Shoulder Girdle and Arm Flashcards
1
Q
shoulder girdle consists of the
A
clavicle and scapula
2
Q
clavicle and scapula articulate with one another at this joint
A
acromioclavicular
3
Q
long, slender bone that lies horizontally across the root of the neck just beneath the skin
A
clavicle
4
Q
clavicle articulates with this/these structures medially
A
sternum and 1st costal cartilage
5
Q
the clavicle articulates with this structure laterally
A
acromion process of the scapula
6
Q
the clavicle acts as a ____
A
strut that holds the arm away from the trunk
7
Q
clavicle transmits forces from the upper limb to the
A
axial skeleton
8
Q
medial two thirds of the clavicle is
a. convex forward
b. concave forward
A
a. convex forward
9
Q
flat triangular bone
A
scapula
10
Q
scapula location
A
posterior chest wall
between 2nd and 7th ribs
11
Q
on the posterior surface of the scapula, this projects backward
A
spine of the scapula
12
Q
lateral end of the spine of scapula is free and forms the
A
acromion
13
Q
this angle of the scapula forms the glenoid cavity or fossa
A
superolateral angle of the scapula
14
Q
shape of glenoid cavity
A
pear-shaped
15
Q
glenoid cavity artiulates with
A
head of the humerus at shoulder joint
16
Q
projects upward and forward above the glenoid cavity
provides attachment for muscles and ligaments
A
coracoid process
17
Q
medial to the base of the coracoid process is the
A
suprascapular notch
18
Q
anterior surface of the scapula is
a. concave
b. convex
A
a. concave
19
Q
spine of the scapula
position
A
posterior surface
20
Q
acromion position
A
lateral
21
Q
glenoid cavity
position
A
lateral
22
Q
coracoid process location
A
lateral
23
Q
subscapular surface
postion
A
anterior
24
Q
concave anterior surface of the scapula forms the shallow
A
subscapular fossa
25
this surface of the scapula is divided by the spine
posterior surface
26
posterior surface of the scapula is divided by the spine into
supraspinous fossa
| infraspinous fossa
27
this part of scapula can be palpated easily in a living subject
inferior angle of scapula
28
inferior angle, marks this level
7th rib
| spine of 7th thoracic vertebra
29
most commonly fractured bone in the body.
clavicle
30
clavicular fracture usually occurs as a result of
fall on the shoulder
| fall on an outstretched hand
31
weakest point of the clavicle
middle and outer thirds
32
this fragment of the clavicle will get depressed by weight of the arm, if it is fractured
lateral fragment
33
what will pull the lateral fragment of the clavicle, after fracture, medially and forward
strong adductor muscles of the shoulder joint
| esp. pectoralis major
34
position of clavicle after fracture
lateral fragment depressed, pulled medially and forwards
medial end, tilted upward
35
what pulls the medial end of clavicle upward after fracture
sternocleidomastoid muscle
36
this nerves cause persistent pain over the side of the neck after clavicular fracture
supraclavicular nerves
37
group of disorders that occur when blood vessels or nerves in the space between your collarbone and first rib are compressed
thoracic outlet syndrome
38
clinical manifestations expected from thoracic outlet syndrome
pain in shoulders and neck
| numbness in fingers
39
fractures of the scapula are due to
a. severe trauma
b. mild trauma
a. severe trauma
such as run-over accident victims
automobile accidents
40
most fractures of the scapula require little treatment because
muscles on the anterior and posterior surfaces adequately splint the fragments
41
what maintains the position of the scapule on the posterior wall
tone and balance of muscles attached to it
42
paralysis of the trapezius results in
dropped shoulder
43
paralysis of the serratus anterior
winged scapula
44
humerus articulates with
scapula at shoulder joint
radius and ulna at elbow joint
45
upper end of the humerus has a
head
46
the head of the humerus forms this shape
1/3 of a sphere
47
humerus articulates with
glenoid cavity of the scapula
48
below the head of the humerus is the
anatomic neck
49
below the neck of the humerus is
greater and lesser tuberosities
50
what separates the greater and lesser tuberosities
bicipital groove
51
where the upper end of the humerus joints the shaft is a
narrow surgical neck
52
halfway down the lateral aspect of the shaft is a roughened elevation called
deltoid tuberosity
53
this landmark accomodates the radial nerve
spiral groove
54
behind and below the deltoid tuberosity
spiral groove
55
lower end of the humerus possesses
```
medial and lateral epicondyles
capitulum
trochlea
radial fossa
coronoid fossa
olecranon fossa
```
56
this landmark of humerus is for articulation with the head of the radius
capitulum
57
this landmark of humerus is for articulation with the trochlear notch of the ulna
trochlea
58
shape of the trochlea
pulley-shaped
59
above the capitulum is
radial fossa
