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Y2 Limbs Anatomy (LCRS2) > The shoulder and arms > Flashcards

The shoulder and arms Flashcards

1
Q

What are the two main processes coming off the scapula?

A

Coracoid process

Acromion process

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2
Q

What are the differences between the anatomical and surgical necks of the humerus?

A

Anatomical – between the head of the humerus and everything else Surgical – the main narrowing of the distal humerus – it is the most common site for fractures of the humerus

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3
Q

What are the three fossae of the scapula?

A

Supraspinous Infraspinous Subscapular

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4
Q

Which part of the scapula articulates with the humerus?

A

Glenoid cavity

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5
Q

On which bones are deltoid tubercles found?

A

Spine of the scapula Humerus

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6
Q

What is the name given to the distinctive notch on the scapula?

A

Suprascapular notch

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7
Q

What is the name given to the groove between the greater and lesser tubercles of the humerus?

A

Intertubercular sulcus (bicipital groove)

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8
Q

What are the two distinctive protrusions on the lateral third of the clavicle and what are their roles?

A

Conoid tubercle Trapezoid line They are the point of attachment of the conoid ligament and trapezoid ligament (both part of the coracoclavicular ligament)

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9
Q

What are the names of the three fossae at the distal end of the humerus?

A

Anterior – coronoid and radial fossae Posterior – olecranon fossa

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10
Q

What are the names given to the two ridges on either side of the distal end of the humerus?

A

Medial supracondylar ridge Lateral supracondylar ridge

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11
Q

What are the five muscle compartments of the region?

A

Anterior pectoral Posterior pectoral Intrinsic shoulder Anterior compartment of arm Posterior compartment of arm

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12
Q

Which muscles make up the anterior pectoral compartment?

A

Pectoralis major Pectoralis minor Serratus anterior Subclavius

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13
Q

What are the attachments of pectoralis major?

A

Proximal:

Medial 1/2 of the clavicle + superior 1/2 of the sternum + the aponeurosis of the external abdominal oblique muscle

Distal:

3 parts of the muscle (clavicular, sternal and abdominal) converge into a flat tendon inserted into the intertubercular groove of the humerus

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14
Q

What are the actions of pectoralis major?

A

Adducts and medially rotates the arm

Clavicular portion - flex the shoulder and adduct the humerus across the midline medially

Sternocostal portion - extends the humerus

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15
Q

Which nerve innervates pectoralis major?

A

Medial pectoral nerve (C5-8)

Lateral pectoral nerve T1

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16
Q

What are the attachments of pectoralis minor?

A

Ribs 2-5 Coracoid process

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17
Q

Which nerve innervates pectoralis minor?

A

Medial pectoral nerve

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18
Q

What are the attachments of subclavius?

A

1st costochondral joint Clavicle

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19
Q

Which nerve innervates subclavius?

A

Subclavian nerve

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20
Q

What are the attachments of serratus anterior?

A

Proximal:

Anteriorly attaches to the ribs (1-9)

Distal:

Costal surface of the vertebral border of the scapula

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21
Q

Which nerve innervates serratus anterior?

A

Long-thoracic (C5, C6, C7)

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22
Q

What can damage to the long thoracic nerve cause?

A

Winging of the scapula

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23
Q

Which muscles make up the posterior pectoral compartment?

A

Trapezius Latissimus dorsi Levator scapulae Rhomboids (minor and major)

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24
Q

What is the motor supply to trapezius?

A

Accessory nerve (CN XI)

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25
Q

Describe the attachments of latissimus dorsi.

A

Proximal:

Aponeurosis of the posterior layer of thoracolumbar fascia, Spinous process of T7-T12, bottom 3 ribs, posterior 1/3 of iliac crest

Distal:

Muscles converge and end as a tendon that attaches to the intertubercular groove of the humerus

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26
Q

Which nerve innervates latissimus dorsi?

