Shoulder & Pectoral Region

Question 1

What are the three kinds of fascia?

Answer 1

1. Pectoral Fascia
2. Axillary Fascia
3. Clavipectoral Fascia

Question 2

Pectoral Fascia

Answer 2

SUPERIORLY attaches to clavicle and sternum

• continuous inferiorly with the fascia of the anterior abdominal wall
• covers pectoralis major m.
• deep to platisma m.

Question 3

Clavipectoral fascia

Answer 3

• deep to pectoralis major
• descends from clavicle
• encloses subclavius m. and pectoralis minor m.
• inferior to pectoralis minor becomes suspensory ligament of the axilla
• pulls the skin of the axilla superiorly with shoulder abduction

Question 4

axillary fascia

Answer 4

• continuation of pectoral fascia laterally
• forms the floor of the axilla
• very fatty and filled with lymph nodes and veins
• need fat to protect the nerves and arteries that pass through there to upper extremity
• in the deep armpit region

Question 5

what does the pectoral fascia cover?

Answer 5

pectoralis major

Question 6

what does clavipectoral fascia enclose?

Answer 6

• subclavius m.

- pectoralis minor m.

Question 7

the axillary fascia is continuous of pectoral fascia in which direction?

Answer 7

laterally

Question 8

what is located on C4/C5?

Answer 8

clavicle

Question 9

What is located on T4?

Answer 9

nipples

Question 10

what is located on T10?

Answer 10

umbilicus

-belly button

Question 11

pectoralis major

Answer 11

large, fan-shaped muscle covering most of anterior thoracic wall

• pulling on humerus gives medial rotation
• allows for adduction and flexion

innervated by: medial and lateral pectoral nerve

Question 12

pectoralis minor

Answer 12

origin: 3rd to 5th ribs
insertion: caracoid process of the scapula

-landmark for axillary structures (axillary a.)

• function: pulls the scapula medially, forward, and downward
• aids in respiration

innervated by: medial pectoral nerve

Question 13

serratus anterior

Answer 13

“boxers/swimmers” muscles

• sawtoothed muscle helps stabilize scapula
• lateral surfaces of upper 8-9 ribs
• hugs the rib cage and goes around to posterior border and inserts at medial border of scapula from underneath side

Question 14

what is the serratus anterior innervated by?

Answer 14

long thoracic nerve

Question 15

what happens if the long thoracic nerve is injured or torn?

Answer 15

winging of scapula

Question 16

what are the functions of the serratus anterior?

Answer 16

when contracts it will pull the scapula forward

• helps keep medial border of scapula down and attached to chest

Question 17

what is the serratus anterior attached to?

Answer 17

the ribs

Question 18

what is the deltoid attached to?

Answer 18

humerus

Question 19

what is the trapezius insertion?

Answer 19

• lateral 1/3 of clavicle
• medial side of acromion
• upper crest and tubercle of scapular spine

Question 20

supraspinatus initiates abduction up to how many degrees?

Answer 20

0-15 degrees

Question 21

what degrees can the deltoid abduct?

Answer 21

15-90 degrees

Question 22

what muscle completes the abduction of the humerus? how many degrees?

Answer 22

trapezius

180 degrees

Question 23

where is the axillary nerve located?

Answer 23

brachial plexus

Question 24

what muscles allow for the greater movement of the shoulder?

Answer 24

rotator cuff muscles

Question 25

what 4 muscles make up the rotator cuffs? [S i t S]

Answer 25

supraspinatus infraspinatus teres minor subscapularis

Question 26

what muscle is most frequently torn in rotator cuff injuries?

Answer 26

supraspinatus

Question 27

T or F. Supraspinatus rotates the humerus

Answer 27

FALSE. it does not rotate humerus -it INITIATES abduction of the arm

Question 28

if you remove the deltoid what muscles will be seen?

Answer 28

rotator cuff muscles

Question 29

what is the roll of the rotator cuff muscles?

