Week 1 Superficial Back- Severson

Question 1

What muscles connect the upper limb to the vertebral column?

Answer 1

Trapzius
Rhomboid Major and Minor
Levator Scapulae
Latissimus Dorsi

Question 2

What nerve supplies the trapezius? Artery? Vein?

Answer 2

Accessory (CN XI)

Transverse cervical a/v

Question 3

What nerve supplies the Rhomboid Major and Minor?

Answer 3

Dorsal scapular nerve

Question 4

What nerve supplies the levator scapulae?

Answer 4

Dorsal scapular nerve

Question 5

What is the function of the latissimus Dorsi? nerve? how can you damage it?

Answer 5

extensor of upper extremity (rock climbing, pulling yourself up)
Thoracodorsal nerve

Question 6

What cranial nerve would be involved in a person with a “droopy” shoulder?

Answer 6

CN XI (Accessory Nerve)

Question 7

What functions are associated with the deltoid muscle? Nerve supply?

Answer 7

Anterior- flex and medially rotate the humerus

Middle- chief abductor of the humerus

Posterior- extend and laterally rotate the humerus

Nerve- Axillary

Question 8

What muscles form the rotator cuff (attaching scapula to the humerus)? Function of the rotator cuff?

Answer 8

Teres minor
Infraspinatus
Supraspinatus
Subscapularis

• helps keep head of the humerus close to the glenoid fossa thus stabalizing the shoulder join during abduction and rotation of upper limb
• injury = from 90 degree abduction the limb will suddenly drop to the side in an uncontrolled manner

Question 9

What is the function of the Serratus anterior? What nerve innervates it?

Answer 9

pulls scapula towards chest wall (protracts it)

long thoracic nerve?

Question 10

What does injury to the long thoracic nerve cause?

Answer 10

Wing scapula (pushes again wall, if nerve is gone scapula protrudes from back)

Question 11

What forms the triangle of auscultation?

Answer 11

trapezius
scapula (medial border)
latissimus dorsi

-breath sounds can be clearly auscultated in the triangle of the 6th intercostal spance

Question 12

What nerve innervates the deltoid?

Answer 12

Axillary nerve ( passes through the quadragular space and comes out at about the surgical neck of the humerus)

Question 13

What forms the quadrangular space? (quadrilateral) What goes through it?

Answer 13

Teres major (inferior)
Teres minor (superior)
Long head of tricep (medial)
Humerus (lateral)

• Axillary nerve and posterior circumflex humeral a/v
• Axillary nerve innervates the deltoid and Teres minor

Question 14

Where is the subacromial bursa located?

Answer 14

aka subdeltoid bursa, located deep to the deltoid and acromion

Question 15

Suprascapular notch

Answer 15

“divet” in superior edge of scapula. Transverse scapular ligament covers the top of the divet/notch. Nerve goes through notch, artery goes about the suprascapular ligament

Question 16

Function of the omohyoid?

Answer 16

anchors hyoid bone (DOE NOT LIFT SHOULDER)

Attaches to scapula medially to suprascapular notch/ligament

Question 17

What nerve innervates the infraspinitus? supraspinatus?

Answer 17

Suprascapular nerve

Question 18

What nerve innervates the teres minor?

Answer 18

Axiallary Nerve

Question 19

What nerve are you likely to injure in a clavicular fracture?

Answer 19

If fracture is in middle third likely to injury suprascapular nerve, results in loss of lateral rotation of the humerus at the glenohumeral joint (ability to initiation abduction of the limb is also affected)

Question 20

Accessory nerve injury (CN XI)

Answer 20

• DROOPING OF SHOULDER is obvious sign of CN XI
• paralysis of the trapezius
• patient cant elevate or retract shoulder
• patient cant raise upper limb higher than horizontal level

Question 21

Winged scapula

Answer 21

• injury to the long thoracic nerve
• paralysis of serratus anterior
• medial border of scapula moves laterally and posteriorly away from the thoracic wall giving a winged appearnace

Question 22

Thoracodorsal nerve injury

Answer 22

• paralysis of the lattisimus dorsi
• person is unable to raise the trunk with the upper limbs (as occurs during climbing)
• person cannot use crutches because the shoulder is pushed superiorly by it (active depression of the scapular is required)

Question 23

Dorsal scapular nerve injury

Answer 23

• nerve to the rhomboids
• injury may cause paralysis of the rhomboids on one side, scapula on the affected side is located farther from the midline that that on the normal side

Question 24

Axillary nerve injury

Answer 24

• deltoid atrophies when severely damaged
• can happen during fracture to the surgical neck of humerus, dislocation of glenohumeral joint, and by compression from the incorrect use of crutches

Question 25

Calcified supraspinatus tendinitis (subacromial bursitis)

Answer 25

inflammation and calcification of the subacromial bursa

• pain, tenderness, and limitation of movement of the glenohumeral joint
• VERY painful to abduct the arm 50-130 degrees
• no pain when glenohumeral joint is adducted

Question 26

Glenohumeral joint dislocation

Answer 26

most dislocations of the humeral head occur in the downward (inferior) direction. However described clinically as anterior because head ends up lying anterior or posterior to the glenoid cavity

Question 27

Lumbar spinal stenosis

Answer 27

narrow vertebral foramen in one or more lumbar vertebrae