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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
What is the action of the teres minor?
externally rotates hummers, stabilizes head of humerus in socket of shoulder joint
26
What nerve is called the 0-30 or the 0-15 degree nerve?
the supra scapular nerve (C5)
27
What does the supra scapular nerve innervate?
supraspinatus muscle | infraspinatus muscle
28
What muscle is called the 0-30 or the 0-15 degree muscle?
supraspinatus muscle
29
What is the action of the supraspinatus muscle?
abduction of the humerus (C5)
30
What is the action of the infraspinatus muscle?
external rotation of the humerus (C5)
31
What can impingement of the nerve in the supra scapular notch cause?
paralysis of the supraspinatus and infraspinatus muscle (b/c the supra scapular nerve innervates these two muscles)
32
Why is the greater tubercle tuberosity of the proximal humerus called the SIT tubercle?
Because these insert on it... Supraspinatus muscle Infraspinatus muscle Teres minor muscle
33
What innervates the teres minor?
C5, C6 (axillary nerve)
34
What is the action of the teres minor muscle?
external rotation of the humerus
35
What innervates the subscapularis muscle?
C5, C6
36
Where does the subscapularis muscle insert?
lesser tubercle
37
What is the action of the subscapularis?
internal rotation of the humerus
38
What does the axillary nerve supply?
deltoid muscle | teres minor
39
What nerve is called the 30-90 or 15+ degree nerve?
axillary nerve
40
What muscle is called the 30-90 or 15+ degree muscle?
deltoid muscle
41
Which muscle is the major abductor of the arm?
deltoid
42
What are the three-fold actions of the deltoid?
anterior (bench press) middle (main abductor) posterior (bent over lateral raise)
43
What are the plain film findings of a chronic rotator cuff tear?
loss of space between humeral head and acromion secondary to chronic full thickness tear of supraspinatus tendon
44
What can cause shoulder impingement syndrome?
subacromial spur impinges on the supraspinatus tendon causing injury to the tendon
45
What structure accounts for 50% of the shoulder's socket joint?
glenoid labrum
46
What happens when the glenoid labrum is torn?
deep pain and a click
47
What muscles adduct the humerus?
pectoralis major teres major latissimus dorsi
48
What innervates the pectoralis major?
medial and lateral pectoral nerve C5-T1
49
What innervates the teres major?
subscapular nerve/ thoracodorsal nerve (C5-C8)
50
What innervates the latissimus dorsi?
thoracodorsal nerve (C6-C8)
51
What passively stabilizes the shoulder?
``` size, shape, and tilt of the glenoid fossa vacuum effect of the joint ligamentous structures (superior, middle, inferior glenohumeral ligament and coracohumeral ligament) ```
52
What is the most important stabilizing structure in the shoulder?
the inferior glenohumeral ligament
53
The Glenohumeral joint is a ____ joint
ball and socket
54
True or False- the glenohumeral joint is unstable
true
55
Glenohumeral instability can cause...
recurrent shoulder dislocations
56
What kind of dislocation leaves the inferior glenohumeral ligament most vulnerable to damage?
anterior shoulder dislocation
57
What can Glenohumeral Ligament Instability (GHLI) be secondary to?
congenital laxity macro traumatic- secondary to an event micro traumatic- secondary to a repetitive injury
58
What is the most common shoulder dislocation?
anterior dislocation (90%)
59
What is the mechanism of injury in an anterior shoulder dislocation?
arm abducted and externally rotated
60
What percentage of anterior shoulder dislocations become recurrent?
40%
61
What kind of injuries occur with an anterior shoulder dislocation?
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
What are bankart-lesions?
anterior glenoid labral injury and fracture of the anteroinferior glenoid
63
What is a hill-sachs fracture?
fracture of the posterior superior humeral head
64
What is a SLAP lesion?
superior labral tear from anterior to posterior
65
How does a SLAP lesion occur?
secondary to overhead and throwing injuries
66
True or False- Posterior dislocations of the shoulder are just as common as anterior dislocations
False- posterior dislocations are much more rare
67
What is the Trough sign and what is it associated with?
reverse hill-sachs deformity, associated with posterior shoulder dislocation
68
Luxatio Erecta refers to...
an inferior shoulder dislocation
69
What is seen in an inferior shoulder dislocation?
arm is abducted, elevated, and fixed humeral head is subcoracoid there is usually an associated greater tuberosity fracture
70
Calcific tendonitis is evidence of...
rotator cuff injury
71
What are the nerve roots of the brachial plexus?
