The shoulder and arms Flashcards
What are the two main processes coming off the scapula?
Coracoid process Acromion process
What are the differences between the anatomical and surgical necks of the humerus?
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

What are the three fossae of the scapula?
Supraspinous
Infraspinous
Subscapular
Which part of the scapula articulates with the humerus?
Glenoid cavity
On which bones are deltoid tubercles found?
Spine of the scapula
Humerus
What is the name given to the distinctive notch on the scapula?
Suprascapular notch
What is the name given to the groove between the greater and lesser tubercles of the humerus?
Intertubercular sulcus (bicipital groove)
What are the two distinctive protrusions on the lateral third of the clavicle and what are their roles?
Conoid tubercle Trapezoid line
They are the point of attachment of the conoid ligament and trapezoid ligament (both part of the coracoclavicular ligament)

What are the names of the three fossae at the distal end of the humerus?
Anterior – coronoid and radial fossae
Posterior – olecranon fossa
What are the names given to the two ridges on either side of the distal end of the humerus?
Medial supracondylar ridge
Lateral supracondylar ridge
What are the five muscle compartments of the region?
Anterior pectoral
Posterior pectoral
Intrinsic shoulder
Anterior compartment of arm
Posterior compartment of arm
Which muscles make up the anterior pectoral compartment?
Pectoralis major
Pectoralis minor
Serratus anterior
Subclavius
What are the attachments of pectoralis major?
Medial 1/2 of the clavicle + sternum + part of costal margin
Lateral lip of intertubercular sulcus

What are the actions of pectoralis major?
Adducts and medially rotates the shoulder
Which nerve innervates pectoralis major?
Lateral pectoral nerve
What are the attachments of pectoralis minor?
Ribs 2-5
Coracoid process

Which nerve innervates pectoralis minor?
Medial pectoral nerve
What are the attachments of subclavius?
1st costochondral joint
Inferior distal part of clavicle

Which nerve innervates subclavius?
Subclavian nerve
What are the attachments of serratus anterior?
Medial border of the costal surface of the scapula Anteriorly attaches to the ribs (1-9)

Which nerve innervates serratus anterior?
Long-thoracic nerve
What can damage to this nerve cause?
Winging of the scapula
Which muscles make up the posterior pectoral compartment?
Trapezius
Latissimus dorsi
Levator scapulae
Rhomboids (minor and major)
What is the motor supply to trapezius?
Accessory nerve (CN XI)
Describe the attachments of latissimus dorsi.
Thoracolumbar fascia and posterior 1/3 of the iliac crest Floor of the intertubercular sulcus

Which nerve innervates latissimus dorsi?
Thoraco-dorsal nerve
What movement is latissimus dorsi responsible for?
Extends, adducts and rotates the humerus
Describe the attachments of the rhomboids.
Both 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
Which nerve supplies the rhomboids?
Dorsal scapular nerve
What movement are the rhomboids responsible for?
Retracts, rotates and fixes the scapula
Describe the attachments of levator scapulae.
Attaches proximally to the transverse processes of C1-C4 Attaches distally to the superior angle of the scapula

Which nerve innervates levator scapulae?
Dorsal scapular nerve (and C3 + C4)
What movements are levator scapulae responsible for?
Elevates and rotates the scapula
Which muscles make up the intrinsic shoulder muscle compartment?
Rotator cuff muscles (supraspinatus, infraspinatus, teres minor and subscapularis)
Teres major
Deltoid
Describe the attachments of deltoid.
Proximal – lateral 1/3 of the clavicle, acromion process and crest of the spine of the scapula
Distal – deltoid tuberosity of the humerus

Which nerve supplies the deltoid and what movement is it responsible for?
Axillary nerve It is responsible for abduction of the arm
Describe the attachment of the rotator cuff muscles and state the nerves that innervate them. Supraspinatus Infraspinatus Teres minor Subscapularis
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
Which rotator cuff muscle is important for abducting the arm?
Supraspinatus is important in the first 15 degree of abduction of the arm, then the deltoid takes over.
Describe the attachments of teres major.
Inferior angle of the scapula to the medial lip of the intertubercular sulcus
Which nerve innervates teres major?
Lower subscapular nerve
Which muscles make up the anterior compartment of the arm and which nerve innervates them?
Biceps brachii Brachialis Coracobrachialis Innervated by: musculocutaneous nerve
Describe the attachments of biceps brachii.
Long head – supraglenoid tubercle Short head – coracoid process
Distal attachment – radial tuberosity

