Upper Extremity: Shoulder, Axilla, & Superficial Back, Scapular region Flashcards
The scapula lies on the posterior chest wall between which ribs?
2nd and 7th ribs
What are the major defining features of the scapula
Borders, Angles, Surfaces, Large bony processes
- 3 Borders (lateral, medial, superior)
- 3 angles (lateral, superior, inferior)
- 2 surfaces (dorsal, coastal)
- 3 bony processes (acromion, spine, coracoid)
On the lateral aspect of the superior border (near the base of the coracoid process) is the scapular notch bridged by the superior transverse scapular ligament
What passes superior (1) and inferior (2) to the superior transverse scapular ligament?
The ARMY goes over the bridge and the NAVY goes under
(1) suprascapular artery
(2) suprascapular nerve
() is a fibrocartilage ring that rims the margin of the glenoid cavity and serves to broaden and deepen the joint cavity
Glenoid labrum
Identify major parts of the scapula
What are the articulations of the humerus bone
(1) glenoid cavity of the scapula
(2) head of the radius and trochlear notch of the ulna (elbow joint)
Important parts of the humerus
The head of the humerus articulates with the glenoid cavity of the scapula to form what joint in the shoulder joint complex?
Glenohumeral joint
Part of the Humeral Bone:
Is the interface between the proximal extremity and the shaft of the humerus
has important relations with the axillary nerve and the anterior and posterior circumflex humeral vessels
Fractures here are common
Surgical neck - of the humeral bone
Part of the Humeral Bone:
The intertubercular (bicipital) groove is the deep groove on the anterior surface of the humerus that separated the greater and lesser tubercles.
What structure does it house?
tendon of the long head of the biceps brachii muscle
Part of the Humeral Bone:
(1) roughened elevation on the lateral proximal end of the humerus
(2) roughened elevation on the anterior proximal end (medial) of the humerus
(1) greater tubercle
(2) lesser tubercle
Part of the Humeral Bone:
Attachment area for the deltoid muscle; posterior edge of the tuberosity defines the frooove for the radial nerve
Deltoid tuberosity
Position on the anterolateral surface of the midshaft of the humerus
Part of the Humeral Bone:
shallow depression that spirals around the posterior and lateral aspects of the midshaft of the humerus
Most distinct where it lies between the deltoid tuberosity and the upper end of the lateral supracondylar ridge
Spiral Groove
Part of the Humeral Bone:
attachment of the common extensor tendon (tendon of origin for several superficial forearm extensor muscles)
Lateral epicondyle
Part of the Humeral Bone:
The ulnar nerve crosses the posterior surface of this epicondyle in the shallow ulnar sulcus - what is the epicondyle
medial epicondyle
Part of the Humeral Bone:
Articulates with the head of the radius - shape allows for both flexion/extension and rotation at the humeroradial joint
capitulum
a pyramid shaped space between the upper part of the arm and the side of the chest
forms an important passage for the nerves, blood vessels and lymph channels
Axilla or armpit
4 walls of the axilla
(1) anterior wall: pectoralis major & minor, subclavius
(2) posterior wall: subscapularis, latissimus dorsi, teres major muscles
(3) medial wall: upper 4 or 5 ribs and their intercostal spaces
(4) lateral wall: coracobrachialis & biceps muscle
Contents: axillary artery, axillary vein, lymph vessels and nodes, brachial plexus
Branches of the Axillary artery
Axillary vein is from the union of what 2 venae comitantes
brachial vein and basilic vein
Brachial Plexus
Need to memorize
Brachial Plexus Distribution 1
Need to Memorize
Brachial Plexus Distribution 2
Need to Memorize
Lymph nodes of the upper extremity
(1) anterior - pectoral group
(2) posterior - subscapular group
(3) lateral group
(4) central group
(5) infraclavicular - deltopectoral group
(6) apical group
Pectoral Region Muscles
Superficial group of muscles of the back
(trapezius, latissimus dorsi, levator scapulae, rhomboid minor, rhomboid major)
connects the shoulder girdle with the ventral column
Muscles of the scapular region
(deltoid, supraspinatus, infraspinatus, teres minor, teres major, subscapularis)
Connects the shoulder girdle with the upper part of the humerus
Significance of the Quadranglular space
Contains the:
(1) axillary nerve
(2) posterior circumflex humeral vessels
Boundaries of the Quadrangular or Quadrilateral space
- superiorly: subscapularis m., teres minor m., capsule of the shoulder joint
- inferiorly: teres major
- medially : long head of triceps brachii m.
- laterally : surgical neck of the humerus
Triangular space contents
circuflex artery - branch of the subcapsular artery
Triangular space boundaries
- superiorly: teres major m.
- inferiorly: teres minor m.
- laterally: long head of triceps brachi m.
What nerve arises from teh posterior cord of the brachial plexus (C5 & C6)
Axillary nerve
Axillary nerve and the circumflex humeral vessels have close relations to the surgical neck and can be readily damaged in association with fracture in the surgical neck
Branches of the Axillary nerve
- articular branch - supply the shoulder joint
- anterior terminal branch - supply the deltoid
- posterior terminal branch - branches to teres minor and deltoid; superior or lateral cutaneous nerve of the arm
Anastamosis of the shoulder joint is found between the
between the branches of the first part of the subclavian artery and the third part of the axillary artery
