Upper Limb session 1

Question 1

Scapular Articulates with….

Answer 1

It articulates with the humerus at the glenohumeral joint, and with the clavicle at the acromioclavicular joint. connects the upper limb to the trunk

Question 2

the fossa of the scapular ….

Answer 2

It contains a largeconcave depression over most of its surface, known as thesubscapular fossa.
Glenoid fossa–a shallow cavity, located superiorly on the lateral border. It articulates with the head of the humerus to form theglenohumeral (shoulder) joint

Question 3

Tubercles of the Scapular

Answer 3

Supraglenoid tubercle–a roughening immediately superior to the glenoid fossa. The place of attachment of the long head of the biceps brachii.

Infraglenoid tubercle–a roughening immediately inferior to the glenoid fossa. The place of attachment of the long head of the triceps brachii

Infraspinous fossa– the area below the spine of the scapula, it displays a convex shape.

Supraspinous fossa– the area above the spine of the scapula, it is much smaller than the infraspinous fossa, and is more convex in shape.

Question 4

Theposterior surfaceof the scapula features

Answer 4

• Spine– the most prominent feature of the posterior scapula. It runs transversely across the scapula, dividing the surface into two.
• Acromion–projection of the spine that arches over the glenohumeral joint and articulates with the clavicle at the acromioclavicular joint.
• Infraspinous fossa– the area below the spine of the scapula, it displays a convex shape.
Supraspinous fossa– the area above the spine of the scapula, it is much smaller than the infraspinous fossa,

Question 5

Clavicle shape and articulation

Answer 5

Theclavicle(collarbone) extends between the manubrium of the sternum and the acromion of the scapula.

sternal end contains alarge facet– for articulation with the manubrium of the sternum at thesternoclavicular joint

Question 6

Functions of the clavicle

Answer 6

clavicle has three main functions: Attaches the upper limb to the trunk as part of the ‘shoulder girdle’, Protects the underlying neurovascular structures supplying the upper limb, Transmits force from the upper limb to the axial skeleton.

Question 7

Muscles that attach to the clavicle

Answer 7

attachment for several muscles – deltoid, trapezius, subclavius, pectoralis major, sternocleidomastoid and sternohyoid

Question 8

what is the acromioclavicular joint

Answer 8

The acromial end houses a small facet for articulation with the acromion of the scapula at theacromioclavicular joint

Question 9

what type of joint is the shoulder joint

Answer 9

The shoulder joint (glenohumeral joint) is a ball and socket joint between thescapula and thehumerus
It is the major joint connecting the upper limb to the trunk.

Question 10

what articulates at the shoulder?

Answer 10

articulation of theheadof the humerus with theglenoid cavity(or fossa)of the scapula.

Question 11

what features are seen in the shoulder joint

Answer 11

• Like most synovial joints, the articulating surfaces are covered withhyaline cartilage.
• The head of the humerus is much larger than the glenoid fossa, giving the joint a wide range of movement at the cost of inherent instability.
• To reduce the disproportion in surfaces, the glenoid fossa is deepened by a fibrocartilage rim, called theglenoid labrum.
• Thejoint capsuleis a fibrous sheath which encloses the structures of the joint
• It extends from theanatomical neckof the humerus to the border or ‘rim’ of the glenoid fossa.
• Thesynovial membranelines the inner surface of the joint capsule, and produces synovial fluid to reduce friction between the articular surfaces.

Question 12

Factors that contribute to stability of the shoulder joint

Answer 12

• Rotator cuff muscles– surround the shoulder joint,attaching to the tuberosities of the humerus, whilst also fusing with the joint capsule. The resting tone of these muscles act to compress the humeral head into the glenoid cavity.
• Glenoid labrum–a fibrocartilaginous ridge surrounding the glenoid cavity. It deepens the cavity and creates a seal with the head of humerus, reducing the risk of dislocation.
• Ligaments–act to reinforce the joint capsule, and form the coraco-acromial arch.
Biceps tendon–it acts as a minor humeral head depressor, thereby contributing to stabilit

Question 13

Neurovasculature supply to the shoulder joint?

Answer 13

The shoulder joint is supplied by theanteriorandposterior circumflex humeral arteries, which are both branches of the axillary artery. Branches of thesuprascapular artery, a branch of the thyrocervical trunk, also contribute.
Innervation is provided by theaxillary,suprascapularandlateral pectoralnerves

Question 14

Name the two superficial extrinsic muscles

Answer 14

There are two superficial extrinsic muscles – the trapezius and latissimus dorsi

Question 15

What is the trapezius

Answer 15

The trapezius is a broad, flat and triangular muscle. The muscles on each side form a trapezoid shape. It is the most superficial of all the back muscles.

