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Anatomy II > Shoulder and Upper Arm > Flashcards

Shoulder and Upper Arm Flashcards

1
Q

Abduction of the arm at the glenohumeral joint is controlled predominantly by ___.

A

C5
Posterior cord C5-T1
axillary nerve

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2
Q

Flexion of the forearm at the elbow is controlled primarily by ___

A

C6
Lateral cordL C5-C7
musculocutaneous nerve

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3
Q

Extension of the forearm at the elbow joint, extension of the wrists, fingers, is controlled mainly by ____

A

C7
posterior cord C5-T1
radial nerve

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4
Q

Flexion of the fingers is controlled mainly by ____

A

C8
lateral/medial cord
C5, C6, C8 , T1
Median nerve

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5
Q

Abduction and adduction of the index, middle and ring fingers is controlled predominantly by ___

A

T1
medial cord: C8-T1
ulnar nerve

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6
Q

Acromioclavicular separation (A/C separation)

A

tear of the acromioclavicular ligament and coracoclavicular ligament
graded 1-6 least-worst
no matter what the grade is, skin tenting is what you need to assess acutely
skin tenting is a sign of skin death

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7
Q

Type I A/C Tear

A

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

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8
Q

Type III A/C Tear

A

a complete disruption of the AC ligament and the coracoclavicular ligament

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9
Q

Type II AC Dislocation

A

complete tear of the AC ligament

partial tear of the coracoclavicular ligament

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10
Q

What kind of assessment should be done in a clavicular fracture?

A

determine location- proximal, middle, or distal

proximal fractures are associated with injuries to structures underneath such as the vasculature and may require surgery

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11
Q

The coracoid process is the origin of…

A
  • coracobrachialis muscle (musculocutaneous nerve C5, C6, C7)
  • pectoralis minor muscle (medial pectoral nerve, C8)
  • short head of the biceps muscle (musculocutaneous nerve C5, C6, C7)
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12
Q

The greater tubercle is the origin of…

A

(SIT)
supraspinatus muscle (subscapular nerve, C5)
infraspinatus muscle (sub scapular nerve, C5)
teres minor muscle (axillary nerve, C5, C6)

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13
Q

The bicipital grove is the origin of…

A

pectorals major muscle (medial and lateral pectoral nerve, C5-T1)
latissimus dorsi muscle (the “miss” between two majors, thoracodorsal nerve, C6-C8)
teres minor muscle (subscapularis nerve, thoracodorsal nerve, C5-C8)

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14
Q

What should be considered if shoulder pain is on the skin?

A

referred pain from diaphragmatic irritation of the phrenic nerve (C3 C4 C5)
gallbladder pain referred to C4
pleurisy of lower lobes referred to C4
posterior duodenal ulcer

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15
Q

What should be considered with deep shoulder pain?

A

tear of the supraspinatus tendon
subdeltoid/subacromial bursitis
myositis, tendonitis, bursitis- generally no pain to passive movement
axillary nerve neuritis- deep pain secondary to abscess
tenosynovitis of long head of biceps- an “uppercut movement” gives pain, ordinarily with flexing of arm only short head used

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16
Q

What are the muscles of the rotator cuff?

A 
SITS 
supraspinatus 
infraspinatus 
teres minor 
subscapularis
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17
Q

What is the origin of the supraspinatus?

A

supraspinatus fossa of the scapula

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18
Q

What is the insertion of the supraspinatus?

A

greater tuberosity of humerus

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19
Q

What is the action of the supraspinatus?

A

initiates abduction of humerus (raising arm to side), stabilizes head of humerus in socket of shoulder joint

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20
Q

What is the origin of the subscapularis?

A

front surface of the scapula in subscapular fossa

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21
Q

What is the insertion of the subscapularis?

A

lesser tuberosity of the humerus

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22
Q

What is the action of the subscapularis?

A

internally rotates humerus, stabilizes head of humerus in socket of shoulder joint

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23
Q

What is the origin of the teres minor?

A

upper part of lateral border of scapula

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24
Q

What is the insertion of the teres minor?

A

back and lower part of the greater tuberosity of humerus

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25
Q

What is the action of the teres minor?

A

externally rotates hummers, stabilizes head of humerus in socket of shoulder joint

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26
Q

What nerve is called the 0-30 or the 0-15 degree nerve?

A

the supra scapular nerve (C5)

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27
Q

What does the supra scapular nerve innervate?

A

supraspinatus muscle

infraspinatus muscle

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28
Q

What muscle is called the 0-30 or the 0-15 degree muscle?

A

supraspinatus muscle

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29
Q

What is the action of the supraspinatus muscle?

A

abduction of the humerus (C5)

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30
Q

What is the action of the infraspinatus muscle?

A

external rotation of the humerus (C5)

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31
Q

What can impingement of the nerve in the supra scapular notch cause?

