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Human Anatomy > Upper Limb: Shoulder Region > Flashcards

Upper Limb: Shoulder Region Flashcards

1
Q

Which fossa is found on the costal surface of the scapula?

A. Supraspinous fossa
B. Infraspinous fossa
C. Subscapular fossa

A

C

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2
Q

Which border of the scapula is located in close proximity to the vertebral column?

A

Medial border (vertebral border)

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3
Q

Which bone prominence (projection) is located on the posterior aspect of the scapula?

A. Spine of scapula
B. Acromion process
C. Coracoid process

A

A

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4
Q

Which of the following is a bony landmark of the proximal humerus? Select all that apply.

Inferior angle
Greater tubercle
Lesser tubercle
Spinoglenoid notch
Surgical neck

A

Greater tubercle
Lesser tubercle
Surgical neck

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5
Q

The acromioclavicular joint is formed by the articulation of which two structures?

A

The acromial end of the clavicle and the acromion process of the scapula

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6
Q

Which ligament prevents the scapula from being displaced medially beneath the clavicle?

A. Coracohumeral
B. Acromioclavicular
C. Coracoacromial
D. Coracoclavicular

A

D

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7
Q

True or false: The glenohumeral joint is a ball and socket joint that allows two degrees of freedom (flexion/extension, adduction/abduction).

A

False

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8
Q

What structures form the coraco-acromial arch? Select all that apply.

Deltoid
Acromion process
Coracoid process
Coracohumeral ligament
Coracoacromial ligament

A

Acromion process
Coracoid process
Coracoacromial ligament

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9
Q

Which structure serves to deepen the glenoid cavity?

A

Glenoid labrum

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10
Q

Which of the following ligaments converts the intertubercular sulcus into a canal?

A. Coracohumeral
B. Transverse humeral
C. Glenohumeral

A

B

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11
Q

What is the functional significance of the three segments of the upper limb?

A

Proximal segment: Places the hand in space
Intermediate segment: Positions the hand
Terminal segment: Manipulation of the environment

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12
Q

What bones form the skeleton of the upper limb?

A

Clavicle
Scapula
Humerus
Radius
Ulna
Carpals
Metacarpals
Phalanges

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13
Q

What is the major joint found in the upper limb?

A

Synovial joint

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14
Q

The scapulothoracic joint is the only joint of the upper limb that is NOT a synovial joint—or a TRUE joint for that matter. What type of joint is it, and why is it not a true joint?

A

Physiological joint

Bones are not articulating; the scapula glides across the muscles below it.

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15
Q

What is the name of the structure that gives rise to the multi-segmental peripheral nerves that supply the upper limb?

A

Brachial plexus

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16
Q

What is the name of the artery that supplies the majority of the upper limb with blood?

A

Axillary artery

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17
Q

Let’s talk about the brachial plexus.

  1. How many roots are there? Where do they originate?
  2. How many trunks are there?
  3. How many divisions?
  4. How many cords?
A
  1. 5 roots originating from the anterior rami of C5-T5
  2. 3 trunks (superior, middle, inferior)
  3. 6 divisions (3 anterior, 3 posterior)
  4. 3 cords (lateral, medial, posterior)

5.

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18
Q

What are the dermatomes of the upper limb? Label the yellow highlights.

A

See image

Key landmarks:
- Thumb: C6
- Pinky: C8
- Armpit: T1

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19
Q

What is the origin for the supraspinatus?

A

Supraspinous fossa

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20
Q

What is the origin for the infraspinatus?

A

Infraspinous fossa

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21
Q

What is important about the greater tubercle of the humerus?

A

It is a point of attachment for 3 of 4 rotator cuff muscles

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22
Q

What are the 4 joints of the shoulder region?

A

Acromioclavicular
Sternoclavicular
Glenohumeral
Scapulathoracic

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23
Q

Why is the scapulothoracic joint a joint of the shoulder region?

A

You can’t have overhead motion without the scapula gliding out superolaterally

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24
Q

What is the difference between a glenohumeral subluxation and glenohumeral dislocation?

