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C&M Upper Limb > Week 1: The Pectoral Girdle and Shoulder > Flashcards

Week 1: The Pectoral Girdle and Shoulder Flashcards

1
Q

Where are the 3 large joints in the upper limb?

A
  • shoulder
  • elbow
  • wrist
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2
Q

What are the 3 neuromuscular ‘spaces’ in the upper limb?

A
  1. axilla
  2. cubital fossa - anterior to elbow
  3. carpal tunnel
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3
Q

What is the most commonly dislocated joint in the body?

A

shoulder

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4
Q

What is the ‘pectoral girdle’?

A

Consists of:

  • the clavicle
  • the scapula
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5
Q

What is the glenohumeral joint?

A
  • the ‘shoulder joint’

- the head of the humerus articulates with a socket on the scapula called the glenoid fossa

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6
Q

Where is the coracoid process?

A

on the lateral edge of the superior anterior portion of the scapula
projects anteriorly

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7
Q

Where is the supra spinous fossa?

A

hollow region on the posterior surface of the scapula, just above the spine of the scapula

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8
Q

What separates the head of the humerus with the greater and lesser tubercles of the humerus?

A

anatomical neck of the humerus

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9
Q

Why is the shoulder joint incongruent/ a poor fit?

A
  • we get a greater range of movement as the joint is less stable
  • we can position our hand where we want it to be
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10
Q

Which features increase the stability of the shoulder joint?

A
  • surrounding muscle
  • tendon of long head of biceps brachii muscle
  • glenoid labrum (ring of cartilage around the edge of the glenoid fossa which improves the fit for the humeral head)
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11
Q

What are the 4 movements of the scapula?

A
  1. Protraction (forwards)
  2. Retraction (backwards)
  3. Elevation (shrugging of shoulders and depression)
  4. Rotation
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12
Q

What are the three muscles of the anterior pectoral girdle?

A
  1. Pectoralis Major
  2. Pectoralis Minor
  3. Serratus Anterior
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13
Q

Which actions can the pec major perform?

A

Adduction

medial rotation of shoulder

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14
Q

What bones are attached to the pec major?

A

humerus
sternum
clavicle

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15
Q

What is the origin point of the pectoralis minor?

A

ribes 3-5

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16
Q

What is the function of the pec minor

A

stabilises the scapula and assists in protraction

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17
Q

What structure does the pectoralis minor insert onto?

A

the coracoid process of the scapula

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18
Q

What is the function of the serratus anterior?

A

protracts the scapula

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19
Q

Which nerve runs down the serratus anterior?

A

long thoracic nerve

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20
Q

Which ribs does the serratus anterior run through?

A

ribs 1-8

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21
Q

What are the 5 muscles of the posterior pectoral girdle?

A
  1. Levator scapulae
  2. Rhomboid minor
  3. Rhomboid major
  4. Trapezius
  5. Latissimus dorsi
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22
Q

What movements of the shoulder is the latissimus dorsi responsible for?

A

adduction
medial rotation
extension

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23
Q

What movements of the scapula is the trapezius muscle responsible for?

A

elevation
contraction
depression

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24
Q

Which muscles of the posterior pectoral girdle are deep and which are superficial

A

deep - levator scapulae, rhomboid major/minor

superficial - latissimus dorsi, trapezius

25
Q

What happens when the levator scapulae contracts?

A

it elevates and pulls the scapula up towards the neck

26
Q

What is the function of the deltoid muscle?

A

abducts, flexes and extends

27
Q

What are the attachment and insertion points of the deltoid muscle?

A

attachment - clavicle and spine of scapula

insertion - deltoid tuberosity

28
Q

Which nerve innervates the deltoid, teres minor and teres major muscle?

A

axillary nerve

29
Q

What are the attachment and insertion points of the teres major?

A

attachment - posterior scapula

insertion - anterior humerus

30
Q

What is the function of the teres major?

