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Movement 1 > The Pectoral Girdle and Shoulder > Flashcards

The Pectoral Girdle and Shoulder Flashcards

1
Q

What does the pectoral girdle comprise of?

A

Scapula + clavicle

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2
Q

How is the scapula attached to the chest wall?

A

Via muscles and soft tissues

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3
Q

How is the upper limb attached to the axial skeleton?

A

Via the pectoral girdle.

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4
Q

What four movements is the scapula capable of?

A

Protraction, retraction, elevation, depression.

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5
Q

What are the two superficial dorsal muscles of PG?

A

trapezius and latissimus dorsi

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6
Q

What are the two superficial dorsal muscles?

A

Trapezius and latissimus dorso

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7
Q

What innervates trapezius?

A

Spinal accessory nerve

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8
Q

What are the different actions on the scapula of the three fibres of trapezius?

A

Upper fibres = elevate. Middle fibres = retract. Lower fibres = depress.

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9
Q

What function do all trapezius fibres to together?

A

Rotate scapula during abduction of humerus above horizontal

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10
Q

what is origin of trapezius?

A

occipital bone, ligamentum nuchae, spinous processes of T1-T12.

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11
Q

What is insertion of trapezius?

A

lateral 1/3 of clavicle, and acromion & scapular spine of scapula.

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12
Q

What is latissimus dorsi?

A

Large muscle over back

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13
Q

What is origin of latissimus dorsi?

A

Spinous process of T6-12, thoracolumbar fascia, iliac crest & inferior 3-4 ribs.

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14
Q

Where does latissimus dorsi insert?

A

Floor of intertubercular sulcus/ groove of humerus

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15
Q

What innervates latissimus dorsi?

A

Thoracodorsal nerve (C6-8)

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16
Q

What are the 3 actions of latissimus dorsi?

A

Extends, adducts, medially rotates the shoulder. e.g. raises the body towards the arms when climbing.

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17
Q

What are the 3 deep muscles dorsal muscles of the back?

A

Levator scapulae, rhomboid major and rhomboid minor.

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18
Q

What is levator scapulae?

A

Small, strap-like muscle from back of neck to scapula

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19
Q

What are the attachments of levator scapulae?

A

Transverse processes of C1-4 and attaches to medial border of scapula.

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20
Q

What innervates levator scapulae and rhomboids?

A

Dorsal scalar nerve (brachial plexus - ventral ramus of C5)

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21
Q

What is action of levator scapulae ?

A

Elevates scapula and rotates scapula medially

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22
Q

Where is rhomboid minor in relation to major?

A

Superior

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23
Q

What are action of rhomboids?

A

Retracts scapula and medially and superiorly. Used in squaring the shoulders.

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24
Q

What are the attachments of rhomboid minor?

A

originates at spinal processes of C7-T1 vertebrae and attaches to medial side of scapula superior to spine.

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25
Q

What are attachments of rhomboid major?

A

Originates at T1-T5 spinous processes and attaches to medial side of scapula inferior to spine.

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26
Q

What are the three ventral pectoral muscles?

A

Serratus anterior, pectoralis major & minor and subclavius.

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27
Q

What are the functions of serratus anterior?

A

PROTRACTS scapula and inferior portion ROTATES scapula laterally. (defined muscles on manny pacquiao).

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28
Q

What are called the boxers muscles and why?

A

Serratus anterior and epctoralis minor as they protract the scapula.

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29
Q

What are the attachments of serratus anterior?

A

Originates at ribs 1-8 and attaches at medial border of scapula

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30
Q

What nerve innervates serratus anterior?

A

Long thoracic nerve (C5-7)

31
Q

What nerve is damaged that would result in winged scapula?

A

Long thoracic nerve (from brachial plexus C5-7)

32
Q

What happens to scapula in winged scapula?

A

Medial border and inferior angle of scapula pull away from posterior thoracic wall.

33
Q

What is the shoulder joint?

A

Ball and socket join between head of humerus and gleaned fossa (cavity of scapula).

34
Q

Why is the shoulder joint initially unstable?

A

Synovial joint surfaces are incongruent (badly fitting) and joint capsule is thin and lax.

35
Q

How is the stability of the shoulder joint improved?

A

The glenoid labrum, ligaments, biceps tendon, rotator cuff muscles.

36
Q

What ligament keeps the tendon of long head of biceps brachii in place on the head of humerus?

A

Transverse humeral ligament.

37
Q

Where is the shoulder joint weakest?

A

Inferiorly.

38
Q

What are the shoulder ligaments?

A

3 x glenohumeral (sup, middle, info), corachumeral and transverse humeral.
Also - coraco-acromial arch.

39
Q

What comprises the coraco-acromial arch and what is its function?

A

The accordion, coracoid process and coracoacromial ligament.

- prevents superior displacement of the humerus.

40
Q

What is torn in AC joint separation?

