnaris

medial half of flexor digitorum profunda in forearm

119
Q

what is the flexor-supinator n of the forearm

A

musculocutaneous n

120
Q

which n innervates the anterior compartment of the arm

A

musculocutaneous

121
Q

what 3 muscles does the musculocutaneous n innervate

A
  1. biceps brachii
  2. brachialis
  3. coracobrachialis
122
Q

what are the 2 fxns of the biceps brachii

A

flexion

supination

123
Q

what is the fxn of the brachioradialis

A

strong flexor of the arm

124
Q

what is the fxn of the coracobrachialis

A

weak adductor

125
Q

the musculocutaneous n emerges from the __ cord of the brachial plexus, which branches from roots

__

A

lateral

C5-7

126
Q

which nerve emerges from the posterior compartment of the arm/forearm

A

radial nerve

127
Q

what is the fxn of the radial n

A

extensor

assistant supinator

128
Q

which roots control the radial n

129
Q

the radial n innervates

A

all the muscles in the posterior compartment of the arm and forearm

130
Q

what 4 muscles does the radial n innervates

A
  1. triceps brachii
  2. extensor compartment: digiti, carpi, pollicis, indicis
131
Q

what n is paralyzed in saturday night palsy and often with humerus fx

A

radial nerve

132
Q

what nerve emerges from roots C6-T1

A

median nerve

133
Q

what is the fxn of the median n

A

flexor

pronator

thumb to finger approximator

134
Q

what muscles does the median n innervate

A

flexor carpi radialis

palmaris longus

pronator quadratus

pronator teres

digital flexors

thenar muscles of the thumb

lateral lumbricals

135
Q

the median n innervates all the muscles of the forearm except

A

flexor carpi ulnaris

medial half of flexor digitorum profundus

136
Q

the median n passes thru the

A

carpal tunnel

137
Q

what is the fxn of the ulnar n

A

finger spreader →

approximator

assistant forearm

flexor

138
Q

which roots does the ulnar n emerge from

139
Q

what muscles does the ulnar n innervate

A
  1. flexor carpi ulnaris
  2. flexor digitorum profundus
  3. flexor digiti minimi
  4. adductor pollicis
140
Q

what is froment’s sign

A

can not hold paper btw thumb and palm or thumb and index finger → compensates w. flexor pollicis m

141
Q

what does ABOF the LAW mean

A

law: muscles of the hand are supplied by the ulnar n

abof the law: muscles that are supplied by the median n instead of the ulnar n

142
Q

what are the abof the law muscles

A

abductor pollicis brevis

opponens pollicis

flexor pollicis longus and brevis

lateral two lumbricals → index finger and long finger

143
Q

the intrinsic muscles of the hand are on the

A

palmar surface

144
Q

what are the intrinsic muscles

A

A OF A OF A:

thenar:

abductor pollicis brevis

opponens pollicis

flexor pollicis longus and brevis

adductor pollicis (neither thenar or hypothenar)

hypothenar:

opponens digiti minimi

flexor digiti minimi

abductor digiti minimi

145
Q

all of the muscles of the thumb are innervated by the median n, except for

A

adductor pollicis

146
Q

which n innervates the adductor policis

147
Q

what are the thenar muscles

A

flexor pollicis brevis

opponens pollicis

abductor pollicis brevis

148
Q

what is the million dollar n

A

the recurrent branch to the thenar muscles

149
Q

what is the superior border of the axilla

A

outer border of the 1st rib

superior border of the

scapula posterior border of the clavicle

150
Q

what is the anterior border of the axilla

A

pectoralis major

pectoralis minor

anterior axillary fold

151
Q

what is the posterior border of the axilla

A

subscapularis

teres major

latissmus

posterior axillary fold

152
Q

what is the medial border of the axilla

A

rib cage

serratus anterior

153
Q

what is the lateral border of the axilla

A

interbubercular sulcus

154
Q

what is the floor of the axilla

155
Q

what are the contents of the axilla

A

axillary artery

axillary vein

brachial plexus → divisions, cords, branches

lymphatics and nodes

tail of the breast

short head of biceps brachii

coracobrachialis

156
Q

the axilla receives 75% of its drainage from

A

the breast

157
Q

what cranial nerve controls the shoulder

158
Q

what are the 5 muscles of the arm

A

all contain brachi:

biceps brachii

brachialis

coracobrachialis

brachioradialis

triceps brachii

A&P II - Exam 1 (3 decks)

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