Shoulders (Limbs)

Question 1

Name of the shoulder joint?

Answer 1

glenohumeral

Question 2

What type and what supports the acromioclavicular joint?

Answer 2

synovial - supported by acromioclavicular and coracoclavicular (fromed by conoid and trapezoid) ligaments

Question 3

what are the movements of the glenohumeral joint?

Answer 3

Flexion, extension, abduction, adduction, medial and lateral rotation and circumduction

Question 4

Where is there a tendency to fracture?

Answer 4

surgical neck of the humerus

Question 5

What forms the trochlear notch?

Answer 5

olecranon and coronoid process

Question 6

What does the capitulum articulate with?

Answer 6

head of radius

Question 7

What do the radius and ulna articulate to form?

Answer 7

proximal and distal radio-ulnar joints`

Question 8

What are the bones of the wrist?

Answer 8

Straight line to pinky, here comes the thumb

Scaphoid, lunate, triquestrum, Pisiform,, trapezium, trapezoid, capitate, hamate

Question 9

What is the pisiform?

Answer 9

Sesamoid bone as it is embedded in the tenddon of the Flexor carpi ulnaris

Question 10

What forms the carpa;l tunnel?

Answer 10

Carpal bones and flexor tendon retinaculum

Question 11

What passes through carpal tunnel?

Answer 11

4 tendons of flexor digitorum profundus and 4 tendons of flexor digitorum superficialis, flexor pollicis longus tendon and median nerve

Question 12

What movements can the metacarpophalangeal joints do?

Answer 12

extend, adduct, abduct, circumduct, flex

Question 13

Where does the pectoralis major arise from?

Answer 13

medial half of the clavicle, superior to costal cartilages and aponeurosis of external oblique

Question 14

Where does the pectoralis major attach?

Answer 14

Lateral lip of intertubecular sulcus

Question 15

What innervates the pectoralis major?

Answer 15

Lateral (C5,6,7) and medial pectoral (C8/T1) nerve

Question 16

What are the pectoral muscles?

Answer 16

Pectoralis major, pectoralis minor, subclavius and serratus anterior

Question 17

How would you test function of the pectoralis major?

Answer 17

Ask patient to adduct arm (bent elbow) agaijnst resistance whilst feeling the pec with the other hand

Question 18

Test for the glenohumeral joint?

Answer 18

Pec test, medial rotation of forearm against resistance, flexion of upper limb against resistance

Question 19

What are the attachments of pectoralis minor?

Answer 19

Origin: anterior surface of ribs 3-5
Inserts: corocoid process of scapula

Question 20

What innervates the pectoralis minor?

Answer 20

Medial pectoral nerve (C8/T1)

Question 21

Attachments of the subclavius?

Answer 21

Origin: first costochondral joint
Inserts: middle 3rd of clavicle

Question 22

Function of pec minor and subclavius respectively?

Answer 22

stabilize the clavicle by drawing anteroinferiorly against thoracic wall, stabilize the clavicle by depressing

Question 23

Serratus anterior attachments?

Answer 23

Origin: Lateral aspects of ribs 1-8
Inserts: medial border of scapula

Question 24

Serratus anterior innervation/

Answer 24

Long thoracic nerve (C5,6,7)

Question 25

Serratus anterior function and test?

Answer 25

laterally rotate and protract the scapula against the ribcage. Arms out against the wall with straight arms and push against it. Feel the muscles under the axilla

Question 26

What are the extrinsic shoulder muscles?

Answer 26

Latissimus dorsi, serratus anterior, Sternocleidomastoid and trapezius

Question 27

What are the Trapezius attachments?

Answer 27

Origin: occipital bone, nuchal ligament and spinous process C7-T12 InsertsL clavicle, acromion and scapular spine

Question 28

Trapezius test?

Answer 28

Raise shoulder against resistance (upper and middle fibres), Head backwards same process is just upper fibres

Question 29

Trapezius innervation?

Answer 29

Spinal Accessory nerve (proprioceptor fibres from C3/4)

Question 30

What controls wrist fine movement?

Answer 30

Ulna nerve

Question 31

Latissimus dorsi attachments?

Answer 31

Origin: vertebra T7-T12, iliac crest and ribs 9-12 Attaches: intertubecular groove of humerus

Question 32

Latissimus dorsi innervation?

Answer 32

Thoracodorsal nerve (long scapular) C6,7,8

Question 33

Teres major innervation?

Answer 33

Lower subscapular nerve (c5/6)

Question 34

`Test for Teres major and Latissimus Dorsi?

Answer 34

Arm is abducted and flexed both and 45 degrees, resist pulling back and in while feeling the contraction

Question 35

What are the superficial extrinsic shoulder muscles?

Answer 35

Trapezius and Latissimus dorsi

Question 36

What are the deep extrinsic shoulder muscles?

Answer 36

Levator scapulae, rhomboid major and minor

Question 37

What are the intrinsic shoulder muscles?

Answer 37

Deltoid, rotator cuff and teres major

Question 38

What are the differences between the intrinsic and extrinsic muscles?

Answer 38

Extrinsic: originate from the torso and attach to the shoulders e.g. clavicle, scapula or humerus Extrinsic: originate from the scapula/clavicle and attach to the humerus

Question 39

What are the deltoid attachments?

Answer 39

Origin: acromion, scapular spine and lateral 3rd of clavicle Inserts: deltoid tuberosity of humerus

Question 40

What innervates the deltoid?

Answer 40

Axillary nerve (C5/6)

Question 41

`Deltoid Test?

Answer 41

Arm extended at trunk, ask to extend from 15-90 degrees

Question 42

What are the teres major attachments?

Answer 42

origin: posterior surface of inferior angle of scapula Insert: medial lip of intertubecular groove of humerus

Question 43

What are the rotator cuff msucles?

Answer 43

Teres minor, subscapularis, infraspinatus and suprspinatis

Question 44

Subscapularis attachments:

Answer 44

Origin: Only one anterior at subscapular fossa Insert: lesser tubercle of humerus

Question 45

Subscapularis innervation?

Answer 45

Upper and lower subscapular nerve

Question 46

Subscapularis function?

Answer 46

Medially rotate arm (internal rotation)

Question 47

Supraspinatus attachments?

Answer 47

Origin: suprasinous fossa of scapula Insert: greater of tubercle of humerus

Question 48

Supraspinatus innervation?

Answer 48

Suprascapular nerve

Question 49

Supraspinatus function?

Answer 49

abductor of humerus to 15 degrees

Question 50

Infraspinatus attachments?

Answer 50

Origin: infrapsinous fossa of scapula Insert: greater tubercle of humerus

Question 51

infraspinatus innervation?

Answer 51

Suprascapular nerve

Question 52

Infraspinatus function?

Answer 52

Laterally rotate the arm (external rotation)

Question 53

Teres minor attachments?

Answer 53

Origin: lateral border of scapula (superior to major) Insert: greater tubercle of humerus

Question 54

teres minor innervation?

Answer 54

Axillary nerve (C5/6)

Question 55

Teres minor function?

Answer 55

Laterally rotate the arm (external rotation)