A

Acromioclavicular ligament

41
Q

What movements are possible at the shoulder?

A

flexion & extension
abduction & adduction
medial rotation

42
Q

What are the muscles involved in abduction?

A

firsty supraspinatus, then deltoid (MOST POWERFUL), then lateral rotation - of humerus = teres minor, of scapula = trapezius & serratus anterior.

43
Q

Describe abduction of shoulder

A

Supraspinatus initiates abduction for first 10-15 degrees.
Deltoid then takes over as most powerful.
Beyond 90 degrees,
- lateral rotation of humerus = teres minor
- lateral rotation of scapula = trapezius and serratus anterior.

44
Q

What are origin/insertion/function/innervation of teres major?

A

Origin - inferior angle of scapula
Insertion - medial lip of inter tubercular of humerus
Function = adducts and medially rotates humerus
Innervation = lower subscapular nerve (C5-6)

45
Q

What are the four rotator cuff muscles?

A
  1. supraspinatus
  2. infraspinatus
  3. teres minor
  4. subscapularis
46
Q

What is the function of the four rotator cuff muscles?

A

Tendons act as a ‘ligament’ keeping the head of the humerus pressed into the glenoid fossa.

47
Q

What is the origin of supraspinatus?

A

Supraspinous fossa of scapula

48
Q

What is the action of supraspinatus?

A
  • Initiates abduction of arm (first 15 degrees)

- Stabilises glenohumeral joint

49
Q

What innervates supraspinatus?

A

Suprascapular nerve

50
Q

How do you test supraspinatus?

A

Abduct arm against resistance

51
Q

What is origin of infraspinatus?

A

Infraspinous fossa of scapula

52
Q

What is action of infraspinatus?

A
  • Lateral rotator of humerus

- stabilises gelnohumeral joint

53
Q

What is innervation of infraspinatus?

A

suprascapular nerve

54
Q

How do you test infraspinatus?

A

Laterally rotate arm against resistance (with elbow flexed and arm abducted?

55
Q

What is origin of teres minor?

A

Middle part of lateral border of scapula

56
Q

What is action of teres minor?

A

Laterally rotates and adducts humerus (w/ infraspinatus)

- stabilises glenohumeral joint

57
Q

What innervates teres minor?

A

Axillary nerve

58
Q

How do you test teres minor?

A

Same as infraspinatus

59
Q

What is origin of subscapularis?

A

Subscapular fossa

60
Q

Where is subscapularis located?

A

In between both infraspinatuses *

61
Q

What is action of subscapularis?

A

Medial rotator and adductor of humerus

- stabilises glenohumeral joint

62
Q

What is innervation of subscapularis?

A

Upper and lower subscapularis nerves (C5-6)

63
Q

How do you test subscapularis?

A

Place the dorsum of hand to the middle of lumbar spine.

Then lift the dorsum of the hand off the back

64
Q

What is the muscle most commonly ruptured in rotator cuff injuries?

A

Supraspinatous tendon (most superior muscle in shoulder).

65
Q

What are symptoms of a rotator cuff injury?

A

Pain when the arm is overhead and weakness

66
Q

How do you test for a rotator cuff (supraspinatous tendon)?

A
  • Abduct arm fully, slowly with control.

- > at 09 degrees arm will suddenly fall to side.

67
Q

What nerve is at risk in anterior dislocation/surgical neck and what would be clinical sign of?

A

Axillary nerve - deltoid wastage and reduced/loss of sensation over C% dermatome.
tested by: difficult abducting beyond 15 degrees

68
Q

What neck is at risk due to scapular fracture (uncommon)?

A 
Suprascapular nerve (C5,6)
- supraspinatus paralysed
tested by: patient can product first 10-15 degrees of abduction by leaning to on side and letting joint abduct passively.
69
Q

What are the boundaries of the quadrilateral space?

A 
Lateral = surgical neck of humerus
Medial = long head of triceps brachii
Inferior = Teres major
Superior = Teres minor
70
Q

What VAN does the quadrilateral space contain?

A

Axillary nerve and posterior circumflex humeral artery and vein.

71
Q

What is quadrilateral space syndrome?

A
  • Uncommon condition that affects athletes who perform overhead movements e.g. tennis
  • transient blockage of axillary nerve and posterior humeral circumflex artery.
  • typically occurs when arm lies in a position of abduction, extension and external rotation.
  • Patients experience shoulder pain and paraesthesia done the arm.
  • often associated with fibrotic bands in the quadrilateral space.
72
Q

What is the brachial plexus?

A

A network of nerve found in the region of the clavicle and axilla.
- gives rise to nerves which provide s and m to entire of upper limb.

73
Q

How many terminal branches does brachial plexus have?

A

5

  1. musculocutaneous
  2. axillary
  3. radial
  4. median
  5. ulnar
74
Q

What vein lies in the deltopectoral groove?

A

Cephalic vein.

Movement 1 (4 decks)

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