A

Thoraco-dorsal nerve (C6-8)

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27
Q

What movement is latissimus dorsi responsible for?

A

Extends, adducts and medially rotates the humerus

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28
Q

Describe the attachments of the rhomboids.

A

Proximal:

Minor = Ligamentum nuchae, spinous process of C7-T1

Major = Spinous process of T2-5

Distal:
Medial border of the scapula

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29
Q

Which nerve supplies the rhomboids?

A

Dorsal scapular nerve (C4-C5)

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30
Q

What movement are the rhomboids responsible for?

A

Retracts, rotates and fixes the scapula

31
Q

Describe the attachments of levator scapulae.

A

Proximal:

Transverse process of C1-C4

Distal:

The superior portion of the medial border of the scapula

32
Q

Which nerve innervates levator scapulae?

A

Branch of the dorsal scapular nerve (C5) and C3 + C4 from the cervical plexus

33
Q

What movements are levator scapulae responsible for?

A

Elevates and rotates the scapula

34
Q

Which muscles make up the intrinsic shoulder muscle compartment?

A

Rotator cuff muscles (supraspinatus, infraspinatus, teres minor and subscapularis) Teres major Deltoid

35
Q

Describe the attachments of deltoid.

A

Proximal:

lateral 1/3 of the clavicle, acromion process and crest of the spine of the scapula

Distal:

deltoid tuberosity of the humerus

36
Q

Which nerve supplies the deltoid and what movement is it responsible for?

A

Axillary nerve (C5, C6)

It is responsible for abduction of the arm (iniated by the supraspinatus muscle)

Clavicular portion - rotates arm medially

Spinous portion - Rotates arm laterally

37
Q

Describe the attachment of the rotator cuff muscles and state the nerves that innervate them.

A

Supraspinatus:

Suprascapular fossa to superior facet of greater tubercle

Innervated by suprascapular nerve (C5 C6)

Infraspinatus:

Infrascapular fossa to the middle facet of greater tubercle

Innervated by suprascapular nerve (C5 C6)

Teres minor:

Upper 2/3 of the lateral margin of the scapula to the inferior facet of the greater tubercle

Innervated by the axillary nerve (C5 C6)

Subscapularis:

Subscapular fossa to the lesser tubercle

Innervated by the upper and lower subscapular nerve (C5 C6)

38
Q

Which rotator cuff muscle is important for abducting the arm?

A

Supraspinatus is important in the first 15 degree of abduction of the arm, then the deltoid takes over.

39
Q

Describe the attachments of teres major.

A

Proximal:

Inferior angle of the scapula

Distal:

medial lip of the intertubercular sulcus

40
Q

Which nerve innervates teres major?

A

Lower subscapular nerve (C6 C7)

41
Q

Which muscles make up the anterior compartment of the arm and which nerve innervates them?

A

Biceps brachii Brachialis Coracobrachialis Innervated by: musculocutaneous nerve

42
Q

Describe the attachments of biceps brachii.

A

Proximal:

Long head – supraglenoid tubercle of scapula

Short head – coracoid process

Distal attachment:

radial tuberosity

Gives of aponeurosis that fuses with the deep fascia of the forearm

43
Q

Describe the attachments of coracobrachialis.

A

Proximal: coracoid process

Distal: medial surface of the shaft of the humerus

44
Q

Describe the attachments of brachialis.

A

Proximal: shaft of the humerus

Distal: coronoid process of ulna

45
Q

Which muscles make up the posterior compartment of the arm?

A

Triceps Anconeus

46
Q

What are the attachments of the triceps?

A

Long head – infraglenoid tubercle Medial and lateral head – proximal part of the shaft of the humerus Distal attachment: olecranon process of the ulna

47
Q

What are the attachments of anconeus?

A

Proximal: lateral epicondyle of the humerus Distal: shaft of the ulna

48
Q

Which nerve innervates the posterior compartment of the arm?