A

Subluxation: Changes relation of humeral head to glenoid fossa but humeral head is not completely out of the glenoid fossa

Dislocation: humeral head completely out of glenoid fossa

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25
Q

What are the primary myotomes of the upper limb and their corresponding spinal nerves?

A
  • C5: shoulder abduction
  • C5, C6: elbow flexion
  • C7: Elbow extension, wrist extension, finger extension
  • C8: wrist flexion, finger flexion
  • T1: Intrinsic muscles
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26
Q

What are the names of the bones of the shoulder region?

A

Clavicle
Scapula
Humerus

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27
Q

Which joint serves as the only bony link between the axial and superior appendicular skeleton?

A

Sternoclavicular joint

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28
Q

What ligament is important for preventing downward displacement of the scapula?

A

Coracoclavicular ligament

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29
Q

Which bones articulate to form the glenohumeral joint?

A

Glenoid fossa of scapula and humeral head

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30
Q

What structures form an arch over the glenohumeral joint?

A

Acromion, coracoid process, and coraco-acromial ligament

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31
Q

What is the name of the bursa that protects the supraspinatus tendon from the coraco-acromial arch?

A

Subacromial bursa

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32
Q

Label the bony landmarks of the clavicle.

A

See image

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33
Q

Label the bony landmarks of the scapula (anterior and posterior view).

A

See image

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34
Q

Label the bony landmarks of the scapula (superior and lateral view).

A

See image

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35
Q

Label the bony landmarks of the humerus.

A

See image

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36
Q

What are the articulations within the sternoclavicular joint?

A

Sternal end of clavicle, clavicular notch of the manubrium

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37
Q

What 3 ligaments are associated with the SC joint?

A

Anterior and posterior sternoclavicular ligaments
Costoclavicular ligament
Interclavicular ligament

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38
Q

What movements occur at the SC joint?

A

Elevation, depression, anterior/posterior gliding, rotation

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39
Q

What is unique about the SC joint in relation to the synovial cavity?

A

There are TWO synovial cavities separated by an articular disc allowing the joint to move freely (similar to a ball and socket joint)

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40
Q

What are the articulations of the acromioclavicular joint?

A

Acromial end of clavicle with acromion process of scapula

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41
Q

What ligaments are associated with the AC joint?

A

Acromioclavicular
Coracoclavicular (conoid and trapezoid)

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42
Q

What movements occur at the AC joint?

A

Rotation during movements of the scapula

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43
Q

What are the articulations of the glenohumeral joint?

A

humeral head and glenoid cavity (fossa) of scapula

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44
Q

What is the purpose of the glenoid labrum?

A

Deepen the cavity of the glenoid fossa

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45
Q

What are the ligaments associated with the GH joint?

A

Coracohumeral
Glenohumeral (superior, middle, inferior)
Transverse humeral

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46
Q

What are the two bursae associated with the GH joint?

A

Subacromial (most important to remember)
Subscapular

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47
Q

What movements occur at the GH joint?

A

Flexion and extension
Adduction and abduction
Internal and external rotation

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48
Q

What are the “articulations” of the scapulothoracic joint?

A

Scapula and thoracic wall (subscapularis and serratus anterior)

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49
Q

What movements occur at the ST joint?

A

Elevation and depression
Retraction and protraction
Upward rotation and downward rotation

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50
Q

What is adhesive capsulitis or frozen shoulder?

A

Inflammation causes a thickening and stiffening of the GH joint capsule and ligaments resulting in pain and decreased mobility of the shoulder.

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51
Q

Which of the following muscles can be easily palpate lateral to the sternum and inferior to the clavicle?

A. Trapezius
B. Pectoralis major
C. Deltoid

A

B

52
Q

True or false: The posterior axillary fold is formed by the teres major and the tendon of the latissimus dorsi.

