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Skin/Musculoskeletal: Anatomy/Dissection > Superficial Back, Deltoid, and Scapula Regions > Flashcards

Superficial Back, Deltoid, and Scapula Regions Flashcards

1
Q

What are the two superficial posterior axioappendicular (extrinsic shoulder) muscles?

A

lattissimus dorse

trapezius

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2
Q

What nerve supplies the latissimus dorsi?

A

thoracodorsal nerve

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3
Q

What are the 3 functions of the latissimus dorsi?

A

extends, adducts, and medially rotates the humerus at the shoulder joint

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4
Q

What nerve supplies the trapezius?

A

Accessory nerve (CN XI)

and C3, C4 spinal nerves

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5
Q

What are the three functions of the trapezius?

upper fibers?

middle fibers?

lower fibers?

A

Upper fibers: Elevate scapula

Middle fibers: Retract scapula

Lower fibers: Depress scapula

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6
Q

What does paralysis of the trapezius muscle result in and why?

A

It causes droopy shoulder - the upper trap helps the serratus anterior in making possible abdution of the humerus of more than 90 degrees

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7
Q

What are the 3 deep axioappendicular (extrinsic shoulder) muscles?

A
  1. Levator scapulae
  2. Rhomboidei (major and minor)
  3. Serratus anterior
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8
Q

What nerve supplies the levator scapulae?

A

dorsal scapular nerve

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9
Q

What is the function of the levator scapulae?

A

elevates and fixes the scapula

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10
Q

What nerve supplies the major and minor rhomboidei?

A

dorsal scapular nerve

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11
Q

What are the main function of the major and mino rhomboidei?

A

retracts and elevates the scapula

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12
Q

WHat nerve supplies the serratus anterior?

A

the long thoracic nerve

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13
Q

What are the functions of the serratus anterior?

A
  1. protracts the scapula and holds it against the thoracic wall
  2. positions the glenoid cavity
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14
Q

What are the 6 scapulohumeral (intrinsic shoulder) muscles?

A
  1. Deltoid
  2. Teres major
  3. Supraspinatus
  4. Infraspinatus
  5. Teres minor
  6. Subscapularis
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15
Q

WHat nerve supplies the deltoid?

A

axillary nerve

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16
Q

What are the three functions of the deltoid?

A

Anterior fibers: Flex and medially rotate the humerus

Middle fibers: Chief abductor of the humerus

Posterior fibers: Extend and laterally rotate the humerus

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17
Q

What nerve supplies the teres major?

A

lower subscapular nerve

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18
Q

What is the function of the teres major?

A

adducts and medially rotates the humerus

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19
Q

What nerve supplies the supraspinatus?

A

Suprascapular nerve

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20
Q

What is the main function of the supraspinatus?

A

abducts the humerus

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21
Q

What nerve supplies the infraspinatus?

A

suprascapular nerve

22
Q

What is the function of the infraspinatus?

A

laterally rotates the humerus

23
Q

WHat nerve supplies the teres minor?

A

axillary nerve

24
Q

What is the function of the teres minor?

A

laterally rotates the humerus

25
Q

What nerves supplies the subscapularis?

A

the upper and lower subscapular nerves

26
Q

What is the function of the subscapularis?

A

medially rorates the humerus

27
Q

What are the two attachments of the omohyoid muscle?

A

the inferior attachment is the superior border of the scapula near the suprascapular notch

the superior attachment is to the hyoid bone on which the muscle acts

28
Q

What 3 nerves supply the omohyoid muscle?

A

CN 1, 2, and 3

29
Q

What is the funciton of the omohyoid bone

A

It depresses, retracts, and steadies the hyoid bone

30
Q

What three arteries are involved in blood cirulation of the upper limb?

A

transverse cervical artery (deep branch)

dorsal scapular artery

suprascapular artery

circumflux scapular artery

31
Q

What muscle of the back connects the upper limb with the thoracic wall? What is its nerve supply?

A
32
Q

How would one clinically test the function of the deltoid?

A

The examiner resists the patient’s abduction of the limb by the deltoid. If the deltoid is acting normally, contraction of the middle part of the muscle can be palpated.

33
Q

What muscles form the posterior axillary fold? What is their nerve supply?

A
34
Q

What muscles form the rotator cuff?

A

Supraspinatus

Infraspinatus

Teres minor

Subscapularis

35
Q

What is the most common site of clavicular fracture?

