Shoulder to Elbow Flashcards
what are some parts at the top of the humerus bone ?
head, greater tubercle, anatomical neck, surgical neck, less tubercle and inter tubercular sulcus
what are some parts at the bottom of the humerus bone ?
medial epicondyle, trochlea, capitulum, olecranon fossa and lateral epicondyle
what are the two arm compartments ?
posterior (extensors) and anterior (flexors)
what nerve innervates the anterior (flexor) compartment ?
musculocutaneous N
what nerve innervates the posterior (extensor)
radial N
what are the three arm flexors ?
- supination (biceps)
- shoulder flexion (coracobrachialis)
- elbow flexion (brachialis)
what happens in the case of a rupture of long head of biceps ?
generally not surgically repaired, minimal weakness in upper limb dur to action of brachialis
what does the rupture of long head of biceps look like ?
Popeye sign
what is the course of the musculocutaneous nerve ?
- in front of the humerus
- pierces coracobrachialis
how can the musculocutaneous N be injured ?
shoulder dislocation (loss of shoulder flexion, forearm supination and elbow flexion)
what nerve supplies the arm extensors ?
radial nerve
what muscle is responsible for forearm extension ?
triceps
what muscle is responsible for arm extensions ?
long head of the biceps
what is the predominate population of humeral shaft fracture ?
- young people, high-energy trauma
- older people, osteopenia
what does it mean if you have osyeopenia ?
more susceptible to fractures
what is a risk of humeral shaft fractures ?
radial N palsy
what symptoms would you expect from a humeral shaft fracture ?
- reduced wrist extension + radial deviation
- reduced elbow flexion (brachialis)
what nerve innervates the whole posterior upper limb ?
the radial nerve
where does the radial nerve course ?
- behind the humerus
- under lateral head of triceps
- along radial groove
what is the axilla ?
- armpit
- fat-filled space
what does the axilla do ?
- provides passageway for blood vessels and nerves
- contains axillary lymph nodes
what three things can you find at the axilla ?
nerves, arteries and veins
what three muscles are the flexors (of the arm) ?
biceps, brachialis and coracobrachialis
what muscle is the extensor (of the arm) ?
triceps
muscles of the arm are innervated by what two nerves ?
musculocutaneous nerve and radial nerve
is radial N palsy possible without a humeral shaft break ?
yes
the axilla represents a transition zone from ____
the thorax to the upper limb
what is radial N palsy ?
condition that affects the radial nerve
what two joints of the elbow form to create the cubital joint ?
humeroradial and humeroulnar
what joint is the elbow ?
hinge joint (synovial)
what joint is affected during a elbow dislocation ?
cubital joint
what happens during an elbow dislocation ?
the radius has come off of the capitulum, and the ulna has come off of the trochlea (both have slipped posteriorly)
what is a radial head subluxation ?
bone dislocation but does back into its normal spot after
what joint permits pronation/supination at the elbow joint ?
the proximal radioulnar joint
what is the cubital fossa ?
triangular shaped region in the arm
what does the cubital fossa act as ?
a key transition zone from the arm to the forearm for a variety of neurvasculature
what three things is the cubital fossa bounded by ?
the epicondyles of the humerus, brachioradialis and pronator teres
what is a phlebotomy ?
the surgical opening or puncture of a vein in order to withdraw blood or introduce a fluid
where is the key location for phlebotomy located ?
cubital fossa
what are the arm flexors muscles acting on the elbow ?
biceps and brachialis
what are the forearm flexor muscles acting on the elbow ?
brachioradialis, pronator Teresa, flexor carpi radialis, palmares longus, flexor carpi ulnarus and flexor digitorum superficialis
what are the arm extensor muscles acting on the elbow ?
triceps
what are the forearm extensor muscles acting on the elbow ?
supinator, extensor carpi radialis longus, extenso carpi radialis brevis, extensor digitorum, extensor digiti minimi and estensor carpi radialis
what are the three joints that exist within the elbow ?
ulnotrochlear, radiocapitellar and proximal radioulnar (URPR)
where does flexion of the elbow occur ?
ulnotrochlear and radiocaputellar joints
where does supination occur (joint) ?
proximal radioulnar joint
blood supply to the upper limb begins here if you re on the right side
brachiocephalic trunk
what are the three fusser’s of the scapula ?
sub scapular, supraspinous and infraspinous
what are the frontal view bones of the pectoral girdle ?
clavicle, acromion, coracoid process, glenoid fossa and sternum
what are the posterior view bones of the pectoral girdle ?
clavicle, acromion and spine of the scapula
what are the four joints of the shoulder ?