A

True

53
Q

What structures form the boundary of the clavipectoral triangle? Select all that apply:

Clavicular portion of the pectoralis major muscle
Trapezius
Deltoid
Clavicle
Sternum

A

Clavicular portion of the pectoralis major muscle
Deltoid
Clavicle

54
Q

Which of the following muscles is a muscle of the anterior axio-appendicular group of muscles? Select all that apply.

Rhomboids
Serratus anterior
Trapezius
Pectoralis minor
Deltoid
Subclavius

A

Serratus anterior
Pectoralis minor
Subclavius

55
Q

Which of the following muscles will have its action on the humerus?

A. Pectoralis minor
B. Teres major
C. Rhomboids
D. Serratus anterior

A

A

56
Q

Which of the following inserts on the lateral lip of the intertubercular sulcus?

A. Pectoralis major
B. Pectoralis minor
C. Subclavius
D. Serratus anterior

A

A

57
Q

Which of the following muscles has an origin point on the rib cage? Select all that apply.

Serratus anterior
Subclavius
Pectoralis major
Pectoralis minor

A

All of them!

Serratus anterior
Subclavius
Pectoralis major
Pectoralis minor

58
Q

Which of the following muscles will contribute to upward rotation of the scapula?

A. Serratus anterior
B. Pectoralis major
C. Subclavius

A

A

59
Q

Which of the following muscles has its insertion on the clavicle, and the acromion process and spine of the scapula?

A. Latissimus dorsi
B. Rhomboids
C. Trapezius
C. Levator scapulae

A

C

60
Q

Which of the following muscles originates from the spinous processes of either the cervical and/or thoracic vertebrae? Select all that apply.

Latissimus dorsi
Levator scapulae
Trapezius
Rhomboids

A

Latissimus dorsi
Trapezius
Rhomboids

61
Q

Which of the following muscles will adduct, internally (medially) rotate, and extend the humerus of the GH joint?

A. Trapezius
B. Latissimus dorsi
C. Rhomboids
D. Levator scapulae

A

B

62
Q

Which of the following muscles has an origin point from the clavicle and the acrimion process and spine of the scapula?

A. Deltoid
B. Supraspinatus
C. Infraspinatus
D. Subscapularis

A

A

63
Q

Which of the following muscles is considered a muscle of the rotator cuff? Select all that apply.

Teres major
Teres minor
Deltoid
Supraspinatus
Infraspinatus
Subscapularis

A

Teres minor
Supraspinatus
Infraspinatus
Subscapularis

64
Q

Which of the following muscles insert onto the greater tubercle of the humerus? Select all that apply.

Teres major
Teres minor
Deltoid
Supraspinatus
Infraspinatus
Subscapularis

A

Teres minor
Supraspinatus
Infraspinatus

65
Q

Which of the following muscles produces abduction, flexion, and extension of the humerus at the GH joint?

A. Teres minor
B. Deltoid
C. Teres major
D. Supraspinatus

A

B

66
Q

Which of the following structures forms the quadrangular space? Select all that apply.

Teres minor
Teres major
Lateral head of triceps
Long head of triceps
Surgical neck of humerus

A

Teres minor
Teres major
Long head of triceps
Surgical neck of humerus

67
Q

Which structure forms the lateral boundary of the triangular space?

A

Long head of triceps

68
Q

Which structures can be seen in the quadrangular space? Select all that apply.

Radial nerve
Posterior circumflex humeral artery
Circumflex scapular artery
Axillary nerve
Profunda brachii artery

A

Posterior circumflex humeral artery
Axillary nerve

69
Q

Which structures form boundaries of the apex of the cervical-axillary canal?

A

Clavicle, 1st rib, superior edge of scapula

70
Q

Which structure forms the lateral wall of the axilla?

A

Proximal humerus (at level of intertubercular sulcus)

71
Q

True or false: Neurovascular structures traveling between the neck and upper limb travel through the cervical-axillary canal.

A

True

72
Q

Which muscle of the shoulder region is the ONLY muscle that is NOT innervated by branches of the brachial plexus? What is it innervated by?

