The Axilla and shoulder girdle Flashcards
where is the sternoclavicular joint
sternum and clavicle
where is the acromioclavicular joint
between clavicle and scapular
where is the glenohumeral joint
between humorous and scapula
palpable
felt through the skin
scapular structure
large
flat
triangular shape
overlays the ribs (2-7 on posterior lateral aspect of the thorax)
dorsal = spine of the scapula = shelf like , thick , ridge of bone
costal = fewer features - one large fossa, carxocid process - attach many ligaments
glenoid cavity
socket between scapula and humerous
acromion
peak of the shoulder
clavicle structure
s shaped contro
convex medially
concave laterally
almost flat near acronym
medial more bulky
conoid tubercle - site of important ligament attachment
humerus
longest bone in upper limb
ball of ball and socket - glint humorous joint
rotator cuff muscles
lesser tubule - subsoil pillars attaches
greater tubule - 3 facets - 3 rotator cuff muscles attach
super stuanuss, infer stunassus and Teres minor
anatomical and surgical neck of humerus
Anatomical neck = region that is directly adjacent to the head
Surgical neck = lower down = point at which humerus commonly fractures
3 parts of sternum
mandibrium
body
xiphoid sterum
3 parts of sternum
mandibrium
body
xiphoid process
common clinical features
clavicle break - weak point at the junction of 2 curves
proximal humero=us fracture - surgical neck - elderly osteoporosis
ligament
bone to bone
tendon
connect muscle to bone
what is the shoulder girdle
region of the body where out upper limbs connect to the trunk
what does the shoulder girdle consist of
clavicle and scapula
palpable parts of shoulder girdle
the prominances of the scapula
- the acromion (the peak of the scapula
- the croacoid process of the scapula
- the protrusions of the humerus on the anterior side
area above the spine of the scapula
supra spina fossa
area below the spine of the scapula
infraspina fossa
coracoid process
site for attatchment of ligaments
greater and lesser tubercles
site of rotator cuff muscles
what muscle attach at the greater tubercle
3 rotator cuff muscles
supraspinatus
infraspinatus
teres minor
which joints are synovial joints
sternoclavicular and acromioclavicular joint
3 specific regions are involved in the steroclavicular joint
medial end of the clavicle, the clavicular notch, manubrium region of the sternum
what is a synovial joint
synovial fluid filled cavity
surrounded by fibrous connective tissue capsule
3 main ligaments in the sternoclavicular joint
costoclavicular, interclavicular and the sternoclavicular ligaments
give strength and allows movement
where is costoclavicular ligament
runs between the costal cartilage and inferior surface of the clavical
where is interclavicular ligament
unites 2 medial ends of the clavicals and some attacine to superior surface of the manubrium
where is the sternoclavicular ligament
Sternoclavicular ligament - between sternum and clavica
3 ligaments in the acromioclavicular joint
acromioclavicular ligament
caracoclavicular (2 parts = trapezoid and conoid ligaments)
corcocromial ligament
why is the glenohumeral joint unstable
because the ball is bigger than the socket to allow for wide range of movement
ball and socket - synovial joint
what provides support for the glenohumeral joint
-glenoid labrum - cartilaginous ring that increase the depth of the glenoid
- ligaments
- support from rotatory cuff muscles
- tendon from the supra glenoid cavity - maintains its position.
glenoid cavity of the scapula
shallow
allows for wide range of motion
unstable joint
glenoid labrum
cartilaginous ring
increases depth of the glenoid
stabilises joint
supra globoid tubercle
dissection of the scapula - runs through the joint in a groove between the greater and lesser cubicle of the humerus = maintain the position - stabilises the head of the humerus within the glenoid - particularly during certain movements - abduction of shoulder joints
common clinical dislocations
the glenohumeral joint in the shoulder - by a blow to an abducted, externally rotated and extended arm or violent muscle movements
can dislocate ant/pos/inf
joint replacement
parts of damaged joint are removed and replaced with metal, plastic or ceramic device
total or hemi-arthroplasty or reverse total shoulder replacement
3 main muscle groups of the shoulder girdle
- anterior axis appendicular
- posterior axis appendicular
- scapulohumeral
anterior axis appendicular
(connect upper limb and thoracic wall)
- posterior axis appendicular
(connect upper limb and vertical column)
- scapulohumeral
(connect scapula and humerus)
what are the 4 anterior axioappendicular muscle
pectoralis major, pectoralis minor, subclavius, serratus anterior
pectorals major muscle
thick
fan shaped muscle
wide range of surfaces
sternal half of clavicle
anterior half of sternum
flexion abduction internal rotation
pectoralis minor
thin triangular muscle
from ribs 3,4,5
insets into caracoid process of scapula
moving scapular - protraction and depression
subclavian muscle
small muscle
between 1st rib and clavicle
stables the sternaclavicular joint
serratus anterior muscle
rib 1-9
muscle fibres run posteriorly around posterior wall
insert on dial border of the costal surface of the scapula
deep costal surface of the scapula in contact with thoracic wall
4 muscles of the anterior axis appendicular muscle
pectoralis major, pectoralis minor, subclavius, serratus anterior
What are the 5 muscles of the posterior axioappendicular muscles?