A

Radial nerve

49
Q

Which four joints make up the pectoral girdle?

A

Sternoclavicular Acromioclavicular Gleno-humeral Scapulo-thoracic (physiological joint)

50
Q

Which two ligaments make up the coracoclavicular ligament?

A

Conoid ligament Trapezoid ligament

51
Q

Which three ligaments surround the glenohumeral joint?

A

Glenohumeral ligament Coracohumeral ligament Transverse humeral ligament

52
Q

What is the ligament of the acromioclavicular joint?

A

Acromioclavicular ligament

53
Q

What type of joint is the glenohumeral joint?

A

Ball-in-socket synovial joint

54
Q

What is the glenoid cavity deepened by?

A

Glenoid Labrum – fibrocartilaginous collar

55
Q

What structure is found between the superior surface of the humerus and the inferior surface of the acromion?

A

Subacromial bursa

56
Q

What does the rotator cuff do to the humeral head?

A

Depresses the humeral head and holds it within the glenoid cavity

57
Q

What are the movements of the scapula-thoracic joint?

A

Elevation/depression Protraction/retraction Rotation

58
Q

What is the shape of the axilla?

A

Pyramid

59
Q

What does the axilla contain?

A

Nerves – the brachial plexus Arteries – axillary artery and its branches Veins – axillary vein and its branches Lymphatic vessels and lymph nodes

60
Q

What are the four walls of the axilla?

A

Apex – between the first rib, clavicle and superior border of subscapularis Floor – skin, subcutaneous tissue and fascia extending from the arm to the chest Anterior wall – pectoralis major and pectoralis minor Lateral wall – humerus Medial wall – upper thoracic wall and serratus anterior Posterior wall – scapula/subscapularis, teres minor and latissimus dorsi

61
Q

Describe the divisions of the subclavian artery as it passes into the axilla and down the arm.

A

As the subclavian artery passes over the first rib it becomes the axillary artery The axillary artery then becomes the brachial artery as it passes the inferior border of teres major The brachial artery has an important branch - profundi brachii Brachial artery then divides into radial and ulnar arteries at the level of the elbow

62
Q

Which branch of the axillary artery goes around the humerus?

A

Circumflex humeral artery

63
Q

Describe the superficial venous anatomy of the arm.

A

There is are two main superficial veins: cephalic (lateral) and basilic (medial) Above the elbow the basilic artery joins the venae comitantes of the brachial artery to form the axillary vein The cephalic vein drains into the axillary vein more superiorly

64
Q

Which small vein joins the cephalic and basilic veins in the cubital fossa?

A

Median cubital vein

65
Q

What are the veins on the dorsal side of the hand called?

A

Dorsal venous network

66
Q

Describe the arrangement of the deep veins of the arm.

A

They follow the arteries back

67
Q

What are the groups of lymph nodes found in the shoulder and arm?

A

Cubital lymph nodes Delto-pectoral lymph nodes Axillary lymph nodes

68
Q

Which two nerves are found near the axillary lymph nodes?

A

Long thoracic nerve Thoraco-dorsal nerve

69
Q

What are the five groups of axillary lymph nodes?

A

Apical Central Pectoral Subscapular Humeral

70
Q

What are the five parts of the brachial plexus?

A

Roots Trunks Divisions Cords Branches

71
Q

What are the five largest nerves of the brachial plexus and which spinal levels supply these nerves?

A

Musculocutaneous (C5-7)

Axillary (C5&6)

Radial (C5-8, T1)

Median (C5-8, T1)

Ulnar (C7-8, T1)

72
Q

Draw the brachial plexus

A
73
Q

What is the action of serratus anterior?

A

Pulls the medial border of the scapula anteriorly towards the thoracic wall

Laterally rotating the inferior angle of the scapula - allowing abduction of the arm above 90o

Y2 Limbs Anatomy (LCRS2) (10 decks)

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