Unit 2 Exam. Flashcards
What group of muscles cover the upper part of the anterior thoracic region and spread posteriorly to cover most of the posterior thoracic region?
shoulder muscles
The shoulder muscles are divided into three distinct groups based on what?
where they originate and insert
Where do the groups of shoulder muscles originate?
vertebral column or skull, thoracic wall, and scapula
Where do the groups of shoulder muscles insert?
shoulder girdle and humerus
What muscles originate on the vertebral column or skull?
trapezius, rhomboid major, rhomboid minor, levator scapula, and latissimus dorsi
What muscle is a large muscle which covers the posterior cervical and thoracic region?
trapezius
What muscle is named because the right and left muscles form a four sided figure known as a trapezoid?
trapezius
Where does the trapezius originate?
external occipital protuberance (EOP),
superior nuchal line,
ligamentous nuchae,
spines of the thoracic vertebrae C7 to T12.
Where does the trapezius insert?
clavicle,
acromion process and spine of the scapula
What are the three actions of the trapezius?
stabilizes the scapula (holds it in normal anatomical position),
upper portion elevates the scapula, and
middle and lower portions adduct (retractions) the scapula
What is the motor nerve supply to the trapezius?
spinal accessory nerve (CN XI)
What is the sensory nerve supply to the trapezius?
C3 and C4
What condition shows a deepening of the shoulder on the affected side?
trapezius palsy
C3 and C4
A weakness of the trapezius muscle, shoulder drops on effected side. Seen with damage to cranial nerve XI and Whiplash injuries
Trapezius Palsy
C3 and C4
What condition shows a shoulder drop on the affected side?
Trapezius Palsy
C3 and C4
What muscle is frequently involved in neck injuries during auto accidents and what is that injury called?
superior portion of the trapezius and a whiplash injury
C3 and C4
The clinical examination to test for the __ cranial nerve is to ask the patient to elevate their shoulders (shrug) against resistance and both sides should be tested at the same, so weakness of one side can be evaluated relative to the other side.
XI (spinal accessory nerve)
What muscle is a flat, thin muscle which is rhomboid in shape and lies deep to the trapezius?
rhomboid major
What is the origin of the rhomboid major?
spine/upper thoracic vertebrae
What is the insertion of the rhomboid major?
vertebral border of the scapula
What muscle lies superior and parallel to the rhomboid major, with which it is sometimes fused?
rhomboid minor
Is the rhomboid major superior to the rhomboid minor?
no its inferior
Is the rhomboid minor superior to the rhomboid major?
yes
What is the origin of the rhomboid minor?
spines/lower cervicals and first thoracic vertebrae
What is the insertion of the rhomboid minor?
vertebral border/scapula
What is a muscle found on the side of the neck, deep to the superior portion of the trapezius?
levator scapula
What is the origin of the levator scapula?
transverse processes/upper cervical vertebrae
What is the insertion of the levator scapula?
superior angle/scapula
What are the three actions of the rhomboids and levator scapula?
elevates, adducts, and stabilizes the scapula
What is the nerve supply to rhomboid major?
dorsal scapular nerve (C5)
What is the nerve supply to rhomboid minor?
dorsal scapular nerve (C5)
What is the nerve supply to levator scapula?
dorsal scapular nerve (C5)
What three muscles of the neck are supplied by the dorsal scapular nerve (C5)?
rhomboid major, rhomboid minor, and levator scapula
Difficulty in completely adducting the scapula is a sign of damage to what nerve?
dorsal scapular nerve and/or C5
A scapula on an affected side further from the midline is a sign of damage to what nerve?
dorsal scapular nerve and/or C5
What muscle is a large, flat muscle which is found over the lower posterior thoracic and lumbar region?
latissimus dorsi
What is the widest muscle of the back region?
latissimus dorsi
What muscle’s tendon of insertion, along with that of teres major, helps to form the posterior fold or border of the axilla?
latissimus dorsi
What is the origin of the latissimus dorsi?
spines/lower thoracic and lumbar vertebrae,
thoracodorsal fascia,
crest/illium, and lower ribs
What is the insertion of the latissimus dorsi?
