Shoulder To Elbow

Question 1

Pectoral girdle

Answer 1

▪️clavicle and scapula

Question 2

Scapula

Answer 2

▪️big lever arm 
▪️increase ps SA that muscles can attach to- muscles move the scapula which in turn moves the humerus. 
▪️structure:
-subscspula fossa (anterior) 
-glenoid fossa (laterally)
-spine (posterior) -divides back into 2
-acromion-articulates with acromial end of clavicle (extended from spine)
-coracoid process-muscles and tendons 
-supraspinous fossa-muscle 
-infraspinous fossa-muscle

Question 3

Clavicle

Answer 3

▪️a strut 
▪️pushes limb out laterally-gives arm space and range of motion from thorax to move 
▪️structure:
-sterna end -flat
-acromial end-curved

Question 4

Humerus

Answer 4

▪️structure:

• head
• greater and lesser tubercle-muscles and tendons
• intertubecular sulcus- between GT and LT
• medial and lateral epicondyle- muscle
• capitulum and trochlea for radial and ulnar articulations
• coranoid fossa-muscle
• olceranon fossa (posterior)-muscle

Question 5

Abduction of the arm

Answer 5

▪️first 120 degrees is the humerus rotating in the glenoid cavity
▪️last 60 degrees is rotation of the scapula (to get hand above head)- points GC superiorly which points humerus superiorly.

Question 6

Joint capsule of glenohumeral joint

Answer 6

▪️redundant capsule (slack) - becomes taught when abducting arm 
-Intrinsic-thickenings of joint capsule 
▪️coracohumeral ligament
▪️superior glenohumeral ligament 
▪️middles glenohumeral ligament 
▪️inferior glenohumeral ligament 

-tendon of the long head of biceps brachii muscle pierce joint capsule and attaches to superior part of glenoid cavity. (Can be damaged if joint has arthritis causing bone growth and snapping of tendon/ligaments)

Question 7

Rotator cuff muscles

Answer 7

▪️group of muscles who’s tendons surround the joint
▪️strengthen and keep head in cavity
-subscapularis, supraspinatus, infraspinatus, teres minor

Question 8

Supraspinatus

Answer 8

▪️initiation of abduction ( 1st 15 degrees)
▪️attached to supraspinous fossa of scapula (posterior)
▪️inserts into greater tubercle

Question 9

Infraspinatous

Answer 9

▪️lateral rotation of humerus
▪️attaches to infraspinous fossa (posterior)
▪️travels behind joint and inserts to greater tubercle

Question 10

Teres minor

Answer 10

▪️lateral rotation of humerus
▪️underneath infraspinatous (posterior)
▪️inserts into greater tubercle

Question 11

Subscapularis

Answer 11

▪️medial rotation of humerus
▪️attaches to subscapula fossa (anterior)
▪️inserts into lesser tubercle

Question 12

Muscle of upper limb

Answer 12

▪️deltoid- major abductor of arm (after the 15dgs takes over)
-attached to clavicle anteriorly and spine of scapular posteriorly and humerus shaft .
▪️pectoralis major-adductor, medially rotates, extends a flexed arm (attaches at clavicle and sternum which join and insert at intertubercular groove)
▪️between D and PM is a surface marking- deltopectoral groove
▪️trapezius- elevation of scapula, rotation of scapula (last 60dgs)(attaches at skull and vertebrae to clavicle and scapula)
▪️pectoralis minor- depression of scapula (attached to coracoid process and 3-5th ribs)
▪️serratus anterior-rotation of scapula (attachment to 1-9th ribs and medial border of scapula)- if paralysed get “wings scapula”

Question 13

Proximal muscles of the arm

Answer 13

▪️subscapularis
▪️biceps brachii 
▪️brachialis
▪️coracobrachialis 
▪️teres major
▪️latissimus dorsi
▪️triceps brachii

Question 14

Biceps brachii

Answer 14

▪️two heads:
-short head: tendon attaches to coracoid process
-long head: tendon attaches superiorly to glenoid cavity and pierces joint capsule, travels through intertubercular sulcus and is held down by transverse humeral ligament.
▪️heads join up and muscle lays on top of humerus.
▪️muscle crosses inside of elbow and attaches to radial tuberosity.

▪️flexor and supinator of forearm, weak flexor of humerus

Question 15

Teres major

Answer 15

▪️ attaches to posterior surface of inferior angle of scapula and medial lip of intertubercular sulcus of humerus

▪️medial rotation
▪️extension of arm

Question 16

Latissimus dorsi

Answer 16

▪️attaches from spinous processes of T7-L5, inferior angle of scapula and inserts at intertubercular groove.

▪️addiction, medial rotation and extension of arm

Question 17

Coracobrachialis

Answer 17

▪️attaches at coracoid process of scapula and inserts at half way down humerus.

▪️flexor and adductor of humerus

Question 18

Brachialis

Answer 18

▪️attaches halfway down humerus (near insertion of deltoid) and inserts at coronoid process of humerus and ulnar tuberosity.

▪️flexor of forearm

Question 19

Triceps brachii

Answer 19

▪️heads:
-long head: lower part of Glenoid Cavity
-lateral head: upper posterior surface of humerus
-medial head: back of humerus under lateral and long heads
▪️merge and attaches to olecranon process

Question 20

Intermuscular septa

Answer 20

▪️layer of deep fascia covering muscles (like a stocking)
▪️moves away from surface and attaches to bone.
▪️creates compartments- anterior and posterior
▪️each compartment has its own nerve and artery supply.
▪️quite thick and strong-muscles can also attach to this as well as bone

Question 21

Spinal nerves

Answer 21

▪️8 cervical spinal nerves 
▪️12 thoracic spinal nerves
▪️5 lumbar spinal nerves 
▪️5 sacral spinal nerves
▪️1 coccyx spinal nerve

Question 22

Motor and sensory nerves

Answer 22

▪️motor nerves (to muscles)- ventral root
▪️sensory nerves (to skin)- dorsal root
▪️spinal nerve- a mix of sensory and motor.
▪️when they leave vertebral column out of intervertebral foramen they immediately divide- dorsal ramus (muscles and skin of back) and ventral ramus (muscles and skin of front)

Question 23

Brachial plexus

Answer 23

▪️roots: C5,C6, C7, C8, T1
▪️trunks: superior, middle, inferior 
▪️divisions: anterior, posterior 
▪️cords: lateral, posterior, medial
▪️terminal nerves:
-musculocutaneous: 5,6,7
-median: 6,7,8,1
-radial: 5,6,7,8,1
-ulnar: 7,8,1

Question 24

Musculocutaneous nerve

Answer 24

▪️supplies anterior compartment

▪️biceps brachii, brachialis, coracobrachialis

Question 25

Radial nerve

Answer 25

▪️supplies posterior compartment

▪️Triceps Brachii