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

Medial 1/2 of the clavicle + sternum + part of costal margin

Lateral lip of intertubercular sulcus

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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

Inferior distal part of 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 this 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
Describe the attachments of latissimus dorsi.
Thoracolumbar fascia and posterior 1/3 of the iliac crest Floor of the intertubercular sulcus
26
Which nerve innervates latissimus dorsi?
Thoraco-dorsal nerve
27
What movement is latissimus dorsi responsible for?
Extends, adducts and rotates the humerus
28
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
29
Which nerve supplies the rhomboids?
Dorsal scapular nerve
30
What movement are the rhomboids responsible for?
Retracts, rotates and fixes the scapula
31
Describe the attachments of levator scapulae.
Attaches proximally to the transverse processes of C1-C4 Attaches distally to the superior angle of the scapula
32
Which nerve innervates levator scapulae?
Dorsal scapular nerve (and C3 + C4)
33
What movements are levator scapulae responsible for?
Elevates and rotates the scapula
34
Which muscles make up the intrinsic shoulder muscle compartment?
Rotator cuff muscles (supraspinatus, infraspinatus, teres minor and subscapularis) Teres major Deltoid
35
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
36
Which nerve supplies the deltoid and what movement is it responsible for?
Axillary nerve It is responsible for abduction of the arm
37
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
38
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.
39
Describe the attachments of teres major.
Inferior angle of the scapula to the medial lip of the intertubercular sulcus
40
Which nerve innervates teres major?
Lower subscapular nerve
41
Which muscles make up the anterior compartment of the arm and which nerve innervates them?
Biceps brachii Brachialis Coracobrachialis Innervated by: musculocutaneous nerve
42
Describe the attachments of biceps brachii.
Long head – supraglenoid tubercle Short head – coracoid process Distal attachment – radial tuberosity
43
Describe the attachments of coracobrachialis.
Proximal: coracoid process Distal: front of the shaft of the humerus
44
Describe the attachments of brachialis.
Proximal: shaft of the humerus Distal: coronoid process of ulna
45
Which muscles make up the posterior compartment of the arm?
Triceps brachii Anconeus
46
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
47
What are the attachments of anconeus?
Proximal: lateral epicondyle of the humerus Distal: shaft of the ulna
48
Which nerve innervates the posterior compartment of the arm?
Radial nerve
49
Which four joints make up the pectoral girdle?
Sternoclavicular Acromioclavicular Gleno-humeral Scapulo-thoracic (physiological joint)
50
Which two ligaments make up the coracoclavicular ligament?
Conoid ligament Trapezoid ligament
51
Which three ligaments surround the glenohumeral joint?
Glenohumeral ligament Coracohumeral ligament Transverse humeral ligament
52
What is the ligament of the acromioclavicular joint?
Acromioclavicular ligament
53
What type of joint is the glenohumeral joint?
Ball-in-socket synovial joint
54
What does the rotator cuff do to the humeral head?
Depresses the humeral head and holds it within the glenoid cavity
55
What are the movements of the scapula-thoracic joint?
Elevation/depression Protraction/retraction Rotation
56
What is the shape of the axilla?
Pyramid
57
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
58
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
59
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
60
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
61
Which small vein joins the cephalic and basilic veins in the cubital fossa?
Median cubital vein
62
What are the veins on the dorsal side of the hand called?
Dorsal venous network
63
Describe the arrangement of the deep veins of the arm.
They follow the arteries back
64
What are the groups of lymph nodes found in the shoulder and arm?
Cubital lymph nodes Delto-pectoral lymph nodes Axillary lymph nodes
65
Which two nerves are found near the axillary lymph nodes?
Long thoracic nerve Thoraco-dorsal nerve
66
What are the five parts of the brachial plexus?
Roots Trunks Divisions Cords Branches
67
What are the five largest nerves of the brachial plexus?
Musculocutaneous Axillary Radial Median Ulnar
68
What is the arm
Between shoulder and elbow
69
3 parts of pec major
Clavicular head Sternocostalhead Abdominal part
70
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
71
3 parts of trapezius
Descending Middle Ascending
72
2 parts of biceps brachii
Long head Short head
73
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
74
3 parts to triceps
Lateral Medial Long heads
75
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
76
Attachments of infraspinatus
Infrascapular fossa to greater tubercle
77
Attachments of supraspinatus
Suprascapular fossa to greater tubercle
78
Attachments of subscapularis
Subscapular fossa to lesser tubercle
79
Attachments of teres minor
upper 2/3 of lateral border of scapula to greater tubercle
80
Only rotator cuff muscle that doesnt attach to greater tubercle
Subscapular