The Shoulder Flashcards

1
Q

Why is the pectoral girdle more fluid than the pelvic girdle?

A

The bones are only attached in place with ligaments and muscles, not bone attachments.

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2
Q

What are the 2 tubercles present on the anatomical head of the humerus?

A

The greater tubercle and the lesser tubercle

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3
Q

Which muscle attaches to the superior facet on the humerus?

A

Supraspinatus

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4
Q

Which muscle attaches to the middle facet of the humerus?

A

Infraspinatus

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5
Q

Which muscle attaches to the inferior facet of the humerus?

A

Teres minor

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6
Q

What are the names of the 2 necks on the proximal end of the humerus?

A

Anatomical neck
Surgical neck

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7
Q

Which muscle attaches to the lesser tubercle?

A

Subscapularis

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8
Q

What inserts onto the deltoid tuberosity and where is it on the humerus?

A

The deltoid muscle inserts, the tuberosity is at the middle of the bone, laterally

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9
Q

What is found in the bicipital groove on humerus?

A

The bicep tendons run here

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10
Q

What is found in the radial groove and where is this on the humerus?

A

The radial nerve is found here, groove passes across on the posterior side of the humerus

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11
Q

Why does the surgical neck of humerus have more weakness than the anatomical neck?

A

Axillary nerve is present here to it is at risk if there is a fracture

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12
Q

What muscle attaches to the medial parts of the middle of the humerus?

A

Coracobracialis muscle

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13
Q

What part of a muscle attaches to the radial groove?

A

The lateral head of the tricep

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14
Q

Name the 3 main parts of the scapula bone

A

Acromion
Spine
Coracoid process

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15
Q

Define tubercle

A

Tubercles are attachments for ligaments

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16
Q

What does the spine on the scapula separate?

A

It separates the superior supraspinous fossa and the inferior infraspinous fossa

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17
Q

Which part of the scapula is most anterior. the coracoid process or the acromion?

A

The coracoid process

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18
Q

What does the acromion articulate with?

A

Articulates with clavicle

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19
Q

What are the anterior and posterior fossae of the scapula called?

A

Anterior - Subscapular fossa
Posterior - Infraspinous fossa

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20
Q

What happens at the glenoid fossa?

A

This is where the joint between the humerus and the scapula is present.

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21
Q

What are the 2 tubercles at the glenoid fossa called?

A

Supraglenoid tubercle
Infraglenoid tubercle

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22
Q

What main feature of the glenohumeral joint allows great mobility?

A

It is a synovial joint, only attached with muscles and ligaments, no bone.
Synovial joint have lots of slack.

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23
Q

What can the scapula dp since it is not attached to the rib cage?

A

It can slide over the posterior rib cage

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24
Q

What are bursae and what do they do?

A

Bursae are fluid filled sacs that work as a ‘cushion’ to reduce friction between fibrous membranes and surrounding ligaments.

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25
Q

What are the main sites in which bursae are found?

A

Shoulders
Elbows
Hips
Knees

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26
Q

What is bursitis?

A

Inflammation of the bursa.
Causes pain and restricts motion.

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27
Q

What does the higher/lateral part of the clavicle articulate with?

A

Articulates with acromion

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28
Q

What does the lower/medial part of the clavicle articulate with?

A

Articulates with the manubrium of sternum and first costal cartilage

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29
Q

Name the tubercle present on the clavicle surface and where it is positioned

A

Coinoid tubercle, present on the lateral/higher third of the clavicle

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30
Q

What attaches to the conoid tubercle on the clavicle?

A

The coracoclavicular ligament

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31
Q

What is the trapezoid line and where is it on the clavicle?

A

The trapezoid line is the attachment of the trapezoid ligament, it is the lateral part of the coracoclavicular ligament (lateral part)

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32
Q

What is the only bony attachment between the trunk and upper limb?

A

Clavicle

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33
Q

What are the ligament and muscle parts of the glenohumeral joint?

A

Glenoid labrum
Biceps tendon
Arch of coracoid and acromion (coracoacromial ligament)
Synovial and fibrous joint membranes
Rotator cuff muscles

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34
Q

What is the name of the synovial joint between the clavicle and acromion?

A

The acromio-clavicular joint

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35
Q

Which ligaments make up the coraclavicular ligament?

A

The trapezoid ligament
The conoid ligament

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36
Q

What 2 ligaments are part of the acromio-clavicular joint?

A

Acromioclavicular ligament
Coraclavicular ligament

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37
Q

Which joint of the shoulder can become dislocated in shoulder separation injuries?

A

The acromioclavicular joint

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38
Q

What is the name of the joint between the sternum and the clavicle?

A

Sternoclavicular joint

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39
Q

What is common between the sternoclavicular, acromioclavicular and glenohumeral joint?

A

They are all synovial joints

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40
Q

Name the 3 ligaments involved in the sternoclavicular joint

A

Interclavicular ligament
Anterior sternoclavicular ligament
Costoclavicular ligament

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41
Q

What is the surface anatomy attachment for the second rib?