A

At the junction of its middle and lateral thirds

this is especially weak in children and often breaks when they catch themsevles with an outstretched hand in a fall

36
Q

Why does the shoulder droop following clavicular fracture?

A

When the clavicle breaks, the sternocleidomastoid pulls the broken piece up

the trapezius is not strong enough to hold up the limb by itself, so the shoulder droops

patients with broken clavicles will often support the arm with the other hand to keep it from drooping too low

it’s kept from dislocating at the AC joint by the strong coracoclavicular ligament

37
Q

What is a ‘greenstick’ fracture?

A

A fracture of the clavicle is often incomplete in younger children—that is, it is a greenstick fracture, in which one side of a bone is broken and the other is bent. This fracture was so named because the parts of the bone do not separate; the bone resembles a tree branch (greenstick) that has been sharply bent but not disconnected.

38
Q

What is “winged scapula” and how does it usually occur?

A

WHen a patient pushes against a wall, the scapula will “wing” out

This is caused by damage to the long thoracic nerve which innervates the serratus anterior

39
Q

What is the triangle of auscultation? When using a stethoscope and listening for lung sounds, what intercostal space would the triangle expose?

A

Triangle of auscultation formed by the trapezius, rhomboid major and latissimus dorsi.

6th and 7th intercostal space

40
Q

What clinical deficit would be apparent with injury to the thoracodorsal nerve?

A

With paralysis of the latissimus dorsi, the person is unable to raise the trunk with the upper limbs, as occurs during climbing.

41
Q

What happens with respect to “chinning” one’s self and the use of crutches with paralysis of the latissimus dorsi?

A

With paralysis of the latissimus dorsi, the person is unable to raise the trunk with the upper limbs, as occurs during climbing. Furthermore, the person cannot use an axillary crutch because the shoulder is pushed superiorly by it. These are the primary activities for which active depression of the scapula is required; the passive depression provided by gravity is adequate for most activities.

42
Q

How would injury to the dorsal scapular nerve effect the position of the scapula?

A

Injury to the dorsal scapular nerve, the nerve to the rhomboids, affects the actions of these muscles. If the rhomboids on one side are paralyzed, the scapula on the affected side is located farther from the midline than that on the normal side.

43
Q

When is injury to the axillary nerve most likely to occur? What would be the appearance of the patient’s shoulder sometime following axillary nerve injury?

A

Because it passes inferior to the humeral head and winds around the surgical neck of the humerus (Fig. B6.8A), the axillary nerve is usually injured during fracture of this part of the humerus. It may also be damaged during dislocation of the glenohumeral joint and by compression from the incorrect use of crutches.

As the deltoid atrophies, the rounded contour of the shoulder is flattened compared to the uninjured side. This gives the shoulder a flattened appearance and produces a slight hollow inferior to the acromion.

44
Q

Which muscle of the rotator cuff is most commonly torn?

A

Trauma may tear or rupture one or more of the tendons of the SITS muscles. The supraspinatus tendon is most commonly ruptured

45
Q

When is dislocation of the shoulder joint most likely to occur? Where would the head of the humerus usually move with a shoulder dislocation?

A

Anterior dislocation of the glenohumeral joint occurs most often in young adults, particularly athletes. It is usually caused by excessive extension and lateral rotation of the humerus

inferoanteriorly, so down and forward

46
Q

When would a patient most likely experience shoulder pain (subacromial bursitis)?

A

Calcification of the supraspinatus tendon leads to inflammation of the bursa, causing pain on abduction of the upper extremity (painful arc syndrome).

47
Q

From where does the accessory nerve take origin? Is it a spinal or cranial nerve?

A

It takes origina from C1-C6

However, it is considered a cranial nerve because it first travels up into the cranium through the fossa magnum and then back down through the neck

48
Q

What muscles are innervated by the dorsal scapular nerve?

A

the rhomoides and the levator scapulae

49
Q

What muscle is innervated by the thoracodorsal nerve and supplied by the thoracodorsal artery?

A

latissimus dorsi

50
Q

Through what space does the axillary nerve pass through?

A

the quadrilateral/quadrangle space

51
Q

Why is the long thoracic nerve unusually susceptible to injury?

A

While nerves usually run deep to the muscles they supply, the long thoracic nerve runs superiorly to the seratus anterior, so it’s more readily exposed when the limb is elevated

Skin/Musculoskeletal: Anatomy/Dissection (12 decks)

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