A

paralysis of the supraspinatus and infraspinatus muscle (b/c the supra scapular nerve innervates these two muscles)

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32
Q

Why is the greater tubercle tuberosity of the proximal humerus called the SIT tubercle?

A

Because these insert on it…
Supraspinatus muscle
Infraspinatus muscle
Teres minor muscle

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33
Q

What innervates the teres minor?

A

C5, C6 (axillary nerve)

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34
Q

What is the action of the teres minor muscle?

A

external rotation of the humerus

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35
Q

What innervates the subscapularis muscle?

A

C5, C6

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36
Q

Where does the subscapularis muscle insert?

A

lesser tubercle

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37
Q

What is the action of the subscapularis?

A

internal rotation of the humerus

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38
Q

What does the axillary nerve supply?

A

deltoid muscle

teres minor

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39
Q

What nerve is called the 30-90 or 15+ degree nerve?

A

axillary nerve

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40
Q

What muscle is called the 30-90 or 15+ degree muscle?

A

deltoid muscle

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41
Q

Which muscle is the major abductor of the arm?

A

deltoid

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42
Q

What are the three-fold actions of the deltoid?

A

anterior (bench press)
middle (main abductor)
posterior (bent over lateral raise)

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43
Q

What are the plain film findings of a chronic rotator cuff tear?

A

loss of space between humeral head and acromion secondary to chronic full thickness tear of supraspinatus tendon

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44
Q

What can cause shoulder impingement syndrome?

A

subacromial spur impinges on the supraspinatus tendon causing injury to the tendon

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45
Q

What structure accounts for 50% of the shoulder’s socket joint?

A

glenoid labrum

46
Q

What happens when the glenoid labrum is torn?

A

deep pain and a click

47
Q

What muscles adduct the humerus?

A

pectoralis major
teres major
latissimus dorsi

48
Q

What innervates the pectoralis major?

A

medial and lateral pectoral nerve C5-T1

49
Q

What innervates the teres major?

A

subscapular nerve/ thoracodorsal nerve (C5-C8)

50
Q

What innervates the latissimus dorsi?

A

thoracodorsal nerve (C6-C8)

51
Q

What passively stabilizes the shoulder?

A 
size, shape, and tilt of the glenoid fossa 
vacuum effect of the joint 
ligamentous structures (superior, middle, inferior glenohumeral ligament and coracohumeral ligament)
52
Q

What is the most important stabilizing structure in the shoulder?

A

the inferior glenohumeral ligament

53
Q

The Glenohumeral joint is a ____ joint

A

ball and socket

54
Q

True or False- the glenohumeral joint is unstable

A

true

55
Q

Glenohumeral instability can cause…

A

recurrent shoulder dislocations

56
Q

What kind of dislocation leaves the inferior glenohumeral ligament most vulnerable to damage?

A

anterior shoulder dislocation

57
Q

What can Glenohumeral Ligament Instability (GHLI) be secondary to?

A

congenital laxity
macro traumatic- secondary to an event
micro traumatic- secondary to a repetitive injury

58
Q

What is the most common shoulder dislocation?

A

anterior dislocation (90%)

59
Q

What is the mechanism of injury in an anterior shoulder dislocation?

A

arm abducted and externally rotated

60
Q

What percentage of anterior shoulder dislocations become recurrent?

A

40%

61
Q

What kind of injuries occur with an anterior shoulder dislocation?

A

bankart lesions
hill-sachs fracture
capsular tears
damage to the anterior band of the inferior glenohumeral ligament
damage to the axillary nerve (test sensory)

62
Q

What are bankart-lesions?

A

anterior glenoid labral injury and fracture of the anteroinferior glenoid

63
Q

What is a hill-sachs fracture?

A

fracture of the posterior superior humeral head

64
Q

What is a SLAP lesion?

A

superior labral tear from anterior to posterior

65
Q

How does a SLAP lesion occur?

A

secondary to overhead and throwing injuries

66
Q

True or False- Posterior dislocations of the shoulder are just as common as anterior dislocations

A

False- posterior dislocations are much more rare

67
Q

What is the Trough sign and what is it associated with?

A

reverse hill-sachs deformity, associated with posterior shoulder dislocation

68
Q

Luxatio Erecta refers to…

A

an inferior shoulder dislocation

69
Q

What is seen in an inferior shoulder dislocation?

A

arm is abducted, elevated, and fixed
humeral head is subcoracoid
there is usually an associated greater tuberosity fracture

70
Q

Calcific tendonitis is evidence of…

A

rotator cuff injury

71
Q

What are the nerve roots of the brachial plexus?

A

C5-T1

72
Q

What are the terminal branches of the brachial plexus?