60
above the trochlea anteriorly
coronoid fossa
61
receives the head of the radius whent he elbow is flexed
radial fossa
62
receives the coronoid process of ulna
coronoid fossa
63
above the trochlea posteriorly
olecranon fossa
64
receives the olecranon process of ulna
landmark on humerus
olecranon fossa
65
elbow is flexed
which fossa receives
a. olecranon fossa
b. radial fossa
b. radial fossa
66
elbow is extended
which fossa receives
a. olecranon fossa
b. radial fossa
a. olecranon fossa
67
fractures of the proximal end of the humerus
humeral head fractures
greater tuberosity fractures
lesser tuberosity fractures
surgical neck fractures
68
fractures of the humerl head can occur during
process of anterior and posterior dislocations of the shouldeer joint
69
what happens when the glenoid labrum of the scapula produces the fracture, and the labrum becomes jammed in the defect
makes reduction of the shoulder joint difficult
70
greater tuberosity of the humerus can be fractured by
direct trauma
displaced by glenoid labrum during dislocation of the shoulder joint
avulsed by violent contractions of the supraspinatus muscle
71
bone fragment of a greater tuberosity fracture will have attachments of
supraspinatus, teres minor, infraspinatus muscles (part of rotator cuff muscles)
72
When associated with a shoulder dislocation, severe tearing of the cuff with the fracture can result in the greater tuberosity remaining ___________ after the shoulder joint has been reduced
displaced posteriorly
73
When associated with a shoulder dislocation, severe tearing of the cuff with the fracture can result in the greater tuberosity remaining displaced posteriorly after the shoulder joint has been reduced.
tx
open reduction of the fracture is necessary to attach the rotator cuff back into place.
74
lesser tuberosity fracture accompanies _____ dislocation of the shoulder joint
a. posterior
b. anterior
a. posterior
75
Lesser Tuberosity Fractures
bone fragment receives the insertion of
subscapularis tendon
76
surgical neck of the humerus
can be fractured by
direct blow on the lateral aspect of the shoulder
indirect manner by falling on the outstretched hand.
77
Fractures of the humeral shaft
displacement of the fragments depends on the relation of the site of fracture to the insertion of the
deltoid muscle
78
When the fracture line is proximal to the deltoid insertion, the proximal fragment is
adducted by the
| pectoralis major, latissimus dorsi, and teres major muscles
79
Fractures of the Shaft of the Humerus (proximal to deltoid insertion)
distal fragment is
pulled proximally by deltoid, biceps, and triceps
80
When the fracture is distal to the deltoid insertion, the proximal fragment and distal fragment is
proximal fragment - abducted by the deltoid
distal fragment - pulled proximally by the biceps and triceps
81
what nerve lies in the spiral groove
radial nerve
82
on what surface of the humerus is the spiral groove
posterior
83
radial nerve lying on the spiral groove is under the cover of what muscle
triceps muscle
84
supracondylar fractures are common in this population
children
85
Supracondylar fractures
| occur when the
child falls on the outstretched hand with the elbow partially flexed
86
supracondylar fractures
| nerve injury
median, radial, and ulnar nerves
87
does function usually quickly returns after reduction of the Supracondylar fractures
yes
88
this artery can be damaged or pressure can be applied in Supracondylar fractures
brachial artery
89
Damage to or pressure on the brachial artery can occur at the time of the fracture or from swelling of the surrounding tissues; the circulation to the forearm may be interfered with, leading to
Volkmann’s ischemic contracture
90
can be avulsed by the medial collateral ligament of the elbow joint if the forearm is forcibly abducted
medial epicondyle
91
can be injured at the time of the fracture (medial epicondyle avulsion)
ulnar nerve
92
role of ulnar nerve in a medial epicondyle fracture
repair p cess of the fracture (in the callus)
irritation on the irregular bony surface after the bone fragments are reunited
93
Anterior wall of the axilla
pectoralis major
subclavius
pectoralis minor
94
shape of the axilla or armpit
pyramid-shaped space
95
upper end of the axilla
apex
96
apex
| bound anteriorly by
clavicle
97
apex
| bound posteriorly by
upper border of the scapula
98
apex
| bound medially by
outer border of the first rib
99
lower end of axilla
base
100
lower end, or base of axilla, is bounded in front by
anterior axillary fold
101
anterior axillary fold formed by the lower border of this muscle
pectoralis major muscle
102
lower end, or base of axilla, is bounded in behind by
posterior axillary fold
103
posterior axillary fold is formed by
tendon of latissimus dorsi a
| teres major muscle
104
the base of the axilla is bound medially by the
