Upper Extremity 1 Flashcards
Articulations of Clavicle
Only connection of axial skeleton to UA
medial: articulates with manubrium–> SC jt
lateral: articulates with the scapula–> Ac jt
Fractures most common on clavicle
junction between middle and lateral third
Glenohumeral Joint
glenoid fossa of scapula articulates with head of humerus
AC Jt
acromium process of SCAPULA articulates with laterl end of CLAVICLE
Acromion
deltoid & trapezius attachment
coracoid process
short head of biceps brachii, coracobrachialis and pec minor attachment
spine of scapula
deltoid & trapezius attachment
wraps around back, clavicle, acromeum, spine (anchor pt for muscle above and below)
Spurpaspinous fossa
supraspinatus attachment
infraspinous fossa
infraspinatus attachment
rotator cuff muscle lands here
subscapular fossa
subscapularis attachment
supraglenoid tuberle
attachment sites for long head of biceps brachii
infraglenoid tubercle
attachment sites for long head triceps
Greater tubericle of humerus
attachment site for external rotators of rotator cuff muscles (supraspinatus, infraspinatus, teres minor muscle)
Lesser tubericle of humerous
attachment for internal rotator of rotator cuff muscles
subscapularis
Bicipital groove of humerous
attachment of tendon of long head of biceps brachii
also attaches pec major, latissimus dorsi, teres major
Pectoralis Major
O- clavicular head–> anterior surface of medial half of clavicle
Sternocostal head–> anterior surface of sternum, superior 6 costal cartilages, aponeurosis of exit oblique
I- lateral lip of intertubercular of humerus
N- lateral & medial pectoral nerves, clavicular head (C5-6), sternal head (C7-T1)
A-adduction and medial rotation of humerus, assists in flex/extension of humerus
Pectoralis Minor
O-ribs 3-5 near costal cartilage
I- medial border and superior surface of coracoid process of scap
N- medial pectoral nerve (C8-T1)
A- stabilizes scapula by drawing it inferiorly and anteriorly against thoracic wall (depressed and protracts scap)
Subclavius
O- jxn of 1st rib and its costal cartilage
I- inferior surface of middle third of clavicle
N-nerve to subclavius (C5-6)
A- anchors and depresses clavicle
Serratus Anterior
O- external surfaces of lateral parts of ribs 1-8
I- anterior surfaces of medial border of scapula
N- long thoracic nerve (C5-7)
A- protracts scapula and holds it against thoracic wall, upward rotation of scapula
Deltopectoral Triangle
Deltoid, pec major, clavicle
cephalic veins passes superficial to deep to join with axillary vein
Trapezius
attaches shoulder girdle to axial skeleton
upper–> elevate, upward rotation, retraction of scapula
middle–> retraction of scapula
lower–> depression, upward rotation, retraction of scapula
Latissimus dorsi
acts on GH joint, indirectly on capulothoracic jt
extends, adducts, medially rotates humerus
Levator Scapulae
elevate & downward rotation of scapula (proximal attachment fixed)
lateral flex, ipsilateral rotation of neck (distal attachment fixed)
Rhomboid Major + Minor
deep to trap
retract & downward rotation of scapula, stabilize scapula
damage to scapula nerve=scapula deviated laterally from midline
Deltoid
innervated by–>axillary nerve
3 heads–> anterior, middle, posterior
synergistically abduct arm, posterior and anterior heads stabilize humerus
Anterior- flex & internal rotation of humerus
Middle- abducts humerus
Posterior head- extends and externally rotates humerus
Teres Major
Innervated–> lower subscapular nerve
fxn: adducts and internally rotates humerus
helps medially rotate humerus w/pec major, pec minor, lats
Muscles of the Rotator Cuff
supraspinatus, infraspinatus, teres minor, subscapularis
Supraspinatus
P- Supraspinous fossa
D- superior facet of greater tuberosity
N- suprascapular nerve
A- abduct humerus
Infraspinatus
P- infraspinus fossa
D- inferior to supraspinatus attachment, middle facet of GT
N- suprascapular nerve
A- works synergistically with teres minor externaly rotate humerus
Teres Minor
P- superior portion of laterl border of scapula
D- inferior to infraspinatus attachment, inferior facet of GT
N- axillary nerve
A- works synergistically with infraspinatus to externally rotate
Subscapularis
P- subscapulari fossa
D- Lesser tuberosity of humerus
N- upper and lower subscapularis nerve
A- Internal rotation of humerus
Upper Triangular Space
