W12 - SHOULDER & ELBOW Flashcards
Brachial Plexus: associations, span, and main 3 cords
*pectoralis mn closely associated, axillary art.
Span C5-T1
MEDIAL
LATERAL
POSTERIOR
= bifurcate
Posterior Cord of Brachial Plexus
Axillary N. = Shoulder and deltoid
(C5,C6)
Radial N. = Posterior forearm and hand
(C5-C8)
Medial Cord of Br. Pl.
ULNAR N. = hand and little bit of forearm
(C8, T1)
MEDIAN N.
(C6-C8, T1)
Lateral Cord of Br. Pl.
MUSCULOCUT. N. = anterior of arm
(C5-C6)
also MEDIAN N.
(C6-C8, T1)
Dorsal Muscles
- TRAPEZIUS
(CN XI)
2. LATISSIMUS DORSI (sixth, seventh, and eighth cervical nerves through the thoracodorsal (long subscapular) nerve -----deeper 3. LEVATOR SCAPULAE = elevate scapula
- RHOMBOIDS: in pair
= retract and elevate scapula
Anterolateral & Ventral Musculature
- SERRATUS ANTERIOR = protraction
(long thoracic n.) = winging scapula - PERCTORALIS Mj. =
* 6th costal cartilage
+EObliques
+ Platysma (superior to clavics. coming down from mandible)
Deltoid Movements
Abductor @ Shoulder Joint
Anterior = Arm flexion
Posterior = Arm extension
Posterior Short Scapular Group
- SUPRASPINATUS = abduction
- INFRASPINATUS = external rotation
- TERES Mn = adduct, internal rot., humeral extension
- TERES Mj = internal rot
* doesnt attach to glenohumeral head/joint
*support glenohumeral head
Anterior Short Scapular Group
- Subscapularis = Internal rot.
Flexors of the Elbow
- BICEPS BRACHII
(musculocut. n)
long head = intertubercular sulcus,
short head = coricoid process of scapula
=> radius
- BRACHIALIS
(musculocut. n.) - brachioradialis = flexor only in mid-position
(radial n.)
Extensors of the Elbow
- TRICEPS BRACHII
Common consequence of midhumeral #
Radial nerve dmg = triceps affected & joints of the hand
= wrist drop
Conditions Affecting Shoulder
FROZEN SHOULDER
IMPINGMENT SYNDROME
ROTATOR CUFF TEARS
OArth
#
DISLOCATIONS
Frozen Shoulder
adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move.
Frozen shoulder most commonly affects people between the ages of 40 and 60, and occurs in women more often than men.
*diabetes are at an increased risk for developing frozen shoulder.
> steroid injection (early presentation)
sx (later)
Impingement Syndrome
pain, weakness and a loss of movement at the affected shoulder
- dt subacromial space narrowing
- painful arc
- suprascapular n. compression as it passes notch between supraspinatus and infraspinatus
> steroid injection
physio
arthroscopic subacromial decompression
Rotator Cuff Tears
aRotator cuff tears are classified as either acute (lasting <3 months) or chronic (lasting >3 months) tears. They can be either partial thickness or full thickness tears.
* traumatic Vs degenerative
*often supraspinatus tear = humeral head will elevate
> Sx (acute, early)
Sx (chronic tears only symptomatic)
OArth affecting shoulder
Glenohumeral osteoarthritis (GH OA) is defined as progressive loss of articular cartilage, resulting in bony erosion, pain, and decreased function.
*
*XR
Conditions affecting Elbow
Tennis & Golfer’s Elbow
Olecranon Bursitis
& Dislocations
Tennis & Golder’s Elbow
inflamm of tendons
TENNIS = LATERAL EPICONDYLITIS
GOLFER = MEDIAL EPICONDYLE
Olecranon Bursitis
olecranon bursa
d/t overuse or sports
> rest
NSAID
Immobilise
Elbow # & Dislocation
> conservative mgmt
Bones of the Shoulder
ACROMION
CORACAOID PROCESS
GLENOID (articulates w/ articular humeral cart.)
What muscles attach to the greater tuberosity
SUPRASPINATUS
INFRASPINATUS
TERES MN.
*rotator cuff = provides stability and protection
What attaches to the clavicle
TRAPEZIUS
DELTOID
PECT. Mj
SUBCLAVIUS
SCM
STERNOHYOID
Ligaments associated with the acromioclavicular joint
ACROMIOCLAVICULAR LIGAMENT
CORACO-ACROMIO LIGAMENT
CORACO-CLAVICULAR LIGAMENT
What is the function of the Labrum?
increases SA and glenoid depth
shock block limiting glenohumeral translation
What is associated with surgical neck of humerus?
or sx. dmg = axillary n. injury = deltoid weakn. and sensory loss in badge area
Clavicular injury/fracture/dislocation
Associated with acromio-clavicular ligament snapping and displacement of the acromion; can become visible
What is the main blood supply to the humeral head?
anterior humeral circumflex artery
Common shoulder and elbow problems associated w/ certain age groups
teens/20s = # and instability
30s-40s = rotator cuff & capsulitis
50s-60s = impingment and AC joint
70s+ = degenerative rotator cuff and joint
What is a Bankart tear?
labral tear is called a Bankart tear. A Bankart tear typically occurs when an individual sustains a shoulder dislocation. As the shoulder pops out of joint, it often tears the labrum, especially in younger patients. The tear is to a part of the labrum called the inferior glenohumeral ligament