Answer 29

hold humerus into joint -give great flexibility -easier to dislocate & injure

Question 30

teres major

Answer 30

adducts and medially rotates arm -similiar function to latissimus dorsi (smaller)

Question 31

latissimus dorsi

Answer 31

extends, adducts, and medially rotates humerus at shoulder

Question 32

levator scapulae

Answer 32

elevates scapula medially, inferiorly rotates glenoid cavity

Question 33

rhomboids

Answer 33

fix scapula to thoracic wall; retract and rotate scapula to depress glenoid cavity -drop shoulder

Question 34

how many parts is the subclavian artery broken down into?

Answer 34

3

Question 35

1st part of subclavian artery

Answer 35

VIT ``` Vertebral artery Internal thoracic artery Thyrocervical trunk -inferior thyroid A. -transverse cervical A. -suprascapular A. ```

Question 36

2nd part of subclavian artery

Answer 36

costocervical trunk

Question 37

3rd part of subclavian artery

Answer 37

dorsal scapular artery

Question 38

what muscle lays on top of subclavian artery?

Answer 38

anterior scalene muscle

Question 39

branches of the axillary a. are related to what muscle?

Answer 39

pectoralis minor

Question 40

1st part of axillary artery

Answer 40

Superior thoracic artery

Question 41

2nd part of axillary artery

Answer 41

thoracoacromial artery | lateral thoracic artery

Question 42

where does the lateral thoracic artery run to?

Answer 42

runs down to lateral portion of chest to supply blood to breast

Question 43

3rd part of axillary artery

Answer 43

- subscapular (cicumflex scapular & thoracodorsal) - anterior cicumflex humeral a. - posterior circumflex humeral a.

Question 44

why is there a suprascapular notch?

Answer 44

ligament converts notch to a "foramen" because will have a superior transverse scapular ligament -above the spine of the scapula

Question 45

what are the boundaries of the triangular space?

Answer 45

- (s) teres minor - (i) teres major - (L) long head of triceps

Question 46

what passes through the triangular space?

Answer 46

circumflex scapular artery

Question 47

what are the boundaries of the quadrangular space?

Answer 47

- (s) teres minor - (i) teres major - (m) long head of triceps - (L) humerus

Question 48

what passes through the quadrangular space?

Answer 48

axillary nerve | posterior humeral circumflex artery (wraps around humerus)

Question 49

what are the boundaries of the triangular interval?

Answer 49

- (s) teres major - (m) long head of triceps - (L) lateral head of triceps

Question 50

what passes through the triangular interval?

Answer 50

radial nerve | profunda brachii artery

Question 51

where does the posterior circumflex humeral artery go to?

Answer 51

deltoid muscle

Question 52

axilla

Answer 52

pyramid-shaped space - inferior to glenohumeral joint - superior to axillary fascia -serves as a protected passageway for the neurovascular structures from the neck to the upper limb axillary A. brachial plexus axillary V.

Question 53

why do you want to keep the axilla space open & protected?

Answer 53

to prevent pinched nerves

Question 54

what % is tubuloalveorlar glands in the breast?

Answer 54

95%

Question 55

how many lactiferous ducts per lobe and sinus?

Answer 55

1

Question 56

what % of tumors originate in the duct?

Answer 56

80%

Question 57

suspensory ligaments (of Cooper)

Answer 57

attach lobes to skin & divide glandular tissue into lobes

Question 58

where are the lactiferous ducts located?

Answer 58

at surface of nipple

Question 59

what are the lymph nodes of the breast? [C.L.A.S.P]

Answer 59

``` Central nodes Humeral (lateral) nodes Apical nodes (below clavicle) Subscapular (posterior) nodes Pectoral (anterior) nodes ```

Question 60

what artery mainly supplies the breast? what cavity does it come from?

Answer 60

lateral thoracic artery -axillary artery

Question 61

internal thoracic artery (internal mammary)

Answer 61

-subclavian artery - runs internal portion of chest - perforating branches that will go through ribs & supply to breast

Question 62

about what % of breast tissue drains medially?

Answer 62

20%

Question 63

where does most of the breast tissue drain to?

Answer 63

laterally

Question 64

what vein is located underneath the clavicle by the apical nodes?

Answer 64

subclavian vein