trapezius, latissiumus dorsi, rhomboid major, rhomboid minor, levator scapulee
trapezius
large triangular muscle
originates from wide number of surfaces
occipital bone of the skull and vertebra in your neck and thorax
clavicle acronym of the scapula and spin elf the scapula
moving neck and stabilising scapula
latissisumus dorsi
large muscle
overlying the lumbar and lower thoracic region
originates from vertebra in thoracic and lumbar region
insert into groove of humerus - adduction, extension, internal rotation of the humerus
where do the rhobboid major, minor and levator scapulae muscle originate and insert into
originate from different vertebra and insert into medial scapula
what are the 6 scapulohumeral muscle
deltoid
teres major
supraspinatus
infraspinatus
subscapularis
teres minor
which 4 of the scapulohumeral muscles are rotator cuff muscle
supraspinatus, infraspinatus, teres minor, subscapularis.
strutcure and function of deltoid
thick
Curved
Triangular
originates from chromium and scapular spine
Inserts about midway down the shaft of the humerus
Tubercle - deltoid tubercle - where the muscle inserts
Deltoid involved in a range of motion - abduction of upper limb, flextion, extension and rotation
structure and function of teres major
Thick
Flat
Dorsal scapula to the humerus
Extension and medial rotation
function of rotator cuff muscles
maintain stability of shoulder joint
function of subscapularis muscle
medial rotation of humerus
function of supraspinatus muscle
initiates abduction of arm
function of infraspinatus muscle
lateral rotation of humerus
types of toattroy cuff tears
intrinsic, extrinsic, complete, incomplete, full thickness, partial thickness
intrinsic rotator cuff tear
degeneration , subnormal collagen fibres, hypovascularity
age, collagen problem, reduction in blood supply
extrinsic rotator cuff tears
impingement, tensile overload (acute vs repetitive)
inflmmation mechanical pressure
how does a rotator cuff tear occur
traumatic injury or excessive activity of the muscle
symptoms of rotator cuff tears
pain, weakness, ADL difficulties
what happens in frozen shoulder (adhesive capsulitis)
capsule and ligament of glenohumeral joint become inflamed
pain in shoulder
stiffen
external roation affected
who is more likley to ave frozen shoulder
females
40-60
certain underlying conditions - diabetes, cardiovascular , thyroid
stages of frozen shoulder
freezing
frozen
thawing = improvement over time
difference between rotator cuff tear and frozen shoulder
the doctor is not able to move a frozen shoulder, whereas they are with a rotator cuff tear
function of cervicoaxillary canal
allows neurovascular structures to pass between the neck and upper limb
anterior wall of axilla
pectoralis major and minor muscles
subclavian muscles
clavipectoral fascia
lateral wall of the axilla
inter tubercular sulcus
medial wall of the axilla
upper thoracic wall
serratus anterior muscle
posterior wall of the axilla
subscapularis
trees major
latissimus dorsi
long head of triceps
brachii muscle
inlet of axilla
lateral margin f rib 1
clavicle
superior margin of scapula to carload process
floor of axilla
skin of armpit
opens laterally into arm
what artery is the main blood supply to the upper limb
brachial artery
3 main regions of axillary artery
Based on position of the artery in relation to the pectoralis minor muscle
1. Proximal to pectoralis minor
2. Posterior to muscle
3. Diastal to muscle
what are the 2 veins that drain the arm
cephalic vein
catholic vein
where is cephalic vein
point of entering the axilla
where is the catholic vein
rubs between the deltoid muscle and pectorals major
when does the axillary vein become the subclavian vein and what is its function?
At the point of leaving the axilla to the first rib - travels to return blood to the heart
lymphatic drainage system of the axilla
all lymph drains into the apical nodes of the axilla, then into the subclavian trunk, before draining back into the venous supply
axilla lymph system parts
axillary lymph node, axillary artery, apical axillary node, pectoralis minor, supraclavicular node, pectoralis major, thoracic nodes, breast tissue.
what is lymphoedema
abnormal accumulation of lymph which cause localised swelling
women treated for breast cancer - at risk
disruption of lay-tic system (by surgery or radiotherapy)
winged scapula
most commonly caused by damage to long thoracic nerve
inverted serratus anterior muscle
keeps medial border at inferior angle of the scapula opposed to the thoracic wall
