Unit II Flashcards

1
Q

Trapezius Origins

A

EOP

superior nuchal line

ligamentous nuchae

spines of the thoracic vertebrae

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2
Q

Trapezius Insertions

A

Clavicle

acromion process

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3
Q

Trapezius actions

A

stabilizes scapula and holds it in anatomical postion

upper portion elevates scapula

lower and middle portions adduct the scapula

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4
Q

Trapezius nerve supply

A

CN X for motor

C4 and C5 for sensory

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5
Q

Weakness of the Trapezius is called

A

Trapezius palsy

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6
Q

What will Trapezius palsy look like?

A

deepening of shoulder and should drop on affected side

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7
Q

What is the clinical examination for Trapezius palsy?

A

have the patient shrug against resistance

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8
Q

Rhomboid Major origin

A

spines/upper thoracic vertebrae

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9
Q

Rhomboid Major insertion

A

vertebral border of scapula

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10
Q

Rhomboid Major Actions

A

elevates scapula

Stabilizes scapula

adducts scpula

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11
Q

Rhomboid Major nerve supply

A

dorsal scapular nerve (C5)

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12
Q

Rhomboid Minor Origin

A

spines/lower cervicals and first thoracic

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13
Q

Rhomboid Minor insertion

A

vertebral border/scapula

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14
Q

Rhomboid Minor actions

A

elevates scapula

Stabilizes scapula

adducts scpula

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15
Q

Rhomboid Minor nerve supply

A

dorsal scapular nerve (C5)

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16
Q

Levator scapula origin

A

transverse processes/upper cervicals

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17
Q

Levator scapula insertion

A

superior angle/scapula

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18
Q

Levator scapula nerve supply

A

dorsal scapular nerve (C5)

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19
Q

Describe damage to the dorsal scapular nerve

A

difficult complete adduction

and scapula will be farther away from mid-line on affected side

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20
Q

Latissimus dorsi origins

A

Spines/lower thoracics and lumber vertebrae

thoracodorsal fascia

crest/illium

lower ribs

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21
Q

Latissimus dorsi insertion

A

intertubercular groove/humerus

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22
Q

Latissimus dorsi actions

A

Extends, adducts, and medially rotates humerus

involved with forced expiration

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23
Q

Latissimus dorsi nerve supply

A

thoracodorsal (C6-8)

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24
Q

Describe what weakness of the Latissimus dorsi would look like

A

forward displacement of the shoulder

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25
Q

What is the lumbar triangle bounded by?

A

latissimus dorsi, crest/illium, and external oblique muscle

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26
Q

What is the clinical significance of the lumbar triangle?

A

a hernia of the posterior abdominal wall may develop here

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27
Q

What is the triangle of auscultation bounded by?

A

latissimus dorsi, trapezius, and vertebral border of the scapula

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28
Q

What is the clinical significance of the triangle of auscultation?

A

it allows lungs to be more easily listened to

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29
Q

How can the triangle of auscultation be enlarged?

A

by having the patient fold their arms across their chest (abduct their scapula)

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30
Q

serratus anterior origin

A

upper ribs

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31
Q

Serratus anterior insertion

A

vertebral border/scapula

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32
Q

Serratus anterior actions

A

abducts (protracts) scapula

stabilizes scapula (most important)

involved with forced inspiration only when humerus is abducted

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33
Q

Serratus anterior nerve supply

A

long thoracic (C5-C7)

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34
Q

Describe Winged scapula

A

patient cant keep vetebral border and inferior angle of scapula next to posterior thoracic wall when abducting against resistance

they may not be able to raise hand above head

some pain around shoulder

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35
Q

What may be some causes of winged scapula?

A

trauma to C5-C7

dislocation of the shoulder joint

being in the same position for a long time

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36
Q

Which muscles comprise the rotator cuff?

A

teres minor, infraspinatus, supraspinatus, and subscapularis

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37
Q

What are the criteria for muscles to be rotator cuff muscles?