Question 16

Origin of the trapezius

Answer 16

. Originates from the skull,nuchalligament and thespinous processes of C7-T12. The fibres attach to the clavicle, acromion and the scapula spine

Question 17

Action of the trapezius

Answer 17

The upper fibres of the trapezius elevate the scapula and rotates it during abduction of the arm. The middle fibres retract the scapula and the lower fibres pull the scapula inferiorly.

Question 18

What is the latissimus dorsi

Answer 18

The latissimus dorsi originates from the lower part of the back, where it covers a wide area.

Question 19

Origin of the latissimus dorsi

Answer 19

Has a broad origin – arising from the spinous processes of T7-T12, iliac crest, thoracolumbar fascia and the inferior three ribs. The fibres converge into a tendon that attaches to the intertubercular sulcus of the humerus.

Question 20

Action of the latissimus dorsi

Answer 20

Extends, adducts and medially rotates the upper limb.

Question 21

What are Rhomboids

Answer 21

There are two rhomboid muscles – major and minor. The rhomboid minor is situated superiorly to the major.

Question 22

Where does the Rhomboid Major Originate

Answer 22

Rhomboid Major

Originates from the spinous processes of T2-T5 vertebrae.

Question 23

Where does the Rhomboid Major articulate

Answer 23

Attaches to the medial border of the scapula, between the scapula spine and inferior angle.

Question 24

Rhomboid Major action

Answer 24

Retracts and rotates the scapula.

Question 25

Where does the Rhomboid Minor Originates

Answer 25

Rhomboid Minor

Originates from the spinous processes of C7-T1 vertebrae

Question 26

where does the Rhomboid Minor attach

Answer 26

Attaches to the medial border of the scapula, at the level of the spine of scapula.

Question 27

Rhomboid Minor action

Answer 27

Retracts and rotates the scapula.

Question 28

lis the four rotator cuff muscles =

Answer 28

four rotator cuff muscles (supraspinatus, infraspinatus, subscapularis and teres minor)

Question 29

What is the delta muscle

Answer 29

The deltoid muscle is shaped like the Greek letter delta – Δ. It can be divided into an anterior, middle and posterior part.

Question 30

Where does the delta muscle originate

Answer 30

Originate from the lateral third of the clavicle, the acromion and the spine of the scapula. It attaches to the deltoid tuberosity on the lateral aspect of thehumerus

Question 31

Delta muscle actions (all 3 sections )

Answer 31

Anterior fibres – flexion and medial rotation. Posterior fibres – extension and lateral rotation. Middle fibres – the major abductor of the arm (takes over from the supraspinatus, which abducts the first 15 degrees).

Question 32

What is the teres major

Answer 32

The teres major forms the inferior border of the quadrangular space – the ‘gap’ that theaxillary nerveand posterior circumflex humeral artery pass through to reach the posterior scapula region

Question 33

Where does there teres major originate

Answer 33

Originates from the posterior surface of the inferior angle of the scapula. It attaches to the medial lip of the intertubercular groove of the humerus.

Question 34

Action of the teres major

Answer 34

Adducts at the shoulder and medially rotates the arm.

Question 35

Role of the rotator cuff muscles

Answer 35

The rotator cuff muscles are a group of four muscles that originate from the scapula and attach to the humeral head. Collectively, the resting tone of these muscles acts to ‘pull’the humeral head into the glenoid fossa. This givestheglenohumeral joint a lot of additional stability.
In addition to their collective function, the rotator cuff muscles also have their own individual actions.

Question 36

Supraspinatus- origin and action

Answer 36

Originates from the supraspinous fossa of the scapula, attaches to the greater tubercle of the humerus. Abducts the arm 0-15o, and assists deltoid for 15-90o

Question 37

Infraspinatus - origin and action

Answer 37

Originates from the infraspinous fossa of the scapula, attaches to the greater tubercle of the humerus. Laterally rotates the arm.

Question 38

Subscapularis - origin ad naction

Answer 38

Originates from the subscapular fossa, on the costal surface of the scapula. It attaches to the lesser tubercle of the humerus. Medially rotates the arm.

Question 39

Teres Minor - origin and actions

Answer 39

Originates from the posterior surface of the scapula, adjacent to its lateral border. It attaches to the greater tubercle of the humerus. Laterally rotates the arm.