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SF 1- Exam 1 > Shoulder Script > Flashcards

Shoulder Script Flashcards

1
Q

What is the subacromial impingement syndrome? What are the three main symptoms?

A

Occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the subacromial space, the passage beneath the acromion. This can result in pain, weakness and loss of movement at the shoulder.

A painful arc of movement may be present during forward elevation of the arm from 60° to 120°

Passive movement at the shoulder will appear painful when a downwards force is applied at the acromion but the pain will ease once the downwards force is removed.

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2
Q

The ___________ is the most proximal bone of the upper limb

A

clavicle

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3
Q

Palpable parts of the scapula

A

Acromion

Corocoid process

Spine

Inferior angle

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4
Q

What are the three most powerful adductors and internal rotators of the arm at the shoulder joint?

A

Latissimus dorsi

Teres major

Pectoralis major

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5
Q

5 major nerves of the upper limb

A

Axillary Nerve. …

Median Nerve. …

Radial Nerve. …

Ulnar Nerve. …

Musculocutaneous Nerve

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6
Q

Nerve of the arm that is most at risk of injury from a fracture of the surgical neck of the humerus.

A

Axillary

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7
Q

The muscular branch of the axillary nerve curves immediately around the medial aspect of the ____________ of the humerus as it extends posteriorly through a space beneath the ____________ of the shoulder joint to reach the anterior border of the ___________ muscle.

A

surgical neck

fibrous capsule

Deltoid

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8
Q

The axillary nerve contains motor neurons which come from the _____ and _____ roots.

A

C5 and C6 cervical

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9
Q

The axillary nerve supplies sensory innevation to the skin of the _________ and motor innervation to the ____________.

A

Lateral arm

Deltoid and teres minor muscles

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10
Q

Branches of the axillary nerve

A

Superior laterial brachial cutaneous

Muscular brances that serve the deltoid and teres minor

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11
Q

Origin of the axillary nerve

A

Posterior cord of the brachial plexus

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12
Q

Origin of the median nerve

A

Lateral and medial cords of brachial plexus

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13
Q

Pathway of the median nerve

A

In the arm, it travels adjacent to the brachial artery.

In the forearm, it travels posterior to the flexor digitorum profundus.

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14
Q

Which arterior accompanies the median nerve, in the forearm? In the arm?

A

Anterior interossous artery

Brachial artery

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15
Q

Branches of the median nerve. Be specific.

A

Muscular branches to pronator teres, flexor carpi radialis, palmaris longus, and flexor digitorum superficialis

Vasomotor nerve to the brachial artery

Articular branches to elbow and proximal radioulnar joint

Anterior interosseous nerve

Palmar cutaneous branches

Medial and lateral divisions

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16
Q

What type of nerve is the median nerve? (Sensory/Motor/Mixed)

A

Mixed

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17
Q

Origin of the radial nerve

A

Posterior cord of the brachial plexus

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18
Q

Pathway of the radial nerve

A
  1. Descends against the posterior axillary wall and passes through the triangular interval to descend with the spiral radial groove.
  2. Pierces the lateral intermuscular septum to enter the anterior arm before reaching the cubital fossa
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19
Q

Branches of the radial nerve

A

Muscular branches

Posterior brachial cutaneous nerve

Posterior antebrachial cutaneous nerve

Two terminal branches (superficial and deep branches)

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20
Q

What is supplied by the radial nerve?

A

Muscles of the posterior arm and forearm

Skin of the posterior arm, forearm, and dorsum of hand

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21
Q

Radial nerve palsy

A

A.K.A Wrist Drop

the wrist and the fingers cannot extend at the metacarpophalangeal joints. The wrist remains partially flexed due to an opposing action of flexor muscles of the forearm. As a result, the extensor muscles in the posterior compartment remain paralyzed.

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22
Q

Possible causes of radial nerve injury

A

fracturing your humerus, a bone in the upper arm

sleeping with your upper arm in an awkward position

pressure from leaning your arm over the back of a chair

using crutches improperly

falling on or receiving a blow to your arm

long-term constriction of your wrist

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23
Q

Origin of the ulnar nerve

A

Medial cord of the brachial plexus

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24
Q

Pathway of ulnar nerve

A
  1. Descends on the medial side of brachial artery and pierces medual intermuscular septum to enter posterio arm.
  2. Passes behind the medial epicondyle of the hymerus, to descend in the forearm.
  3. Nerve enters the palmar aspect of the hand
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25
Q

Branches of the ulnar nerve

A

Muscular and cutaneous branches (Dorsal cutaneous branch, palmar cutaneous branch, and digital branches) and superficial and deep branches

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26
Q

The ulnar nerve consists of fibers from which spinal nerves?