A

tendon of insertion makes a cuff around head of humerus

they participate in either medial or later rotation of humerus

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38
Q

Deltoid origins

A

clavicle (anterior)

acromion process (middle)

spine of scapula (posterior)

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39
Q

Deltoid insertion

A

deltoid tuberosity

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40
Q

Deltoid Actions

A

anterior-flexes and medially rotates humerus

middle-abducts the humerus

posterior-extends and laterally rotates humerus

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41
Q

Deltoid nerve supply

A

axillary nerve (C5-C6)

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42
Q

Describe Crutch paralysis

A

shoulder has a flat appearance

loss of sensation of lateral aspect of arm

abduction of arm impaired

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43
Q

What could be causes of Crutch paralysis?

A

damage to the axillary nerve

fracture of surgical neck

dislocation of joint

pressure of a crutch on the axilla

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44
Q

Supraspinatus origin

A

supraspinatus fossa

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45
Q

Supraspinatus insertion

A

greater tuberosity

46
Q

Supraspinatus actions

A

initiates abduction of humerus (first 30-40 degrees)

laterally rotates humerus

stabilizes shoulder joint

47
Q

Supraspinatus nerve supply

A

suprascapular (C5-C6)

48
Q

Describe rotator cuff tendonitis

A

irritation and inflammation of supraspinatus tendon

pain is sharp or aching on lateral/anterior aspect of shoulder

may feel like a twinge

shoulder movement may be weaker

49
Q

Common causes of rotator cuff tendonitis

A

genetic; born with a hooked acromion

weakness of cuff causes humerus to ride up and compress tendons

excess stress and repetition

trauma injury

calcium deposits

50
Q

Describe rotator cuff tears

A

tendon usually ruptures at or near insertion

in young people, usually from traumatic injury

in old only need a minor injury

patients will have issues with abduction

51
Q

Describe the drop test for rotator cuff tears

A

have patient lower fully abducted arm and it should drop all of the sudden

52
Q

Describe bursitis

A

inflammation of a shoulder bursa that seperates the tendon from the acromion process

53
Q

Infraspinatus origin

A

infraspinatus fossa

54
Q

Infraspinatus insertion

A

greater tuberosity

55
Q

Infraspinatus actions

A

laterally rotates humerus

stabilizes the shoulder joint

56
Q

Infraspinatus nerve supply

A

suprascapular (C5-C6)

57
Q

Subscapularis origin

A

subscapular fossa

58
Q

Subscapularis insertion

A

lesser tuberosity

59
Q

Subscapularis actions

A

medialy rotates

stabilizes shoulder joint

60
Q

Subscapularis nerve supply

A

upper and lower subscapular (C5-C6)

61
Q

Teres Minor origin

A

axillary border/scapula

62
Q

Teres minor insertion

A

greater tuberosity

63
Q

Teres minor actions

A

laterally rotates humerus

stabilizes shoulder joint

64
Q

Teres minor nerve supply

A

axillary (C5-C6)

65
Q

Teres Major origin

A

inferior angle/scapula

66
Q

Teres major insertion

A

medial lip of the intertubercular groove

67
Q

Teres major actions

A

adducts and medially rotates the humerus

stabilizes shoulder joint

68
Q

Teres major nerve supply

A

lower subscapular (C6)

69
Q

What is the location of quadrilateral space?

A

the more lateral space between the teres minor and major

70
Q

What structures does the quadrilateral space contain?

A

axillary nerve and humeral circumflex blood vessels

71
Q

What is the location of triangular space?

A

the more medial space between the teres minor and major

72
Q

What structures are in the triangular space?

A

the circumflex scapular branch of the subscapular artery

73
Q

What is the most stable joint of the upper extremity?

A

the sternoclavicular joint

74
Q

List the articulations of the sternoclavicular joint

A

sternal end of clavicle

clavicular and costal notches of sternum

medial end of first rib

75
Q

What is the function of the articular disc in the sternoclavicular joint?

A

the prevent the clavicle from being displaced from the sternum

act as a shock absorber

76
Q

What is the classification of sternoclavicular joint?

A

plane gliding

77
Q

What is the sternoclavicular joint innervation?

A

supraclavicular and subclavius

78
Q

What actions do the Anterior and Posterior Sternoclavicular ligament prevent?

A

excessive forward or backward movement (retraction and protraction)

79
Q

Describe the anterior and posterior sternoclavicular ligament

A

it reinforces the capsular ligament

extrinsic and acts like a wall

80
Q

What actions does the interclavicular ligament prevent?