superior–> teres minor
inferior–> teres major
laterla–> long head of tricep
contents: circumflex scapular artery
Lower Triangle
Superior–> teres major
medial–> long head of triceps
lateral–> lateral head of tricep
contents- radial nerve and deep artery of arm
Quadrangular Space
superior- teres minor and subscapularis inferior- teres major medial- long head of triceps lateral-surgical neck of humerus contents- axillary nerve and posterior humeral circumflex artery
Triangle of Auscultation
bordered by trapezius, latissimus dorsi and medial border of scapuka
breath sounds heard most cleary
Axillary Artery
arises: from subclavian artery
begins:outer boarder of first rib
ends: inferior border of teres major
three portions of axillary artery
Brachial Artery
arises from axillary artery
begins: inferior border of teres major
end: divides into radial and ulna arteries at elbow
then goes on to divide into ulna and radial arteries
Anastomoses to scapula
suprascapula a, subscapular a, transverse cervical a
Anastomoses to Shoulder
anterior & posterior circumflex humeral arteries
Anastomoses of elbow and distal humerus
deep artery of arm branches off brachial artery
eventually supplies radial collaterals that supply elbow
brachial artery supplies ulnar collaterals to supply elbow
recurrent arteries of radial and ulna arteries from anastomoses w/above collaterals
Lateral cord divides into
musculocutaneous
lateral pectoral nerve
lateral cord and medial cord merge–> median nerve
Medial cord divides into
lateral + median cord= median nerve medial pectoral nerve medial brachial cutaneous n medial antebrachial cutaneous n ulnar nerve
Posterior cord
axillary n radial n thoracodorsal n upper subscapular nerve lower subscapular nerve
coracobrachialis
coracoid process of scapula
middle third of medial humerus
musculacutaneous nerve
flex and adduct arm
biceps brachi
P- long head–>supraglenoid tubercle of scapula
short head- coracoid process of scapula
D- radial tuberosity of radius
bicipital aponeurosis
musculocutaneous nerve
flexes arm and forarm, supinates forearm
Brachialis
P- distal half of anterior surface of humerus
D- coronoid tuberosity of ulna
I-musculocutaneous nerve
A- primary flexor of forearm, flexes forearm in all positions (supinated, neutral or pronated)
Triceps brachii
P-long head–> infraglenoid tubericle
lateral head–> posterior humerus superior to radial groove
Medial head–> posterior humerus inferior to radial groove
Distal attachments–> olecranon process of ulna
I-radial Nerve
A-primary extensor of forearm
Aconeus
p-(lateral epicondyle)
d- olecranon process of ulna
I- radial nerve
A- assist in forearm extension, stabilize elbow joint
Axillary nerve
Emerges from posterior cord, passed through quaff angular space, inner gates deltoid
Musculocutaneous nerve
Begins inferior border of pec minor
Pierced coracobrachialis, travels between biceps brachii and brachialis
Innervates bicep and brachialis
Becomes lateral cutaneous of forearm
Radial nerve
Emerges from posterior cord Posterior to brachial artery Descends with deep artery of arm Travels posterior to humerus Travels between brachialis and brachioradialis
Median nerve
Emerges from medial and lateral cords
Follows brachial artery
DOES NOT SUPPLY MUSCLES OF ARM
Ulnar Nerve
Emerges from medial cord
DOES NOT SUPPLY ARM MUSCLES
Travels medial to brachial artery and anterior to triceps
AC ligament
Superior and inferior portion of AC joint
Coracoclavicular ligament
2 ligaments connect coracoid to scapula
Trapezoid–>coracoid to trapezoid line clavicle
Conoid–> conoid to conoid tubercle of clavicle
Type 1AC joint separation
Partial injury to AC, coracoclavicular is intact
Type 2 AC joint separation
Disruption of AC ligament, coracoclavicular still intact
Type 3 AC joint separation
Disruption if AC and coracoavicular, clavicle displaced superiorly
Glenohumeral ligament
Strengthen anterior aspects of joint
Glenoid to humeral head
Coracohumeral ligament
Coracoid process to greater tuberosity
Coracoacromial ligament
Forms coracoacromial arch
Coracoacromial ligament and acr onion process
From actinium to coracoid process
Transverse humeral ligament
Bridge over bicipital groove
medial epicondyle
attachment site for flexor muscles of forearm
lateral epicondyle
attachment site for extensor muscles of forearm
