The Upper LimbL Shoulder/axilla

Question 1

What are the attachments and actions of the Pectoralis major

Answer 1

Medial 1/2 off clavicle, Ant sternum, costal cartilages 1-6, aponeurosis —> Latearl lip of intertubercular groove on humerus

Adducts and medically rotates humerus

Question 2

What are the attachments and actions of the Pectoralis minor?

Answer 2

Costal Cart and ribs 3-5 —> Coracoid process of scapula

Draws scapula inferiorly and anteriorly

Question 3

What are the attachments and actions of the subclavius?

Answer 3

Junctions of rib1 and costal cartilage —> inferior surface of clavicle

Anchors and depresses clavicle

Question 4

What are the attachments and actions of the serratus anterior?

Answer 4

Ribs 1-8 —> Anterior surface of medial border of scapula

Holds scapula against thoracic cage

Question 5

What are the attachments and actions of the deltoid?

Answer 5

Lateral 1/3 clavicle, acromion, spine of scapula —> Deltoid tuberosity

Abduction, extension, and lateral rotation of humerus

Question 6

What are the muscles of the rotator cuff?

Answer 6

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

Question 7

What are the attachments and actions of Supraspinatus.

Answer 7

Suprspinous fossa —> Superior facet of greater tubercle

Lateral rotation; Assists abduction

Question 8

What are the attachments and actions of the infraspinatus.

Answer 8

Infraspinatous fossa —> Middle facet of greater tubercle

Lateral Rotation, Keeps Head of humerus in during abduction

Question 9

What are the attachments and actions of teres minor.

Answer 9

Lateral Border of scapula -> Inferior facet of greater tubercle

Lateral rotation and adduction

Question 10

What are attachments and actions of teres major?

Answer 10

Inferior angle of scapula —> Medial lip of intertubercular groove of humerus

Adduction and medial rotation

Question 11

What are the attachments and actions of the subscapularis?

Answer 11

Subscapularis fossa —> Lesser tubercle of humerus

Medial rotation

Question 12

What are the contents of the deltopectoral triangle?

Answer 12

• Cephalic vein

- Thoracocaromial artery

Question 13

What is the subacromiol bursa?

Answer 13

Fluid which separates the supraspinatus from the coracoacromial ligament, acromion, and deltoid muscle.

Question 14

Which part of the rotator cuff is most torn?

Answer 14

Supraspinatus tendon

Question 15

How are Rotator cuff injuries classified?

Answer 15

Type I: Tenderness over greater tubercle w/out limitation in ROM or weakness

Type II: Tendonitis and pain, usually worse at night with pain and limited abduction and external rotation

Type III: Significant degeneration and tear

Question 16

What are the boundaries and contents of the Quadra gulag space?

Answer 16

Superior: Teres minor

Inferior: Teres Major

Medial: Lateral side of the long head of triceps brachi

Lateral: Surgical neck of numeral shaft

Contents:
Axillary nerve
Posterior circumflex humeral vessels

Question 17

What are the boundaries and contents of the triangular space of the Axilla?

Answer 17

Superior: Teres minor/Subscapularis

Inferior: Teres Major

Lateral: Medial side of long head of triceps

Question 18

Describe the sternoclavicular joint.

Answer 18

• Saddle Joint - very strong
• Rarely dislocated/injured
• Clavicle will usually break before joint dislocated

Question 19

What type of joint is the AC joint?

Answer 19

Synovial

Question 20

What is easily seen in patients with AC joint dislocation?

Answer 20

Pronounced acromion on shoulder

Question 21

What is the most common dislocation of the glenohumeral joint?

Answer 21

Anterior dislocation

Question 22

What are the three types of glenohumeral dislocations?

Answer 22

Anterior

Posterior

Inferior

Question 23

What are the 4 anterior dislocation locations, and which is most prominent?

Answer 23

• Subcoacoid (most common)
• Subglenoid
• Subclavicular
• Intrathoracic

Question 24

What are the three primary treatments of GHJ dislocation?

Answer 24

• Milch Technique
• Modified Hippocrates
  Technique
• Reduction of Luxato Erecta

Question 25

What are the boundaries of the Axillary Region?

Answer 25

Base: Axillary Fascia Anterior Wall: Pectoralis Major/minor Posterior Wall: Lat Dorsi, Teres minor, subscapularis Medial Wall: Ribs and intercostal muscles, serratus ant Lateral Wall: Intertubercular groove and long head of biceps Apex: Directed superiority towards the neck located on the medial side of coracoid process

Question 26

What are the contents of the axilla?

Answer 26

- Axillary artery - Axillary vein - Cords of brachial plexus - Lateral cutaneous branches of intercostal nerves - Long thoracic nerve - Cephalic vein - Axillary lymph nodes

Question 27

Which vein of the brachium ruins laterally?

Answer 27

Cephalic vein

Question 28

What connects the cephalic and basilic vein at the elbow?

Answer 28

Median Cubital vein

Question 29

What structure is used to identify subclavian veins?

Answer 29

First Rib —> they lie superior to it

Question 30

What are the branches off the subclavian artery?

Answer 30

- Internal thoracic - Vertebral - Thyrocervical trunk - Costocervical trunk - Descending scapular

Question 31

What defines the first part of the axillary artery, and what are the branches?

Answer 31

Between lateral border of rib 1 and superior border of Pectoralis minor - Superior thoracic

Question 32

What defines the 2nd part of the axial artery, and what are the branches?

Answer 32

Deep to Pectoralis minor - Thoracoacromial artery - Lateral Thoracic artery

Question 33

What defines the third part of the axial artery, and what are the branches?

Answer 33

From inferior border of Pectoralis minor or inferior border of teres major - Subscapularis artery - Anterior circumflex artery - Posterior circumflex humeral artery

Question 34

Where in the neck does the brachial plexus descend in?

Answer 34

Posterior cervical triangle between scalene anterior and mediums; superior to clavicle and lateral to SCM

Question 35

What are the 5 main Nerves which come from brachial plexus?

Answer 35

``` Musculoskeletal Ulnar Axillary Radial MEdian ```