Shoulder region Flashcards
supraspinous n and a pass through which two notches on the posterior scapula
supraspinous notch, spinoglenoid notch because it has to go around the spine
What does the inferior side of the clavicle look like compared the the superior side
superior is much more smooth. less articulations
conjoint tendon
short head of the biceps and coracobrachialis
Thyrocervical trunk gives rise to 3 arteries
Inferior thyroid artery
Suprascapular artery
Transverse cervical artery (ultimately becomes dorsal scapular artery)
When does the subclavian artery become the axillary artery
after the first word
When does Axillary artery become brachial artery
after it passes teres major
What is a good indicator of the separation of rhomboid major/minor
medial angle of the scapula
Two attachments of pectoralis minor
coracoid process of scapula and costochondral joints
Three categories of movement that scapula does
elevation/depression
protraction/retraction
upward rotation/downward rotation
- combination of scapular and glenohumeral joint movement
scapulohumeral rhythm
T or F elevation/depression of the scap can only occur in protraction
F elevation/depression can occur at any time
Rhomboids and serratus anterior are agonist/antagonist muscles for what?
Scap.
r-medial upward rotation
s-lateral upward rotation
Teres major and latissimus dorsi come together ______ to form what looks like a common tendon
on the medial lip of bicipital groove of humerus
Latissimus dorsi attachment lies ______ to the teres major on the bicipital groove
anterior
posterior wall of axilla
supscalularis
floor of axilla
axillary skin
apex boundary of axilla
rip 1
medial boundary of axilla
serratus anterior
lateral border of axilla
humerus
anterior boundary of axilla
pectoralis minor, coracobrachialis, pectoralis major
Triangular space
boundaries
contents
teres minor, major, long head of triceps brachii
circumflex scapular artery
quadrangular space
boundaries
contents
teres major, minor, long head of triceps brachii, humerus
axillary n., posterior circumflex humeral artery
triangular interval
boundaries
contents
teres major, long head of triceps brachii, humerus
radial nerve, deep brachial artery
posterior circumflex humeral artery runs along with
axillary nerve
Which segments form the brachial plexus
C5-T1
Which segment of brachial plexus does not combine
C7
The ventral ramus of spinal nerves C5-T1 create
the roots of the brachial plexus
the three trunks of the brachial plexus divide into
dorsal and ventral divisions
terminology of brachial plexus from medial to distal
Roots>trunks>divisions>cords>branches
posterior cord of b. plexus bifurcates into
axillary and radial nerve
Lateral cord ends as
musculocutaneus nerve
medial cord ends as
ulnar nerve
median nerve is formed by
lateral part of medial cord, medial part of lateral cord?
lateral and medial cords combine to become how many nerves
3
Lateral cord of the b. plexus contains which segments
C5-C7
Medial cord of b. plexus is innervated by which segments
C8-T1
the spine of the scapula divides the dorsal surface into….
supraspinous and infraspinous fossae
what is the spinoglenoid notch
lateral extent or great scapular notch
what is the acromial angle
bend at spinoglenoid notch
from inferior angle to glenoid cavity. Widens superiorly as infraglenoid tubercle
lateral border of scap
from inferior angle to superior angle
medial border
superior angle to suprascapular notch
superior border
what angle overlies 7th intercostal space (rib)
inferior
angle medial to superior border
superior angle
wich angle contains the glenoid cavity
lateral head
described along the medial border at the end of the spine
medial angle
from top of head of scap (lateral to suprascapular notch) points laterally and anteriorly
coracoid process
articulates w/ the manubrium of the sternum and the acromion of the scap.
clavicle
between paired articulations of the clavicles is the
jugular, suprasternal notch
part of clavicle that is flattened
acromial end (flattened for articulation with acromion)
part of clavicle enlarged for articulation with the manubriumof sternum and 1st costal cartilage
sternal end
how is the shaft to the clavicle laid out?
medial 2/3 convex anteriorly, lateral 1/3 concave anteriorly
the head of the humerus articulates with
the glenoid cavity of the scap; glenohumeral joint
what are the greater and lesser tubercles of the head of the humerus separated by
intertubercular groove (sulcus; also known as bicipital groove)
where is the humeral head most likely to break
surgical neck (as apposed to the anatomical neck)
anterolateral bump indicating insertion of deltoid muscle
deltoid tuberosity
what groove does the radial nerve run
radial groove (spiral groove) posterior aspect
what part of the humerus articulates with ulna
trochlea
funny bone
lateral to trochlea is a deep groove, sulcus for ulnar nerve
what humeral structure articulates with the radius
capitulum
rotator cuff supports
the ligaments and capsules of the glenohumeral joint
what is the glenoid cavity enlarged or deepened by
fibrocartilaginous labrum (research indicates this may be dense connective tissue instead)
what is the weakest part of the articular capsule of the glenohumeral joint
posterior part because it is not supported by any ligaments
which ligament covers intertubercular groove
transverse humeral ligament
which ligament strengthens superior part of capsule
coracohumeral ligament
this structure contains coracoid process, coracoacromial ligament, and acromion and prevents superior displacement of humerus
coracoacromial arch
O of pectoralis major
clavicular head- anterior surface of sternal 1/2 of clavicle
sternocostal head - anterior surface of sternum and adjacent sup. 6 costal cartilages
aponeurosis of external abdominal oblique
I of pectoralis major
common tendon to the lateral lip of the intertubercular groove
action of pectoralis major
adducts and medially rotates humerus
clavicular head flexes humerus
sternocostal head extends humerus
Innervation of pectoralis major
clavicular head- lateral pectoral n. (C5-C6)
sternocostal head -medial pectoral n (C7,C8,T1); C7 comes from communicating branch off lateral pectoral n.