A

displacement of the clavicle when one is carrying a heavy object

81
Q

Describe the interclavicular ligament

A

its attached to both sternal ends of clavicle

extrinsic and acts as a rope

82
Q

What actions does the costoclavicular ligament prevent?

A

elevation at medial end of clavicle

83
Q

Describe the costoclavicular ligament

A

attached at costal impression of clavicle and first rib

reinforces capsular ligament

extrinsic and acts as a rope

84
Q

Describe a dislocation of the sternoclavicular joint

A

usually from direct trauma to the anterior aspect of the sternal end of the clavicle

can be life threatening from compression of trachea or blood vessels in neck

85
Q

List the articulations of the Acromioclavicular joint

A

acromion process and lateral end of clavicle

86
Q

What is the classification of the acromioclavicular joint?

A

plane gliding

87
Q

What is the nerve supply of the acromioclavicular joint?

A

dorsal scapular, suprascapular, and axillary nerves

88
Q

What do the inferior and superior acromioclavicular ligaments prevent?

A

the clavicle from losing contact with the acromion process

89
Q

Describe the superior and inferior acromioclavicular ligaments

A

they reinforce the capsular ligament

extrinsic and acts as a rope

90
Q

What is the function of the coracoclavicular ligament?

A

holds and suspends the weight of the scapula from the clavicle

limits protraction, elevation, and rotation of scapula

91
Q

Describe the coracoclavicular ligament

A

connects clavicle with coracoid process

divided into conoid and trapezoid portion

extrinsic and acts as a rope

92
Q

Describe a dislocation of the acromioclavicular joint (shoulder separation)

A

usually occurs from a severe blow to the shoulder

the lateral end of clavicle is displaced and acromion process is more palpable than normal

93
Q

Describe a grade III dislocation of the acromioclavicular joint

A

both acromionclavicular and coracoclavicular ligaments are ruptured and clavicle separates from scapula

94
Q

How can one tell if the subclavian artery is compromised in a dislocation of the acromioclavicular joint?

A

a diminished brachial or radial pulse

95
Q

What are the articulations of the glenohumeral joint?

A

head of the humerus and glenoid cavity/scapula

96
Q

What purpose does the glenoid labrum serve in the glenohumeral joint?

A

to deepen the cavity to accommodate to the head of the humerus

97
Q

What is the classification of the glenohumeral joint?

A

ball and socket joint

98
Q

What is the nerve supply to the glenohumeral joint?

A

the axillary and suprascapular nerve

99
Q

Describe the capsular ligament for the glenohumeral joint

A

it has an opening infero-laterally placed for long head of biceps brachii to pass through

is superiorly strengthened by ligaments and rotator cuff muscle tendons

100
Q

What does the glenohumeral ligament prevent?

A

lateral rotation

101
Q

Describe the glenohumeral ligament

A

strengthens anterior aspect of capsule

intrinsic and acts as a rope

102
Q

Describe the transverse humeral ligament

A

spans intertuburcular groove making it a canal

keeps long head of biceps brachii in place

103
Q

What does the coracohumeral ligament limit?

A

lateral rotation of the humerus

104
Q

Describe the coracohumeral ligament

A

strengthens ligament from above

extrinsic and acts as a rope

105
Q

What does the coracoacromial ligament prevent?

A

upward displacement of the head of the humerus

106
Q

Describe the cracoacromial ligament

A

attaches coracoid and acromion processes to the scapula

is extrinsic and acts as a wall

107
Q

Describe the suprascapular ligament

A

spans the scapular notch

108
Q

What is primarily responsible for keep the shoulder joint from separating?

A

mostly muscles (rotator cuff muscles)

109
Q

Describe an anterior dislocation of the glenohumeral joint

A

most common and at the inferior aspect of the capsular ligament

usually caused by excessive extension and lateral rotation of the humerus

rounded shoulder appearance is lost and deltoid tuberosity can no longer be palpated

loss of sensation on lateral aspect of arm due to injury of the musculocutaneous and axillary nerves

110
Q

What happens to the humerus in an anterior dislocation of the should joint?

A

head of the humerus is forced thru the anterior part of the capsular ligament and ends up below the coracoid process (subcoracoid dislocation)

111
Q

Levator Scapula actions

A

elevates scapula

Stabilizes scapula

adducts scpula