C5-T1
72
What are the terminal branches of the brachial plexus?
``` Most Alcoholics Must Really Urinate Musculocutaneous Axillary Median Radial Ulnar ```
73
What are the trunks of the brachial plexus?
superior or upper (C5-C6) Middle (C7) Inferior or Lower (C8-T1)
74
What are the divisions of the brachial plexus?
anterior and posterior
75
The cords in the brachial plexus are named in relation to which structure?
the axillary artery
76
What are the cords of the brachial plexus?
anterior cord C5-T1 medial cord C5-T7 posterior cord C8-T1
77
The median nerve gets input from which spinal nerve roots?
all of the roots- C5-T1
78
The musculocutaneous nerve gets input from which spinal nerve roots?
C5-C7
79
The radial nerve gets imput from which spinal nerve roots?
all of the nerve roots- C5-T1
80
The ulnar nerve gets input from which spinal nerve roots?
C8-T1
81
What do the superior rami innervate?
the proximal muscles of the upper limb (shoulder)
82
What do the inferior rami innervate?
the distal muscles (hand muscles)
83
What is the major function of the muscles in the arm?
they act mainly to move the forearm at the elbow joint
84
What is the major function of the muscles in the forearm?
to move the hand at the wrist joint and fingers and thumb
85
What is Erb's palsy?
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
Which nerve is the flexor-supinator of the forearm?
the musculocutaneous nerve (C5-C7)
87
What does the musculocutaneous nerve innervate?
the anterior compartment of the arm biceps brachii brachialis coracobrachialis
88
What is the action of the biceps brachii?
flexor and supinator of the forearm (C6)
89
What is the action of the brachialis?
the strong flexor of the forearm (C6)
90
What is the action of the coracobrachialis?
weak adductor- the landmark muscle (C6)
91
Which nerve is the extensor, assistant supinator of the upper extremity? (C5-T1)
the radial nerve
92
What does the radial nerve innervate?
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
What is the action of the triceps brachii?
extensor of the elbow joint (C7)
94
Which nerve is the flexor, pronator, thumb to finger approximator nerve?
median nerve (C5-T1)
95
What nerve passes through the carpal tunnel?
median nerve
96
What muscles does the median nerve innervate?
``` all muscles in the anterior compartment of the forearm (exceptions) three thenar muscles of the thumb and two lateral lumbericals forearm flexors (exceptions) ```
97
What nerve is the finger spreader-approximator, assistant forearm flexor nerve?
ulnar nerve (C8, T1)
98
What nerve are you hitting on the "funny bone"?
ulnar nerve
99
What muscles does the ulnar nerve innervate?
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
What is Froment's Sign?
cannot hold paper between thumb and palm or thumb and index finger ulnar nerve?
101
Where does the distal head of the biceps brachii muscle insert?
proximal radius (radial tuberosity)
102
Which muscle is the flexor of the elbow?
biceps brachii
103
which muscle is the supinator of the forearm?
biceps brachi
104
Which muscle, along with the supinator muscle, is the "screwdriver" muscle?
biceps brachii
105
Which muscle flexes the shoulder joint?
biceps brachii
106
Which muscle is also called the corkscrew muscle?
biceps brachii
107
What structure does the triceps insert on?
the olecranon process
108
When assessing fractures, what should be looked at?
distal arterial blood flow and nerve function
109
What should be assessed in a proximal humerus/surgical neck fracture?
axillary nerve and posterior circumflex humeral artery
110
What should be evaluated in a midshaft humeral fracture?
the radial nerve and deep brachial artery
111
What should be evaluated for involvement in distal humeral supracondylar fractures?
median nerve and brachial artery
112
What can a fracture of the medial epicondyle involve?
ulnar nerve

Anatomy II (4 decks)

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