chest wall
105
posterior wall
| axilla
subscapularis
latissimus dorsi
teres major muscles
106
medial wall
| axilla
upper four or five ribs and the intercostal spaces
| serratus anterior
107
lateral wall
| axilla
coracobrachialis
| biceps muscles in the bicipital groove of the humerus
108
triangular muscle that lie pectoralis major
Pectoralis Minor
109
Pectoralis Minor
| arises from
3rd, 4th, and 5th ribs
110
insertion
| pectoralis minor
coracoid process (scapula)
111
It is used when describing the axillary artery to divide it into three parts
pectoralis minor
112
nerves and arteries crossed by the pectoralis minor
axillary artery
| brachial plexus
113
strong sheet of connective tissue that is attached above to the clavicle
clavipectoral fascia
114
clavipectoral fascia
| it splits to enclose the pectoralis minor muscle and then continues downward as the
suspensory ligament of the axilla
115
this important nerve plexus is in the axilla
brachial plexus
116
important artery in the axilla
axillary artery and its branches
117
supplies blood to the upper limb
axillary artery
118
drain blood from upper limb
axillary vein
119
the structures in the axilla are embedded in
fat
120
axillary artery begins at
begins at the lateral border of the 1st rib
121
axillary artery is a continuation of the
subclavian
122
The axillary artery ends at the
lower border of the teres major muscle
123
at the lower border of the teres major muscle
the axillary artery continues as the
brachial artery
124
Throughout its course, the axillary artery is closely related to the cords of the
brachial plexus and their branches
125
axillary artery and cords of the brachial plexus and their branches
is enclosed in a connective tissue sheath called the
axillary sheath
126
axillary sheath
upward
is continuous with the
prevertebral fascia
127
this muscle crosses in front of the a lary artery and divides it into three parts
pectoralis minor muscle
128
First Part of the Axillary Artery This extends from the
lateral border of the 1st rib to the upper border of the pectoralis minor
129
Second Part of the Axillary Artery
lies behind the pectoralis minor muscle
130
Third Part of the Axillary Artery
extends from the lower border of the pectoralis minor to the lower border of the teres major
131
anterior
| First Part of the Axillary Artery
pectoralis major
| cephalic vein
132
First Part of the Axillary Artery
| posterior
long thoracic nerve
133
First Part of the Axillary Artery
| lateral
three cords of the brachial plexus
134
First Part of the Axillary Artery
| medially
axillary vein
135
Second Part of the Axillary Artery
| anterior
pectoralis minor
| pectoralis major
136
Second Part of the Axillary Artery
| Posteriorly
posterior cord of the brachial plexus
subscapularis muscle
shoulder joint
137
Second Part of the Axillary Artery
| medially
medial cord of the brachial plexus
| axillary vein
138
is the most commonly missing part of an Absent Pectoralis Major
sternocostal origin
139
Second Part of the Axillary Artery
| Laterally
lateral cord of brachial plexus
140
absent sternocostal origin of pectoralis major may cause
weakness in adduction and medial rotation of the shoulder joint.
141
Third Part of the Axillary Artery
| anterior
pectoralis major
| medial root of the median nerve
142
Posteriorly
| Third Part of the Axillary
subscapularis
latissimus dorsi
teres major
axillary
radial nerves
143
Third Part of the Axillary Artery
| Laterally
coracobrachialis
biceps
humerus
lateral root of the median and musculocutaneous nerves
144
Medially
| Third Part of the Axillary Artery
ulnar nerve
axillary vein
medial cutaneous nerve
145
first branch of Axillary Artery, is small and runs runs along the upper border of the pectoralis minor.
highest thoracic artery
146
second part of the branches of the axillary artery, which immediately divides into terminal branches
thoracoacromial artery
147
this branch of the axillary artery runs along the lower border of the pectoralis minor
lateral thoracic artery
148
second part of the axillary artery after highest thoracic artery
thoracoacromial artery
| lateral thoracic artery
149
third part of the branches of the axillary artery, runs along the lower border of the subscapularis muscle.
subscapular arter
150
third part of axillary artery, wind around the front and the back of the surgical neck of the humerus, respectively
anterior and posterior circumflex humeral arteries
151
The axillary vein (Fig. 9.12) is formed at the lower border of the
teres major muscle
152
axillary vein is formed by the
venae comitantes of the brachial artery
| basilic vein
153
location of the axillary vein
lower border of thhe teres major muscle
runs upward on the medial side of the axillary artery
ends at the lateral border of the 1st rib
154
at the lateral border of the 1st rib, the axillary vein becomes
subclavian vein.