A

Trapezius
CN XI (Spinal Accessory Nerve)

73
Q

Which of the following branches of the brachial plexus supplies the serratus anterior?

A. Long thoracic nerve
B. Thoracodorsal nerve
C. Lateral pectoral nerve
D. Medial pectoral nerve

A

A

74
Q

Which never innervates both the supraspinatus and infraspinatus?

A

Suprascapular

75
Q

True or false: The blood supply to the muscles of the shoulder region arise from branches of the subclavian and axillary arteries.

A

True

76
Q

Which of the following arteries are branches of the thoracoacromial artery? Select all that apply.

Clavicular
Lateral thoracic
Subscapular
Pectoral
Acromial
Deltoid

A

Clavicular
Pectoral
Acromial
Deltoid

77
Q

Which of the following arteries supply the humeral head and GH joint with blood?

A. Anterior and posterior circumflex humeral arteries
B. Thoracodorsal and lateral thoracic arteries
C. Circumflex scapular and suprascapular arteries

A

A

78
Q

Which of the following arteries network together to form anastomoses around the scapula? Select all that apply.

Lateral thoracic
Dorsal scapular
Suprascapular
Circumflex scapular
Thoracodorsal

A

Dorsal scapular
Suprascapular
Circumflex scapular

79
Q

Which artery is vulnerable to damage secondary to a fracture of the surgical neck of the humerus?

A

Posterior circumflex humeral

80
Q

What structures form the boundaries of the cervico-axillary canal?

A

First rib, scapula, superior edge of scapula

81
Q

What forms the apex of the axilla?

A

Cervico-axillary canal

82
Q

The subscapularis, teres major, and latissimus dorsi form which wall of the axilla?

A

Posterior

83
Q

What do the suprascapular and nerve to subclavius have in common?

A

Both originate from ventral rami of C5 and C6

84
Q

Which suprascapular nerve originates from only one spinal root?

A

Dorsal scapular nerve

85
Q

Which nerve root originates from 3 spinal nerves and before the trunks of the brachial plexus?

A

Long thoracic nerve

86
Q

Which muscle of the upper limb is innervated by a nerve DIFFERENT than the brachial plexus? What nerve innervates it?

A

Trapezius
CN IX (accessory)

87
Q

How many suprascapular nerves are there? What are their names and origins?

A
  1. Dorsal scapular (ventral ramus, C5)
  2. Long thoracic nerve (ventral rami, C5, C6, C7)
  3. Supraclavicular nerve (C5, C6 —> superior trunk)
  4. Nerve to subclavius (C5-C6 —>superior trunk)
88
Q

How many infraclavicular branches are there?

A

6

89
Q

How many TERMINAL branches originate from the posterior cord of the brachial plexus and what are their names?

A

2
Axillary nerve
Radial nerve

90
Q

How many NONTERMINAL branches originate from the posterior cord? What are their names?

A

3
Upper subscapular
Lower subscapular
Thoracodorsal

91
Q

The intercostal brachial nerve originates from which spinal nerve? What does it supply?

A

T2; Axilla

92
Q

Which artery supplies the rhomboids, levator scapulae and trapezius and contributes to scapular anastomoses?

A

Dorsal scapular artery

93
Q

True or false: The thoracoacromial artery has 2 branches.

A

False; it has 4!

Clavicular, pectoral, acromial, deltoid

94
Q

True or false: The subscapular artery has 2 branches.

A

True!

Thoracodorsal, circumflex scapular

95
Q

What structure/s does the circumflex humeral artery supply?

A

Anterior and posterior head of humerus and glenohumeral joint

96
Q

The _____________ artery supplies teres major and minor and contributes to blood supply to the entire rotator cuff vis anastomoses.

A

Circumflex scapular

97
Q

Which of the following arteries form anastomoses around the scapula?