A

C7, C8, and T1

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27
Q

Origin of the musculocutaneous nerve

A

Lateral cord of brachial plexus

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28
Q

Pathway of the musculocutaneous nerve

A

It accompanies the third part of the axillary artery in lower part of the axilla, pierces coracobrachialis to enter the front arm and descends between biceps brachii and brachialis muscle

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29
Q

Branches of the musculocutaneous nerve

A

Lateral antebrachial cutaneous nerve

Muscular and articular branches

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30
Q

What is supplied by the musculocutaneous nerve?

A

Motor innervation to flexor muscles of the arm

Sensory innervation to skin of lateral side of forearm and elbow joint

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31
Q

The musculocutaneous nerve contains nerve fibers from which spinal nerves?

A

C5-C7

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32
Q

Biceps reflex

A

a reflex test that examines the function of the C5 reflex arc and the C6 reflex arc.

test activates the stretch receptors inside the biceps brachii muscle which communicates mainly with the C5 spinal nerve and partially with the C6 spinal nerve to induce a reflex contraction of the biceps muscle and jerk of the forearm.

Indicates musculocutaneous nerve damage

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33
Q

A supracondylar humerus fracture can result in damage to which nerve?

A

Median nerve

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34
Q

Carpal tunnel syndrome

A

due to compression of the median nerve as it travels through the wrist at the carpal tunnel

Weak grip strength may occur, and after a long period of time the muscles at the base of the thumb may waste away

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35
Q
A
36
Q

Sternoclavicular joint is found between which two bones?

A

Clavicle and sternum

37
Q

What joint is the only joint between a bone of the upper limb and a bone of the axial skeleton?

A

Sternoclavicular joint

38
Q

What ligament stabilizes the acromioclavicular joint?

A

Coracoclavicular ligament by attaching the clavicle to the coracoid process of the scapula

39
Q

Do shoulder separations involve injury to the shoulder joint?

A

No

40
Q

A partial dislocation is called a ____________

A

Subluxation

41
Q

A subluxed AC joint is called a grade_______ shoulder separation.

A

II

42
Q

. If a patient has a grade II shoulder separation, comparison of AP radiographs of the patient’s injured and non-injured shoulders shows a CC space of normal width in the injured shoulder but an AC space that is at least _________% wider than that measured in the uninjured shoulder.

A

50

43
Q

A completely dislocated AC joint is called a grade _______separation.

A

III

44
Q

Which joint provides more range and freedom of movement than any other synovial joint in the body?

A

The shoulder joint

45
Q

The shoulder joint has a __________configuration in which the humeral head is free to rotate in any direction on the surface of the glenoid cavity.

A

ball-and-socket

46
Q

What component of the shoulder joint enhances the extent to which the humerus can rotate?

A

The comparatively small surface area of the glenoid cavity.

NOTE: The glenoid cavity is not sufficiently extensive to hold the humeral head in place in the should joint. Hence, the shoulder can easily dislocate.

The lax fibrous capsule is also a contributing factor.

47
Q
A
48
Q

___________ dislocation of the humeral head is the most common type of shoulder joint dislocation.

A

Anterior

49
Q

What is an anterior dislocation?

A

A dislocation that is produced by trauma that drives the humeral head anteroinferiorly from its articulation with the glenoid cavity

The head of the humerus typically comes to ret in a subglenoid, subcarocid, or subclavicular position

50
Q

Clenidocranial dystosis

A

Characterized by defective ossification of cranial bones and the clavicles.

Defect can cause complete absence of the clavicles

51
Q

Most commonly fractures bone in the body

A

Clavicle

52
Q

Explain the strut role served by the clavicle. How can this role be abolished?

A

The strut role braces the shoulders superoprly, posteriorly and laterally.

The role is abolished by a fracture of the clavicle proximal to the coracoclavicular ligament.

*A patient with this fracture presents with a shoulder that is displaced inferiorly, anteriorly, and medially.

