Superficial Back, Pectoral, And Intrinsic Shoulder Flashcards
What innervates the trapezius? What functions?
CN XI; elevates, depresses, retracts, and rotates scapula
What innervates the latissimus dorsi? What functions?
Thoracodorsal nerve; adducts, extends, and medically rotates humerus
What innervated the levator scapulae? What movements?
Dorsal scapular nerves; elevates scapula
What innervates the rhomboids? What movements?
Dorsal scapular nerve; retract and elevate scapula
What are the 3 pectoral region muscles? What is the first innervated by?
Pectoral is major, minor, and serratus anterior
They adduct, medially rotate, and flex humerus
Major: Medial and lateral pectoral nerves
What innervates the pectoralis minor? What movements?
Medial pectoral nerve; depress and inferiorly rotate scapula
What innervates the serratus anterior? What’s its movements?
Long thoracic nerve; protracts and rotates scapula
What does a lesion of the long thoracic nerve cause
Winged scapula
What are the 6 intrinsic shoulder muscles?
Deltoid, teres major, rotator cuff muscles (subscapularis, supraspinatus, infraspinatus, and teres major)
What innervates the deltoid & what’s its function?
Axillary nerve; abducts arm, flexes and medially rotates arm, extends and laterally rotates arm
Where is the teres major? What innervates it? What’s its function?
Lower subscapular nerve; adducts, extends, and medially rotates humerus
What is the order of the rotator cuff muscles?
SITS
Suprasubscapularis
Intrasubscapularis
Teres minor
Subscapularis
What is the most commonly damaged rotator cuff muscle?
Supraspinatus
What innervates the supraspinatus and infraspinatus?
Suprascapular nerve
S - initiates abduction
I - laterally rotates humerus
What innervates the subscapularis?
Upper and lower subscapular nerves; medially rotates humerus
Name theses muscles
What tendons surround the shoulder joint EXCEPT for inferiorly?
SITS muscle tendons
Describe a rotator cuff injury
- common shoulder injury, usually in dominant arm, most often involves supraspinatus
- acute tears - sudden, traumatic injuries (falls, etc.)
- chronic tears - result of repetitive strain/overuse
- treatment: physical therapy/surgery
What muscles are required for complete abduction of arm?
> 90° traps and serratus anterior
90° deltoid
15° supraspinatus
Which muscle initiates abduction?
Supraspinatus
How are veins classified?
Deep veins and superficial veins
Describe deep veins
Deep to investing fascia, runs WITH arteries
Describe superficial veins
In superficial fascia, no accompanying arteries
Describe an accompanying vein
Venae comitantes; Paired deep veins accompanying arteries; names for associated arteries
What regulates the direction of blood flow?
Valves (veins)
How are deep structures of the limb drained?
By veins that are often paired and extended alongside arteries (venae comitantes) that eventually form or open into the axillary vein that becomes the subclavian vein
What are superficial veins?
They help drain the limb but are not critical for survival
Describe the cephalic vein
Begins on radial side of hand; ascends laterally to deltopectoral triangle (interval between pectoralis major and deltoid) to empty into axillary vein
Describe the basilic vein
Begins on ulnar side of hand and ascends medially, will pierce brachial fascia, joining with the brachial veins to form the axillary vein
Describe the median cubital vein
Lies superficial to bicipital aponeurosis; communication between cephalic vein and basilic vein; common site for venipuncture
What is a common site on hand for venipuncture?
Dorsal venous network
What is the deltopectoral triangle?
Formed by pectoralis major, adjacent deltoid, and clavicle; the cephalic vein runs here; another common site for placement of catheters and leads
What is the function of the lymphatic system?
Drain interstitial fluid and return it to the venous system
Filter fluid
What are the components of the lymphatic system?
Lymphatic capillaries and vessels
Lymph nodes (filter fluid)
How much of lymph fluid is taken back up by capillaries?
90%
What is the general pattern of lymph fluid drainage of the body?
Lymphatic capillaries form plexus in tissues
Lymphatic capillaries converge and form larger lymph vessels
Lymphatic vessels contain valves to direct flow centrally towards heart
Lymphatic vessels take lymph to (and then away from) lymph nodes
There are superficial and deep lymphatic vessels and nodes
- superficial: superficial to deep to fascia; usually follow superficial veins; superficial veins will eventually drain into deep lymphatic vessels
- deep are deep to the deep fascia; vessels follow arteries (and deep veins); large lymphatic vessels enter large collecting vessels called lymphatic trunks which empty into either the right lymphatic duct or the thoracic duct
Describe specific pattern of drainage for the upper left limb
LEFT UPPER LIMB: drainage enters through the left subclavian trunk —> then enters thoracic duct: left jugular trunk, left subclavian trunk, left bronchomediastinal trunk, vessels from posterior intercostal and mediastinal regions, and vessels from lower trunk and limbs drain into cisterna chyli
Empties into the junction of the left subclavian and left internal jugular veins
drains 3/4 body
Describe specific drainage of the right upper limb
RIGHT LYMPHATIC DUCT: tributaries include right jugular trunk, right subclavian trunk, and right bronchomediastinal trunk
Empties into the junction of the right subclavian and right internal jugular veins
What are the superficial lymph nodes of the upper limbs and where do they drain?
What are the superficial lymph nodes of the upper limbs and where do they drain?
Where do most upper limb lymphatic vessels drain?
Deep to axillary nodes
What surface area can you palpate on the superficial back and shoulder? (Bones)
What surface area should you be able to palpate on the back (muscles)?
What surface should you be able to palpate anteriorly, female?
What surface anatomy should you be able to palpate, anteriorly male/muscle?
What surface anatomy should you be able to palpate, anteriorly male/muscle?