- acromio clavicular joint
- glenohumeral joint
- scapulothoracic joint
- sternoclavicular joint
what does the ant. sternclavicular ligament do ?
helps secure the head of the clavicle to the first rib
what does the inter-clavicular ligament do ?
this between the two clavicles hold them together
where does the acromiclavicular ligament exist ?
between the acromion and the clavicle
where do shoulder separations occur ?
acrmioclavicular + sternoclavicular joints
describe a grade 1 shoulder seperation ?
stretching of AC ligament
describe a grade 2 shoulder seperation ?
rupture of AC lig, stretching of CC ligament
describe a grade 3 shoulder seperation ?
rupture of AC + CC
what joint is the shoudler ?
ball and socket
what joint has articulation between the head if the humerus and the glenoid fossa ?
glenohumeral joint
what are glenohumeral ligaments ?
thickening of the joint capsule, primarily anteriorly, superiorly and inferiority
what four ligaments are found at the glenohumeral joint ?
- superior glenohumeral ligament
- middle glenohumeral ligament
- inferior glenohumeral ligament
- coracohumeral ligament
what type of joints do glenoid labrum only exist at ?
ball and socket
what is the glenoid labrum ?
thickening of fibrocartilage around the glenoid fossa
what does the glenoid labrum do ?
deepens the socket for better contact with the humeral head
what happens if you dislocate the should (in regards the glenoid labrum) ?
it may be torn
what joint is affected during a shoulder dislocation ?
glenohumeral joint
what does the scapulothoracic joint allow for ?
allows for movement between the scapula + thoracic cage, which is critical for arm abduction
what two joints allow for arm abduction ?
- glenohumeral jt
- scapulothoracic jt
what is Saturday night palsy ?
brachial plexus nerve compression leading to wrist drip and sensory loss on posterior arm (back of arm pushed directly up into the axilla; arm faced down)
what nerve is compressed with Saturday night palsy ?
the radial nerve
radial nerve compression can lead to ________
Saturday night palsy
what are the superficial layer muscles acting on the shoudler ?
- trapezius
- latissimus dorsi
- rhomboids
- teres major
what are the pectoral muscles acting on the shoulder ?
- serrates anterior
- pectoralis major
- pectoralis minor
what are the deep layer (rotator cuff) muscles acting on the shoulder ?
- supraspinatus
- infraspinatus
- teres minor
- subscapularis
what are the brachium muscles acting on the shoulder ?
- deltoid
- long head of biceps
- long head of triceps
what nerve innervates the trapezius ?
accessory nerve
what nerve innervates the latissimus dorsi ?
thoracodorsal nerve
what nerve innervates the rhomboids ?
dorsal scapular nerve
what nerve innervates the teres major ?
lower subscaoular nerve
what nerve innervates the supraspinatus ?
suprascapular nerve
what nerve innervates the infraspinatus ?
supra scapular nerve
what nerve innervates the teres minor ?
axillary nerve
what nerve innervates the subscapularis ?
upper and lower sub scapular nerves
what are the three muscles of the rotator cuff (SITS) ?
supraspinatous, infraspinatous, teres minor and subscapularis
what innervates the pectorals major ?
lat + med pectoral nerves
what innervates the pectorals minor ?
medial pectoral nerve
what innervates the serrates anterior ?
long thoracic nerve ?
what is winged scapula ?
clinical implication where intact pectorals minor pulls coracoid foward
what nerve is impacted during winged scapula ?
long thoracic
what’s happening in the body during winged scapula ?
inactive serrates anterior allows medial boarder of the scapula to move backwards
what nerve is innervated by the deltoid ?
axillary nerve
what three actions does the deltoid do ?
flexion, extension and abduction
what range of motion of should joint movement is the most fully abducted ?
160-180 degrees (serrates anterior muscle and long thoracic nerve)
what four joints exist within the shoulder girdle ?
-acromioclavicular
- sternoclavicular
- glenohumeral
- scapulothoracic
what two joints are responsible for arm abduction ?
the glenohumeral and scapulothoracic joints