O of pectoralis minor
Ribs 3-5 near their costal cartilages
I of pectoralis minor
medial border and superior surface of coracoid process of scapula
Action of pectoralis minor
stabilizes scap by pulling it anteriorly and inferiorly against thoracic wall.
minor protractor by moving scap laterally and anteriorly around the thoracic cage.
Innervation of pectoralis minor
medial pectoral n. C8-T1
O of subclavius
junction of rib 1 and its costal cartilage
I of subclavius
inferior surface of middle 1/2 of clavicle
Action of subclavius
draws clavicle medially
innervation of subclavius
nerve to subclavius C5-C6
O of serratus anterior
external surfaces of lateral parts of ribs 1-8
fascia overlying external intercostal muscles
I of serratus anterior
anterior surface of medial border of scapula
Action of serratus anterior
protracts scpaula and holds it against thoracic wall (along with subclavius) rotates scap (by pulling on the inferior angle of scapula; assists trapezius)
Innervation of serratus anterior
long thoracic nerve C5-C7
O of trapezius
medial 1/3 of sup. nuchal line external occipital protuberance ligamentum nuchae spinous processes of C7-T12 lumbar and sacral spinous processes-by pulling on thoracolumbar fascia
I of trapezius
Lateral 1/3 of clavicle
acromion and spine of scapula
superior fibers extend more laterally
inferior fibers insert on the spine as an aponeurosis without extening out to the acromion
action of trapezius
sup fibers- elevate scap
middle fibers - retract scap
inf fibers - depress scap
sup and inf work together to sup rot the lat angle (assisted by serratus ant)
innervation of trapezius
spinal accessory n. (CN XI)
ventral rami of cervical n. C3-C4 (these may be primarily sensory for proprioceptive and plain sensation)
o of latissimus dorsi
spinous processes of T6-T12
thoracolumbar fascia
iliac crest and inf 3-4 ribs (ribs9-12)
i of latissimus dorsi
floor of intertubercular groove of humerus
action of latissimus dorsi
extends, adducts and medially rotates humerus
raises body towards arms during climbing
innervation of latissimus dorsi
thoracodorsal n. C6-C8
O of levator scapulae
posterior tubercles of transverse processes of C1-C4 vertebrae
I of levator scapulae
sup. part of medial border of scapula
Action of levator scapulae
elevates scapula and inferiorly rotates lateral angle of scapula
innervation of levator scapulae
dorsal scapular n. C5
cervical n. C3-C4
O of rhomboid minor
ligamentum nuchae and spinous processes of C7-T1
O of rhomboid major
spinous processes of T2-T5
I of rhomboids
medial border of scapula from level of spine of scapula to inferior angle
action of rhomboid
retracts scapula and inferiorly rotates lateral angle
depresses glenoid cavity
fixes scapula to thoracic wall
innervation of rhomboids
dorsal scapular n C4-C5
o of deltiod
lateral 1/3 of clavicle
acromion
spine of scapula
i of deltoid
deltoid tuberosity of humerus
action of deltiod
ant part - flexes and medially rotates arm
mid part - abducts arm
post part - extends and lat rotates arm
innervation of deltiod
axillary n. C5-C6
Muscles of rotator cuff
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Origin of supraspinatus
supraspinous fossa of scap
I of supraspinatus
sup. facet of greater tubercle of humerus
action of supraspinatus muscle
abduct arm (assists deltiod)
innervation of supraspinatus
suprascapular n. C4-C6
o of infraspinatus
infraspinous fossa of scapula
i of infraspinatus
middle facet on greater tubercle of humerus
action of infraspinatus
laterally rotate arm
innervation of infraspinatus
suprascapular n. C5-C6
o of teres minor
sup. part of lateral border of scapula
insertion of teres minor
inferior facet on greater tubercle of humerus
action of teres minor
laterally rotates arm
innervation of teres minor
axillary n. C5-C6
o of teres major
dorsal surface of inferior angle of scapula
i of teres major
medial lip of intertubercular groove of humerus
action of teres major
adducts and medially rotates arm
innervation of teres major
lower subscapular n C5-C7
O of subscapularis
subscapular fossa
insertion of subscapularis
lesser tubercle of humerus
action of subscapularis
medially rotates and adducts arm
innervation of subscapularis
upper and lower subscapular n. C5-C7
Which 4 muscles help hold head of humerus in glenoid cavity
rotator cuff
What does the triangular space contain
circumflex scapular arteries
Learn triangular border thing that maggie sent
do it
what contains the poster circumflex humeral vessels and axillary n.
quadrangular space
what contains the brachial artery and the radial n.
triangular interval
what is the subclavian artery called after it passes the first rib
axillary artery
damage to the long thoracic nerve (or the ventral rami that eventually form this nerve) causes what clinically
winged scapula
what muscle is inhibited in winged scapula
serratus anterior
if the patient is unable to abduct the arm above the horizontal or push with the arm since the scapula is limited in superior rotation
scapular winging
atrophy of deltoid muscle could be due to damage to
the axillary nerve
patient is unable to maintain abduction of arm against resistance and roundness of shoulder is absent.
damage to axillary nerve
inability to do chin ups
damage to thoracodorsal nerve
damage to the thoracolumbar nerve will cause paralysis to the
latissimus dorsi muscle.
What is the weakest support dynamically of the glenohumeral joint
inferior due to lack of supporting tendons
Which tendons of the rotator cuff support the posterior aspect of the joint?
infraspinatus and teres minor
Which tendon reinforces the superior aspect of the glenohumeral joint
supraspinatus
Which tendon supports the anterior aspect of the glenohumeral joint
supscapularis