intertubercular groove (lesser tubercle)/humerus
What are the actions of the latissimus dorsi?
extends,
adducts,
and
medially rotates the humerus and is involved with forced expiration
What is the nerve supply to the latissimus dorsi?
thoracodorsal (C6, C7, and C8)
Forward displacement of the shoulder is a sign of damage to what muscle?
latissimus dorsi
What is a depression found at the lower portion of the latissimus dorsi?
lumbar triangle
What is bounded by the latissimus dorsi, crest of the ilium, and the external oblique muscle?
lumbar triangle
What is the lumbar triangle bounded by?
latissimus dorsi, crest of the ilium, and the external oblique muscle
What is the clinical significance of the lumbar triangle?
a hernia of the posterior abdominal wall may develop here
What is a depression found at the superior border of the latissimus dorsi (medial to the inferior angle of the scapula)?
triangle of auscultation
What is bounded by the latissimus dorsi, trapezius, and vertebral border of the scapula?
triangle of auscultation
What is the triangle of auscultation bounded by?
latissimus dorsi, trapezius, and vertebral border of the scapula
Why is the triangle of auscultation clinically significant?
the relatively thin layer of tissue here allows lung sounds to be easily heard with a stethoscope
How can the triangle of auscultation be enlarged?
abducting the scapula (folding the person’s arms across the his or her chest)
What muscle is a broad muscular sheet, which passes posteriorly around the thoracic cage from an extensive costal attachmnet to a more limited attachment on the scapula?
serratus anterior
What muscle’s anterior portion lies immediately beneath the skin, just below the axilla and can be easily seen in muscular individuals, especially when they abduct their scapula against resistance?
serratus anterior
What is the origin of the serratus anterior?
upper ribs
8 or 9.
What is the insertion of the serratus anterior?
vertebral border/scapula
What are the actions of the serratus anterior?
abducts the scapula (prime mover), stabilizes the scapula, and is involved with forced respiration (but only when the humerus is abducted)
What is the nerve supply to the serratus anterior?
long thoracic (C5, C6, and C7)
Common Side for posterior abdominal hernia.
Lumbar Triangle
Bounded by: Latissimus Dorsi, Crest illium, external Oblique muscle
Lumbar Triangle
Relatively thin layer of tissue, allows lung sounds to be easily heard.
Triangle of ossification
Bounded by:Latissimus Dorsi, crest illuim, external Oblique of scapula.
Triangle of ossification
What is the condition in which the serratus anterior muscle is weakened due to damage to the long thoracic nerve or C5, C6, and C7?
long thoracic nerve palsy (winged scapula)
What is the most important clinical sign for winging of the scapula?
patient will have difficulty keeping the vertebral border and inferior angle of the scapula against the posterior thoracic wall when carrying out abduction against resistance
Patients who experience difficulty in abducting their scapula and thus have problems in raising the extremity over their head show signs of what condition?
long thoracic nerve palsy (winged scapula)
What is a symptom of long thoracic nerve palsy?
patients may or may not develop pain around the shoulder region
What are the causes of long thoracic nerve palsy?
trauma/subluxation (affecting C5, C6, and C7), traction injuries involving the shoulder joint,
Surgical Procedures, example removal of breast tumors to procedures.
What are the 6 scapular muscles?
deltoid, supraspinatus, infraspinatus, subscapularis, teres major, and teres minor
Weakening of the serratus anterior muscle, causing the scapula to protrude of the chest wall.
Long Thoracic nerve Palsy
May be due to traction of the long thoracic nerve
Long thoracic nerve palsy.
What are the 6 scapular muscles?
deltoid, supraspinatus, infraspinatus, subscapularis,
teres major,
and
teres minor
What muscles are a part of the subgroup of scapular shoulder muscles known as the rotator cuff muscles?
supraspinatus, infraspinatus, subscapularis, and teres minor
What are the two criteria that allows a muscle to be part of the rotator cuff group?
its tendon of insertion must contribute to forming a cuff around the proximal part of the humerus and they participate in either lateral or medial rotation of the humerus
What muscle is a large, complex muscle which is named for its resemblance to the greek letter delta (∆)?
deltoid
How many portions is the deltoid divided into?
3