A 
Most Alcoholics Must Really Urinate
Musculocutaneous 
Axillary 
Median 
Radial 
Ulnar
73
Q

What are the trunks of the brachial plexus?

A

superior or upper (C5-C6)
Middle (C7)
Inferior or Lower (C8-T1)

74
Q

What are the divisions of the brachial plexus?

A

anterior and posterior

75
Q

The cords in the brachial plexus are named in relation to which structure?

A

the axillary artery

76
Q

What are the cords of the brachial plexus?

A

anterior cord C5-T1
medial cord C5-T7
posterior cord C8-T1

77
Q

The median nerve gets input from which spinal nerve roots?

A

all of the roots- C5-T1

78
Q

The musculocutaneous nerve gets input from which spinal nerve roots?

A

C5-C7

79
Q

The radial nerve gets imput from which spinal nerve roots?

A

all of the nerve roots- C5-T1

80
Q

The ulnar nerve gets input from which spinal nerve roots?

A

C8-T1

81
Q

What do the superior rami innervate?

A

the proximal muscles of the upper limb (shoulder)

82
Q

What do the inferior rami innervate?

A

the distal muscles (hand muscles)

83
Q

What is the major function of the muscles in the arm?

A

they act mainly to move the forearm at the elbow joint

84
Q

What is the major function of the muscles in the forearm?

A

to move the hand at the wrist joint and fingers and thumb

85
Q

What is Erb’s palsy?

A

secondary to traumatic vaginal delivery- shoulder dystocia occurs when the baby’s anterior shoulder gets caught on the mother’s pubic bone and stretches the upper brachial plexus trunks

86
Q

Which nerve is the flexor-supinator of the forearm?

A

the musculocutaneous nerve (C5-C7)

87
Q

What does the musculocutaneous nerve innervate?

A

the anterior compartment of the arm
biceps brachii
brachialis
coracobrachialis

88
Q

What is the action of the biceps brachii?

A

flexor and supinator of the forearm (C6)

89
Q

What is the action of the brachialis?

A

the strong flexor of the forearm (C6)

90
Q

What is the action of the coracobrachialis?

A

weak adductor- the landmark muscle (C6)

91
Q

Which nerve is the extensor, assistant supinator of the upper extremity? (C5-T1)

A

the radial nerve

92
Q

What does the radial nerve innervate?

A

all muscles in the posterior compartment of the arm and forearm
triceps brachii
extensor (posterior) compartment- digiti, carpi, pollicis, indicis
assistant supinator
Saturday night paralysis nerve (humeral fractures)

93
Q

What is the action of the triceps brachii?

A

extensor of the elbow joint (C7)

94
Q

Which nerve is the flexor, pronator, thumb to finger approximator nerve?

A

median nerve (C5-T1)

95
Q

What nerve passes through the carpal tunnel?

A

median nerve

96
Q

What muscles does the median nerve innervate?

A 
all muscles in the anterior compartment of the forearm (exceptions) 
three thenar muscles of the thumb and two lateral lumbericals 
forearm flexors (exceptions)
97
Q

What nerve is the finger spreader-approximator, assistant forearm flexor nerve?

A

ulnar nerve (C8, T1)

98
Q

What nerve are you hitting on the “funny bone”?

A

ulnar nerve

99
Q

What muscles does the ulnar nerve innervate?

A

flexor carpi ulnaris
flexor digitorum profundus (4th and 5th fingers)
flexor digiti minimi (little finger flexor)
abductor digiti minimi (little finger abductor)
adductor pollicis (adducts thumb)

100
Q

What is Froment’s Sign?

A

cannot hold paper between thumb and palm or thumb and index finger
ulnar nerve?

101
Q

Where does the distal head of the biceps brachii muscle insert?

A

proximal radius (radial tuberosity)

102
Q

Which muscle is the flexor of the elbow?

A

biceps brachii

103
Q

which muscle is the supinator of the forearm?

A

biceps brachi

104
Q

Which muscle, along with the supinator muscle, is the “screwdriver” muscle?

A

biceps brachii

105
Q

Which muscle flexes the shoulder joint?

A

biceps brachii

106
Q

Which muscle is also called the corkscrew muscle?

A

biceps brachii

107
Q

What structure does the triceps insert on?

A

the olecranon process

108
Q

When assessing fractures, what should be looked at?

A

distal arterial blood flow and nerve function

109
Q

What should be assessed in a proximal humerus/surgical neck fracture?

A

axillary nerve and posterior circumflex humeral artery

110
Q

What should be evaluated in a midshaft humeral fracture?

A

the radial nerve and deep brachial artery

111
Q

What should be evaluated for involvement in distal humeral supracondylar fractures?

A

median nerve and brachial artery

112
Q

What can a fracture of the medial epicondyle involve?

A

ulnar nerve

Anatomy II (4 decks)

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