Thoracodorsal
Dorsal scapular
Thoracoacromial
Suprascapular
Circumflex scapular
Circumflex humeral

A

Dorsal scapular
Suprascapular
Circumflex scapular

NOTE: The circumflex humeral artery DOES anastomose, but it does so around the GH joint, NOT the scapula!

98
Q

True or false: the scapulohumeral muscles of the shoulder region can be divided into anterior and posterior groups.

A

FALSE

The axio-appendicular muscles are divided into anterior and posterior groups

99
Q

What four muscles are found in the anterior axio-appendicular shoulder region? What do they act on? What nerve/s innervate them?

A

Subclavius: acts on clavicle; innervated by nerve to subclavius

Serratus anterior: acts on scapula; innervated by long thoracic nerve

Pectoralis major: acts on scapula; innervated by lateral and medial pectoral nerves

Pectoralis minor: acts on humerus; innervated by medial pectoral nerve

100
Q

True or false: The posterior axio-appendicular muscles of the shoulder region are divided into superficial and deep subgroups.

A

True

101
Q

Which posterior axio-appendicular muscles of the shoulder region are superficial? What do they act on? What innervates them?

A

Trapezius: acts on scapula; innervated by CN XI (accessory nerve)

Latissimus dorsi: acts on humerus; innervated by Thoracodorsal nerve

102
Q

Which posterior axio-appendicular muscles of the shoulder region are deep? What do they act on? What innervates them?

A

Levator scapulae: acts on scapula; innervated by dorsal scapular nerves and C3 and C4

Rhomboids: act on scapula; innervated by dorsal scapular nerve

103
Q

Which of the following scapulohumeral muscles is NOT a muscle of the rotator cuff? Select all that apply.

A. Deltoid
B. Subscapularis
C. Supraspinatus
D. Infraspinatus
E. Teres minor
F. Teres major

A

A, F

104
Q

True or false: The muscles of the rotator cuff act on the scapula.

A

FALSE!

They all ORIGINATE on the scapula, but insert and ACT on the humerus.

105
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Pectoralis major

ORIGIN: Clavicular head: anterior surface of medial half of clavicle. Sternocostal head: anterior surface of the sternum and superior 6 costal cartilages. Abdominal head: Aponeurosis of external oblique.

INSERTION: lateral lip of intertubercular sulcus of humerus

INNERVATION: Lateral and medial pectoral nerves

ACTION: Adducts and medial rotates GH joint. Acting alone the clavicular head flexes the shoulder and sternocostal head extends the shoulder from a flexed position.

106
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Pectoralis minor

ORIGIN: 3rd to 4th ribs near their costal cartilages

INSERTION: medial border and superior surface of coracoid process of scapula

INNERVATION: medial pectoral nerve

ACTION: stabilizes scapula by drawing it inferiorly and anteriorly against the thoracic wall (protracts scapula)

107
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Serratus anterior

ORIGIN: External surfaces of lateral parts of 1st through 8th ribs

INSERTION: Anterior (costal) surface of the medial border of the scapula

INNERVATION: Long thoracic nerve

ACTION: Protracts the scapula and holds it against the thoracic wall; rotates scapula upward

108
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Subclavius

ORIGIN: Junction of 1st rib and its costal cartilage

INSERTION: inferior surface of middle 1/3 of clavicle

INNERVATION: Nerve to subclavius

ACTION: Anchors and depresses the clavicle

109
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Trapezius

ORIGIN: Medial 1/3 of superior nuchal line; external occipital protuberance, nuchal ligament and spinous processes of the c7-T12 vertebrae

INSERTION: Lateral 1/3 of clavicle, acromion, and spine of the scapula

INNERVATION: CN XI (accessory nerve; motor) and c3 and c4 (pain and proprioception)

ACTION: elevates (superior fibers), depresses (inferior fibers), retracts (middle fibers), and upwardly rotates scapula

110
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Latissimus dorsi

ORIGIN: Spinous processes of inferior 6 thoracic vertebrae, thoracolumbar fascia, iliac crest, and inferior 3-4 ribs