A

Sternal angle, between manubrium and sternum

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42
Q

Name the 2 main ligaments involved in the shoulder joint (glenohumeral)

A

Glenohumeral ligaments
Coracohumeral ligaments

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43
Q

What 3 bands in the glenohumeral joint run from the glenoid fossa to the anatomical neck of humerus?

A

Superior
Middle
Inferior
Stabilises anterior aspect of shoulder

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44
Q

What 2 places does the coracohumeral ligament on the humerus attach to?

A

Attaches from the base of the coracoid process to the greater tubercle of humerus.

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45
Q

What is the glenoidal labrum in the glenohumeral joint?

A

Fibrocartilaginous ridge surrounding glenoid cavity. Reduces risk of dislocation.

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46
Q

Where does the joint capsule of the shoulder extend from?

A

Extends from the anatomical neck to the border of the glenoid fossa.

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47
Q

Name the 2 bursae within the shoulder joint

A

Subacromial
Subscapular

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48
Q

Where is the subacromial bursa located and what does it support?

A

Located inferior to the deltoid and acromion.
Superior to supraspinatus tendon and joint capsule.
It supports the deltoid and supraspinatus.

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49
Q

Where is the sub scapular bursa located and what does it support?

A

Located between the subscapularis tendon and the scapula.
Reduces wear and tear of the shoulder joint during movement.

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50
Q

What is the origin of the supraspinatus?

A

Supraspinous fossa

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51
Q

What is the insertion of supraspinatus?

A

Superior facet of greater tubercle of humerus

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52
Q

What innervates the supraspinatus?

A

Suprascapular nerve C5,6

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53
Q

What is the action of supraspinatus?

A

Initiates abduction of arm 0-15 degrees

54
Q

What is the origin of infraspinatus?

A

Infraspinous fossa

55
Q

What is the insertion of infraspinatus?

A

Middle facet of greater tubercle of humerus

56
Q

What innervates the infraspinatus?

A

Suprascapular nerve C5,6

57
Q

What is the action is infraspinatus?

A

Lateral rotation of arm

58
Q

What is the origin of teres minor?

A

Lateral infraspinous fossa

59
Q

What is the insertion of teres minor?

A

Inferior facet of greater tubercle of humerus

60
Q

What innervates the teres minor?

A

Axillary nerve C5,6

61
Q

What is the action of teres minor?

A

Lateral rotation of arm

62
Q

What is the action of teres minor?

A

Lateral rotation of arm

63
Q

Is teres major a rotator cuff muscle or not?

A

No it’s not!

64
Q

What is the origin of teres major?

A

Posterior surface of scapula near inferior angle

65
Q

What is the insertion of teres major?

A

The bicipital groove

66
Q

What innervates the teres major?

A

Inferior sub scapular nerve C5,6

67
Q

What is the action of teres major?

A

Medially rotates and extends arm

68
Q

What is the origin of subscapularis?

A

Subscapular fossa

69
Q

What is the insertion of subscapularis

A

Lesser tubercle of humerus

70
Q

What innervates the subscapularis?

A

Superior and inferior sub scapular nerves C5,6,7

71
Q

What is the action of subscapularis?

A

Medial rotation of arm

72
Q

Which rotator cuff muscle is anterior on the shoulder?

A

Only the subscapularis!

73
Q

What are the superficial extrinsic muscles to the humerus?

A

Trapezius
Latissimus dorsi

74
Q

What are the deep extrinsic muscles to the humerus?

A

Levator scapulae
Rhomboid major
Rhomboid minor

75
Q

What is the origin of the trapezius?

A

Spinous processes C7-T12

76
Q

What is the insertion of the trapezius?

A

Lateral third of clavicle, acromion and spine of scapula

77
Q

What innervates the trapezius?

A

Accessory nerve C3,4

78
Q

What is the action of trapezius?

A

Rotates scapula to elevate arm
Elevates, depresses, retracts scapula
Extends and rotates the head

79
Q

What is the origin of latissimus dorsi?

A

Spinous processes T6-L5
Sacrum
Iliac crest
Ribs 10-12

80
Q

What is the insertion of latissimus dorsi?

A

The bicipital groove of humerus

81
Q

What innervates the latissimus dorsi?

A

Thoracodorsal nerve C6,7,8

82
Q

What is the action of latissimus dorsi?

A

Powerful adduction, medial rotation and extension of the arm

83
Q

What is the origin of levator scapulae?

A

Transverse processes of C1-4

84
Q

What is the insertion of levator scapulae?

A

Upper medial border of scapula

85
Q

What innervates the levator scapulae

A

C3,4 and dorsal scapular nerve C4,5

86
Q

What is the origin of rhomboid major?

A

Spinous processes of T2-5

86
Q

What is the origin of rhomboid major?

