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 neck of the humerus: between the head of the humerus and everything else

Surgical neck of the humerus: 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 groove/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 upper limb 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 (1)

Pectoralis minor (2)

Serratus anterior (4)

Subclavius (3)

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13
Q

What are the proximal and distal attachments of pectoralis major?

A

Proximal:

Medial 1/3 of the clavicle

Sternum

Part of costal margin

Distal:

Lateral lip of intertubercular sulcus/groove

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14
Q

What are the actions of pectoralis major?

A

Adducts and medially rotates the shoulder

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15
Q

Which nerve innervates pectoralis major?

A

Lateral pectoral nerve

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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

Medial border of the costal surface of the scapula

Anteriorly attaches to the ribs (1-9)

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21
Q

Which nerve innervates serratus anterior?

A

Long-thoracic nerve

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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

Thoracolumbar fascia and posterior 1/3 of the iliac crest

Floor of the intertubercular sulcus

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26
Q

Which nerve innervates latissimus dorsi?

A

Thoraco-dorsal nerve

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27
Q

What movement is latissimus dorsi responsible for?

A

Extends, adducts and rotates the humerus

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28
Q

Describe the attachments of the rhomboids.

A

Both major and minor rhomboids attach distally to the medial border of the scapula

Rhomboid minor attaches proximally to the spinous processes of C7 and T1

Rhomboid major attaches proximally to the spinous processes of T2-T5

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29
Q

Which nerve supplies the rhomboids?

A

Dorsal scapular nerve

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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

Attaches proximally to the transverse processes of C1-C4

Attaches distally to the superior angle of the scapula

32
Q

Which nerve innervates levator scapulae?

A

Dorsal scapular nerve (and C3 + C4)

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 It is responsible for abduction of the arm

37
Q

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

Supraspinatus

Infraspinatus

Teres minor

Subscapularis

A

Supraspinatus:

Suprascapular fossa to greater tubercle

Innervated by suprascapular nerve

Infraspinatus:

Infrascular fossa to greater tubercle

Innervated by suprascapular nerve

Teres minor:

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

Innervated by the axillary nerve

Subscapularis:

Subscapular fossa to the lesser tubercle

Innervated by the subscapular nerve

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

Inferior angle of the scapula to the medial lip of the intertubercular sulcus

40
Q

Which nerve innervates teres major?

A

Lower subscapular nerve

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

Long head: Supraglenoid tubercle

Short head: Coracoid process

Distal attachment: Radial tuberosity

43
Q

Describe the attachments of coracobrachialis.

A

Proximal: coracoid process

Distal: front 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

A gateway for nerves and vessels to enter and leave the upper limbs is known as?

A

The axilla

59
Q

Define the axilla and describe its shape.

A

A gateway for nerves and vessels to enter and leave the upper limbs

Pyramid

60
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

61
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

62
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

63
Q

Which branch of the axillary artery goes around the humerus?

A

Circumflex humeral artery

64
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

65
Q

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

A

Median cubital vein

66
Q

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

A

Dorsal venous network

67
Q

Describe the arrangement of the deep veins of the arm.

A

They follow the arteries back

68
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 (Apical, central, humeral, pectoral)

Subscapular (located posteriorly)

69
Q

What are the five groups of axillary lymph nodes and where are they located in relation to eachother?

A

Apical

Central

Pectoral (Anterior)

Subscapular (Posterior)

Humeral (Lateral)

70
Q

Which two nerves are found near the axillary lymph nodes?

A

Long thoracic nerve

Thoraco-dorsal nerve

71
Q

What are the five parts of the brachial plexus?

A

Roots

Trunks

Divisions

Cords

Branches

72
Q

What are the five largest nerves of the brachial plexus?

A

Musculocutaneous

Axillary

Radial

Median

Ulnar

73
Q

Which nerves tend to be affected by common sites of damage of the upper limbs?

A

Radial

Ulnar

Axillary