53
Q
A
54
Q

Bones that form the shoulder girdle

A

Scapula and clavicle

The shoulder girdle serves as a mobile boom for the upper limb because its movements at the sternoclavicular and acromioclavicular joints greatly extend the range of movement of the arm

55
Q

6 ways in which the arm can be moved at the shoulder joint

A

Flexion

Extension

Internal rotation

External rotation

Abduction

Adduction

56
Q

Forward and backward movement of the shoulder is achieved mainly through forward and backward rotation of the __________

A

Clavicle

57
Q

On average during arm abduction, lateral rotation of the scapula contributes 1 degree arm abduction for every ________ degree arm abduction provided by upward rotation of the humerus.

A

2

58
Q

4 shoulder muscles that suspend the shoulder girdle from the spine

A

Trapezius

Levator scapulae

Rhomboid major

Rhomboid minor

59
Q

Which muscle provides much of the force required to lift the arm above the shoulder?

A

Trapezius

60
Q

Which nerve innervates the trapezius?

A

Acessory nerve

61
Q

Levator scapulae is innervated by the ___________ nerve and nerve fibers from ____ and ________.

A

Dorsal scapular (C5); C3 and C4

62
Q

Functions of levator scapulae

A

Raising shoulder

Medially rotating the scapula

63
Q

Innervation and function of rhomboid minor and major

A

Innervation: Dorsal Scapular Nerve (C5)

Function: Retract the shoulder and medially rotate the scapula

64
Q

Muscles that pull upon the shoulder girdle from the anterior chest wall

A

Serratus anterior (most powerful)

Pectoralis minor

Subclavis

65
Q
A
66
Q
A
67
Q

Function of serratus anterior. Innervation.

A

Protraction of the shoulder

Lateral rotation of the scapula

Innervation: Long Thoracic Nerve

68
Q

Function and innervation of pectoralis minor.

A

Function: Lower the shoulder and protract the shoulder

Nerve: Medial pectoral nerve

69
Q

Function and innervation of subclavis.

A

Function: Depression of the clavicle

Nerve: Nerve to Subclavis

70
Q

Muscles of the rotator cuff

A

Supraspinatus

Infraspinatus

Teres Minor

Subscapularis

71
Q

Tendons of insertion of the muscles that make up the rotator cuff form a ___________ cuff about the shoulder joint.

A

Musculoctendinous

72
Q

Which nerve innervates the supraspinatus? Which nerve fibers?

A

Suprascapularis nerve; Fibers C5 and C6

73
Q

Which nerve innervates the infraspinatus? Which nerve fibers?

A

Supracscapular nerve; C5 AND C6

74
Q

Which nerve innervates the teres minor? Which fibers specifically?

A

Axillary nerve; C5 and C6

75
Q

Main function of the muscles of the rotator cuff

A

Stabilizing the dynamic intergrity of the shoulder joint when powerful forces are exerted across the joint

76
Q

Primer mover for abduction of the arm at the shoulder joint

A

Deltoid

77
Q

Functions of the deltoid

A

Flexion

Internal rotation

Extension

External rotation

78
Q

Which nerve innervates the deltoid muscle? Which nerve fibers?

A

Axillary nerve; C5 and C6

79
Q

Prime movers of adduction of the arm at the shoudler joint

A

Pectoralis major

Teres major

Latissimus dorsi

80
Q

Function and Innervation Pectoralis Major

A

Function: Fexion of the arm

Rotaion of the arm at the shoulder joint

Adduction of the arm

Innervation: Lateral pectoral nerve and Medial pectoral nerve

81
Q

What nerve innervates the teres major? Which nerve fibers?

A

Lower subscapularis

C5 and C6

82
Q

Function and innervation of the latissimus dorsi.

A

Functions: Extension of the arm, internal rotation of the arm, adduction of the arm

Innervation: Thoracodorsal nerve

83
Q

Abduction of the arm 180 degres from the anatomical position is dependent on which 4 muscles

A

Suprapinatus (10-15 degrees)

Deltoid (120 degrees)

Trapezius

Serratus anterior

*Without Trapezius and Serratus anterior the arm could only go 110 degrees from anatomical position

84
Q

Role of the subacromial-subdeltoid bursa

A

Establishes discontinuities between tissues which provide for much freedom of movement over a limited range.

85
Q

The space in the shoulder bordered superiorly by the coracoacromial arch and inferiorly by the capsule of the shoulder joint is called the _____________.

A

subacromial space

86
Q
A

SF 1- Exam 1 (10 decks)

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