Upper limb sheet 3

Question 1

Ask your model to demonstrate the action of punching
What movement is occurring at the Shoulder girdle? Now, list all other movements of shoulder girdle. Name the muscles responsible for elevation movement.

Answer 1

Protraction as you punch out, then retraction on returning to normal.
Protraction, retraction, elevation, depression, upwards/ downwards rotation.

Elevation = Rhomboids, trapezius, levator scapulae

Question 2

In what axis does glenohumeral flex and ext occur?

Answer 2

Sagittal plane, mediolateral axis

Question 3

Explain Global Stabiliser with example(s) and explain how it is different to Local Stabiliser

Answer 3

Local = stabilises one attachment to allow movement of required attachment
Global = stabilises body position rather than muscle

E.G. lev scap wants to side flex and elevate scapula, trapezius lower fibres stabilise scap to perform efficient side flexion

Question 4

Classify the GH joint. Describe the articulating surfaces, intracapsular and extracapsular structures of GHJ. List the ligaments of GHJ.

Answer 4

Synovial ball + socket, 3 degrees of freedom

Allows for flex/ ext, abd/ add, int/ext rotation

Glenoid fossa with head of humerus

Capsule formed from glenoid labrum to anatomical neck of humerus, slack inferiorly

Ligaments = superior/ middle/ inferior glenohumeral ligament, transverse humeral ligament (intracapsular), coracoacromial ligament, coracohumeral ligament

Question 5

Explain the morphology, attachments, and actions of Sternocleidomastoid. Name the nerve that supplies.

Answer 5

Thick, strap like muscle

Origin: manubrium, medial portion of clavicle

Insertion: Mastoid process, superior nuchal line

Actions: Contralateral C-rotation, ipsilateral flexion

Nerve: Accessory nerve

Question 6

Explain the morphology, attachments, and actions of Deltoid. Name the nerve that supplies.

Answer 6

Thick triangular shoulder muscle, 3 sets of fibres, ant, post and middle

Origin: Lateral 1/3 of clavicle, acromion, spine of scapula

Insertion: Deltoid tuberosity of humerus

Actions: Abduction, flexion and extension, some int/ext rotation

Nerve: Axillary nerve

Question 7

What is the root value of Median nerve .Outline the course and list the muscles supplied by the nerve?

Answer 7

C5,6,7,8,T1

Supplies = pronator teres, flexor compartment (lateral), thenar eminence, 1st +2nd lumbricals

Brachial plexus to hand

Question 8

What is the root value of Radial nerve .Outline the course and list the muscles supplied by the nerve?

Answer 8

C5,6,7,8,T1

Triceps, anconeus, brachio-radialis, lateral part of brachialis

brachial plexus to hand

Question 9

What is the root value of Ulnar nerve .Outline the course and list the muscles supplied by the nerve?

Answer 9

C8,T1

Flexor compartment of forearm, hypothenar eminence, adductor pollicis, 3rd and 4th lumbricals

brachial plexus to hand

Question 10

Name the ligament associated with the head of the radius. Identify the attachments.

Answer 10

Annular ligament

Forms a circle around the head of the radius to help form the capsule.

Question 11

Name the muscles responsible for flexion or extension or abduction at shoulder.

Answer 11

Flexion = anterior fibres of deltoid, pectoralis major, biceps brachii (long head)

Extension = posterior fibres of deltoid, triceps, latissimus dorsi, teres major

Abduction = Supraspinatus, deltoid middle fibres