Describe the attachments of coracobrachialis.
Proximal: coracoid process Distal: front of the shaft of the humerus

Describe the attachments of brachialis.
Proximal: shaft of the humerus Distal: coronoid process of ulna

Which muscles make up the posterior compartment of the arm?
Triceps brachii
Anconeus
What are the attachments of the triceps?
Long head – infraglenoid tubercle
Medial and lateral head – proximal part of the shaft of the humerus
Distal attachment: olecranon process of the ulna

What are the attachments of anconeus?
Proximal: lateral epicondyle of the humerus
Distal: shaft of the ulna

Which nerve innervates the posterior compartment of the arm?
Radial nerve
Which four joints make up the pectoral girdle?
Sternoclavicular Acromioclavicular Gleno-humeral Scapulo-thoracic (physiological joint)
Which two ligaments make up the coracoclavicular ligament?
Conoid ligament Trapezoid ligament

Which three ligaments surround the glenohumeral joint?
Glenohumeral ligament Coracohumeral ligament Transverse humeral ligament

What is the ligament of the acromioclavicular joint?
Acromioclavicular ligament
What type of joint is the glenohumeral joint?
Ball-in-socket synovial joint
What does the rotator cuff do to the humeral head?
Depresses the humeral head and holds it within the glenoid cavity
What are the movements of the scapula-thoracic joint?
Elevation/depression Protraction/retraction Rotation
What is the shape of the axilla?
Pyramid
What does the axilla contain?
Nerves – the brachial plexus Arteries – axillary artery and its branches Veins – axillary vein and its branches Lymphatic vessels and lymph nodes
What are the four walls of the axilla?
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
Describe the divisions of the subclavian artery as it passes into the axilla and down the arm.
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

Describe the superficial venous anatomy of the arm.
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

Which small vein joins the cephalic and basilic veins in the cubital fossa?
Median cubital vein
What are the veins on the dorsal side of the hand called?
Dorsal venous network
Describe the arrangement of the deep veins of the arm.
They follow the arteries back
What are the groups of lymph nodes found in the shoulder and arm?
Cubital lymph nodes Delto-pectoral lymph nodes Axillary lymph nodes
Which two nerves are found near the axillary lymph nodes?
Long thoracic nerve Thoraco-dorsal nerve
What are the five parts of the brachial plexus?
Roots Trunks Divisions Cords Branches
What are the five largest nerves of the brachial plexus?
Musculocutaneous Axillary Radial Median Ulnar
What is the arm
Between shoulder and elbow
3 parts of pec major
Clavicular head Sternocostalhead Abdominal part
Attachments of trapezius
Medially to nuchal line of skull and then spines of vertebra down to t12 Laterally to a acromion and clavicle anteriorly as curls around to the front
3 parts of trapezius
Descending Middle Ascending

2 parts of biceps brachii
Long head Short head
2 distal attachments of biceps brachii
Long and short head form both tendon attaching to radial tuberosity and an aponeurosis which attaches to fascia of forearm
3 parts to triceps
Lateral Medial Long heads
Lymphatic drainage of arm and shoulder
In arm superficial and deep systems follow veins into firstly cubital lymph nodes then more proximally delto-pectoral nodes and axillary lymph nodes into subclavian lymph trunk
Attachments of infraspinatus
Infrascapular fossa to greater tubercle
Attachments of supraspinatus
Suprascapular fossa to greater tubercle
Attachments of subscapularis
Subscapular fossa to lesser tubercle
Attachments of teres minor
upper 2/3 of lateral border of scapula to greater tubercle
Only rotator cuff muscle that doesnt attach to greater tubercle
Subscapular