155
the axillary vein receives tributaries, which correspond to the branches of the
axillary artery, and the cephalic vein
156
Spontaneous thrombosis of the axillary vein occasionally occurs after
excessive and unaccustomed movements of the arm at the shoulder joint
157
axillary sheath encloses
axillary vessels and brachial plexus
158
how is a brachial plexus nerve block achieved
distal part of the sheath is closed with finger pressure, and a syringe needle is inserted into the proximal part of the sheath. The anesthetic solution is then injected into the sheath, and the solution is massaged along the sheath to produce the nerve block.
159
The position of the axillary sheath can be verified by
feeling the pulsations of the third part of the axillary artery
160
third part of the axillary artery
subscapular artery
| anterior and posterior circumflex humeral arteries
161
important functions of nerves in the brachial plexus
sensory innervation to the skin and deep structures (the joints)
motor innervation to the muscles
diameters of the blood vessels by the sympathetic vasomotor nerves
sympathetic secretomotor supply to the sweat glands
162
At the root of the neck, the nerves form a complicated plexus called the
brachial plexus
163
location of the brachial plexus
posterior triangle of the neck
164
bbrachial plexus is formed by what nerves
union of the anterior rami of the 5th, 6th, 7th, and 8th cervical and the 1st thoracic spinal nerves
165
brachial plexus can be divided into
roots
trunks
divisions
cords
166
upper trunk
roots of C5 and 6
167
middle trunk
root of C7
168
lower trunk.
C8 and T1
169
anterior divisions of the upper and middle trunks unite to form the
lateral cord
170
anterior division of the lower trunk continues as the
medial cord
171
posterior divisions of all three trunks join to form the
posterior cord
172
The roots, trunks, and divisions of the brachial plexus reside in the
lower part of the posterior triangle of the neck
173
The cords become arranged around this structure
axillary artery
174
position of the cords of the brachial plexus to the first part of the axillary artery
above and lateral
175
this cord of the brachial plxus crosses behind the axillary artery to reach the medial side of the second part of the artery
medial cord
176
this cord lies behind the second part of the artery
posterior cord
177
this cord lies on the lateral side of the second part of the artery
lateral cord
178
the cords of the plexus have the relationship to the ______________ that is indicated by their names
second part of the axillary artery
179
The rotator cuff consists of the tendons of the
subscapularis, supraspinatus, infraspinatus, and teres minor muscles
(fused to the underlying capsule of the shoulder joint)
180
role of the Rotator Cuff
stabilizing the shoulder joint by pressing the humeral head into the glenoid cavity
181
Failure of the rotator cuff is due to either
wear ( Degenerative changes in the bursa are followed by degenerative changes in the underlying supraspinatus tendon, and these may extend into the other tendons of the rotator cuff)
and tear
182
During abduction of the shoulder joint, this tendon is exposed to friction against the acromion
supraspinatus tendon
183
Under nomal conditions, the amount of friction (between supraspinatus tendon and acromion) is reduced to a minimum by
the large subacromial bursa, which extends laterally beneath the deltoid
184
Rotator Cuff Tendinitis (when the subacromial bursa degenerates which results in degeneration of supraspinatus tendon)
Clinically, the condition is known as
subacromial bursitis, s spinatus tendinitis, or pericapsulitis
185
It is characterized by the presence of a spasm of pain in the middle range of abduction, when the diseased area impinges on the acromion.
Rotator Cuff Tendinitis
186
Rotator Cuff Tendinitis
| Extensive acute traumatic tears are best repaired
surgically as soon as possible
187
Small chronic cuff injuries are best managed
without surgery using nonsteroidal anti-inflammatory drugs and muscle exercises
188
In advanced cases of rotator cuff tendinitis, the necrotic supraspinatus tendon can become
calcified or rupture
189
Rupture of the supraspinatus tendon seriously interferes with the
normal abduction movement of the shoulder joint
190
main function of the supraspinatus muscle
hold the head of the humerus in the glenoid fossa at the commencement of abduction
191
The patient with a ruptured supraspinatus tendon is unable to
initiate abduction of the arm
192
The patient with a ruptured supraspinatus tendon is unable to initiate abduction of the arm. However, if the arm is passively assisted for the first _______ of abduction, the ______ can then take over and complete the movement to a right angle.
15°
| deltoid
193
The accessory nerve can be injured as the result of
stab wounds to the neck
194
The axillary nerve can be injured in
dislocations of the s der joint
195
how to preserve the upper limb when it is necessary to ligate axillary artery
existence of the anastomosis (anastomosing circle by circumflex arteries) around the shoulder joint