INSERTION: Floor of intertubercular sulcus of humerus

INNERVATION: Thoracodorsal nerve

ACTION: extends, adducts, and medially rotates GH joint

111
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Levator scapulae

ORIGIN: posterior tubercles of transverse processes of c1-c4 vertebrae

INSERTION: superior part of medial border of scapula

INNERVATION: dorsal scapular nerve (motor) and c3-c4 spinal nerves (pain an proprioception)

ACTION: elevates and downwardly rotates the scapula

112
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Rhomboids major (minor not picture; lays superior to major)

ORIGIN: Minor: nuchal ligament and spinous processes of c7-t1 vertebrae. Major: spinous processes of t2-t5 vertebrae

INSERTION: Minor: medial border at level of spine. Major: medial border from spine to inferior angle

INNERVATION: Dorsal scapular nerve

ACTION: Retracts and downwardly rotates scapula; fixes scapula to thoracic wall

113
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Deltoid

ORIGIN: lateral 1/3 clavicle, acromion, and spine of scapula

INSERTION: Deltoid tuberosity of humerus

INNERVATION: Axillary nerve

ACTION: Anterior: flexes and medially rotates GH joint. Middle: abducts GH joint. Posterior: Extends and laterally rotates GH joint

114
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Subscapularis

ORIGIN: Subscapular fossa

INSERTION: Lesser tubercle of humerus and medial lip of intertubercular sulcus

INNERVATION: Upper and lower subscapular nerves

ACTION: Medially rotates GH joint; helps to hold humeral head in glenoid cavity

115
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Supraspinatus

ORIGIN: Supraspinous fossa

INSERTION: Superior facet of greater tubercle of humerus

INNERVATION: Suprascapular nerve

ACTION: initiates and assists deltoid in abduction of GH joint and acts with other rotator cuff muscles to stabilize the shoulder joint

116
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Infraspinatus

ORIGIN: Infraspinous fossa

INSERTION: Middle facet of greater tubercle of humerus

INNERVATION: Suprascapular nerve

ACTION: laterally (externally) rotates the GH joint; helps hold humeral had in glenoid cavity of the scapula

117
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Teres minor

ORIGIN: superior part (about 2/3s) of the lateral border of the scapula

INSERTION: Inferior facet of greater tubercle of the humerus

INNERVATION: Axillary nerve

ACTION: Laterally (externally) rotates the GH joint; helps hold humeral head in glenoid cavity of scapula

118
Q

What muscle is this? Name its origin, insertion, innervation, and action.

A

NAME: Teres major

ORIGIN: Inferior part of the lateral border and dorsal surface of the inferior angle of scapula

INSERTION: medial lip of intertubercular sulcus of humerus

INNERVATION: Lower subscapular nerve

ACTION: abducts and medially rotates the GH joint

119
Q

The ________ and __________ muscles form a force couple to abduct the humerus.

A

Supraspinatus
Deltoid

120
Q

The ________ and __________ muscles together act as lateral rotators of the humerus and prevent translations of the humeral head during overhead arm movements.

A

Infraspinatus
Teres minor

121
Q

If the serratus anterior is paralyzed or weak, what happens to the scapula?

A

“Winging”; the medial border of the scapula will lift off the thorax

122
Q

If you have an injury to the axillary nerve and experienced paralysis of the deltoid, what would you see?

A

Loss of rounding of the deltoid and inability to abduct the arm past 15 degrees (that is because supraspinatus imitators abduction but deltoid takes over)

123
Q

True or false: Teres minor acts alone in external rotation of the shoulder.

A

False

It works with infraspinatus

124
Q

True or false: If the suprascapular nerve were injured, you might see paralysis in supraspinatus.

A

False

You would see paralysis in supraspinatus AND infraspinatus

125
Q

__________ is the medial rotator of the humerus; coupled with the middle and inferior glenohumeral ligaments, it has been shown to be an important stabilizer of the GH joint, particularly when the arm is held at about a 45 degree abduction.

A

Subscapularis

Human Anatomy (15 decks)

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