A

medially rotates and adducts the shoulder

31
Q

Where do the rotator cuff muscles originate and insert?

A

originate from the scapula

insert on the humerus

32
Q

What are the 4 rotator cuff muscles?

A
  1. Supraspinatus
  2. Infraspinatus
  3. Subscapularis
  4. Teres minor
33
Q

What is the function of the supraspinatus?

A

starts abduction (first 20*)

34
Q

Which rotator cuff muscles are lateral rotators of the shoulder?

A

infraspinatus and teres minor

35
Q

What is the function of the subscapularis?

A

adducts and medially rotates the shoulder

36
Q

Which arteries and veins are found in the pectoral region and shoulder?

A
  • at the axilla, the subclavian artery and vein becomes the axillary artery and vein
  • these give rise to the anterior and posterior circumflex humeral arteries
37
Q

What is the major superficial vein that drains into the axillary vein?

A

cephalic vein

38
Q

Where is the cephalic vein?

A

lies between the deltoid and the pectoralis major in a groove called the deltapectoral groove

39
Q

What is an avulsed nerve?

A

when a nerve is pulled away from its origin

40
Q

What is a common problem associated to the supraspinatus tendon?

A

the supraspinatus tendon can get trapped (impinged) between the humeral head and the acromion and become inflamed

41
Q

What causes a ‘winged’ scapula

A
  • shoulder blade protrudes from a persons back abnormally
  • injury to the long thoracic nerve, which innervates the serratus anterior
  • patient would have problems protracting the scapula
42
Q

What is the function of the pectoral girdle?

A

to anchor and secure the upper limb to the axial skeleton

43
Q

What part of the sternum does the clavicle articulate with?

A

the manubrium of the sternum (at the sternoclavicular joint)

44
Q

Which part of the clavicle is the weakest?

A
  • the point between the medial third and lateral third
  • between the convexity and concavity of the clavicle
  • this is where it tends to fracture
45
Q

What is a characteristic feature of the posterior aspect of the scapula?

A

the spine of the scapula - extends upwards and lateral to the acromion

46
Q

What is a comminuted fracture?

A

when a fracture has more than two fragments

47
Q

What is the acromion clavicular joint?

A

bony articulation between our clavicle and our scapula

48
Q

What is the function of the rhomboid muscles?

A

acts as retractor and elevator of the scapula

49
Q

Which part of the humerus is most commonly fractured?

A

the surgical neck

50
Q

Where does the subscapularis muscle insert?

A

the lesser tubercle of the humerus

51
Q

Where do the supra spinatus, infraspinatus and teres minor muscles insert?

A

the greater tubercle of the humerus

52
Q

What type of joint is the glenohumeral joint?

A

Synovial

53
Q

Which ligaments attach the acromion and clavicle to the coracoid process?

A
  • coraco-acromial ligament

- coraco-clavicular ligament

54
Q

Explain how abduction of the shoulder is carried out

A
  1. first 30 degrees by supraspinatus
  2. 30-90 degrees by deltoid
  3. 90-180 degrees by trapezius
    - GHJ and STJ must be synchronous
55
Q

What is the maximum range of the following movements:

  1. Abduction
  2. Adduction
  3. Lateral/medial rotation
  4. Flexion
  5. Extension
A
  1. Abduction - 180
  2. Adduction - 45
  3. Lateral/medial rotation - 90
  4. Flexion - 180
  5. Extension - 50
56
Q

Which nerve innervates the supraspinatus and infraspinatus

A

suprascapula nerve

57
Q

What is another term for ‘frozen shoulder’?

A

adhesive capsulitis

58
Q

What is ‘frozen shoulder’?

A
  • unknown aetiology
  • painful global restriction of GH movements in all planes, both active and passive, in the absence of joint degeneration
59
Q

What are the clinical features of frozen shoulder?

A
  • rare in <40s
  • diabetes increases risk
  • pain, ache, night pain, spasm, stiffness

C&M Upper Limb (10 decks)

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