A

Spinous processes of T2-5

87
Q

What is the insertion of rhomboid major?

A

Between scapula spine and inferior angle

88
Q

What innervates rhomboid major?

A

Dorsal scapular nerve C4,5

89
Q

What is the action of rhomboid major?

A

Elevates and retracts scapula

90
Q

What is the origin of rhomboid minor?

A

Spinous processes C7-T1

91
Q

What is the insertion of rhomboid minor?

A

Medial edge of scapula at level of spine

92
Q

What is the insertion of rhomboid minor?

A

Medial edge of scapula at level of spine

93
Q

What innervates rhomboid minor?

A

Dorsal scapular nerve C4,5

94
Q

What is the action of rhomboid minor?

A

Elevates and retracts scapula

95
Q

What is the origin of the deltoid?

A

The clavicle and scapula (opposite the trapezius)

96
Q

What is the insertion of the deltoid?

A

The deltoid tuberosity on the humerus

97
Q

What innervates the deltoid?

A

Axillary nerve C5,6
Used to test the C5 myotome

98
Q

What is the action of the deltoid?

A

Powerful abduction of arm beyond 15 degrees

99
Q

Name the 5 anterior muscles of the shoulder

A

Pectoralis major
Pectoralis minor
Subclavius
Coracobrachialis
Serratus anterior

100
Q

What is the origin of the pectoralis major?

A

Medial half of clavicle
Anterior surface of sternum and first 7 costal cartilages

101
Q

What is the insertion of the pectoralis major?

A

Lateral part of the bicipital groove

102
Q

What innervates pectoralis major?

A

Medial and lateral pectoral nerve C5-T1

103
Q

What is there action of pectorals major?

A

Powerful adduction, flexion, extension and medial rotation of the arm

104
Q

What is the origin of pectoralis minor?

A

Anterior surfaces of rib 3-5

105
Q

What is the insertion of pectoralis minor?

A

Coracoid process

106
Q

What innervates pectoralis minor?

A

Medial pectoral nerves C5-T1

107
Q

What is the action of pectoralis minor?

A

Rotates and protracts scapula

108
Q

What is the origin of the subclavius?

A

The first rib costal cartilage

109
Q

What is the insertion of the subclavius?

A

Middle third of clavicle

110
Q

What innervates the subclavius?

A

Nerve to subclavius C5,6

111
Q

What is the action of the subclavius?

A

Depresses clavicle and stabilises the joint

112
Q

What is the origin of the coracobrachialis?

A

The coracoid process

113
Q

What is the insertion of the coracobrachialis?

A

Medial aspect of the humerus

114
Q

What innervates the coracobrachialis?

A

Musculocutaneous nerve C5-7

115
Q

What is the action of coracobrachialis?

A

Flexes the arm

116
Q

What is the origin of the serratus anterior?

A

Lateral surfaces of rubs 1-8/9

117
Q

What is the insertion of the serratus anterior?

A

Medial border of scapula costal surface

118
Q

What innervates the serratus anterior?

A

Long thoracic nerve C5-7

119
Q

What is the action of serratus anterior?

A

Protracts and rotates scapula

120
Q

What is winging and how does it involve serrates anterior?

A

Winged scapula is when serrates anterior is not holding the scapula in place.

121
Q

Name the 2 posterior nerves of arm

A

Suprascapular nerve
Axillary nerve

122
Q

Outline the pathway of the suprascapular nerve

A

1) Travels from superior trunk of brachial plexus
2) Travels through the suprascapular foramen between bone and supraspinatus muscle
3) Travels through greater scapular notch to infraspinatus

123
Q

Outline the pathway of the axillary nerve

A

1) Travels from posterior cord of brachial plexus
2) Passes posteriorly to surgical neck of humerus - so it is in danger is fractures

124
Q

Which rotator cuff muscles are innervated by the subscapular nerve?

A

Supraspinatus
Infraspinatus

125
Q

Which rotator cuff muscles are innervated by the axillary nerve?

A

Teres minor and deltoid

126
Q

What is the importance for the arterial anastomoses around the shoulder?

A

Allows blood to keep flowing in whichever direction the scapula is moving - joint movement can lead to temporary occlusion of blood vessels

127
Q

How many anastomoses are there between he subclavian and axillary artery?

A

2

128
Q

Outline the path of the anastomoses involving the circumflex scapular artery

A

Thyrocervical trunk -> Suprascapular artery -> Circumflex scapular artery -> Subscapular artery -> Axillary artery

129
Q

Outline the path of anastomoses involving the deep branch/dorsal scapular artery?

A

Thyrocervical trunk -> Transverse cervical artery -> Deep branch/dorsal scapular artery -> Circumflex scapular artery -> Subscapular artery -> Axillary artery

130
Q

Is there an anastomoses between the axillary artery?

A

Yes there is!

131
Q

What arteries is the axillary-axillary anastomoses between?

A

The humeral circumflex artery and profound brachii artery