Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Week 3 > Flashcards

Week 3 Flashcards

1
Q

Which two muscles form the floor of the cubital fossa?

A

The supinator and brachialis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which structure lies between the two heads of the supinator?

A

The radial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which muscles produce the characteristic shape of the shoulder?

A

Deltoid and trapezius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which level of the vertebrae does the trapezius origination extend down to?

A

T12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the motor and sensory innervation of the trapezius muscle?

A

Motor: accessory nerve; Sensory: ventral rami of 3rd and 4th cervical nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the action of the trapezius?

A

Upper fibres: elevate the scapula and rotate it during abduction of the arm
Middle fibres: retract the scapula Lower fibres: pull the scapula inferiorly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How can you test the accessory nerve?

A

Test how well the trapezius is functioning; get the patient to elevate the shoulder against resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the latissimus dorsi muscle

A

Flat, wide, found laterally on the back of the trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the action of the latissimus dorsi?

A

It acts to extend the arm at the shoulder, adduction at the shoulder and medial rotation of the arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the innervation of the latissimus dorsi?

A

Thoracodorsal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the location of the levator scapulae

A

Lies in the back and neck, deep to the trapezius and sternocleidomastoid muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the action of the levator scapulae?

A

Elevates the scapula, rotates the scapula, and tilts the glenohumeral joint inferiorly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the innervation of the levator scapulae?

A

Dorsal scapular nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the rhomboid muscles?

A

Pair of muscles, rhomboid major and rhomboid minor; they lie deep to the trapezius and have a rhomboid appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the difference in size between the rhomboids?

A

Major is twice the width of minor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the innervation of the rhomboid muscles?

A

Dorsal scapular nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the action of the rhomboids?

A

Retract the scapula, rotate the scapula to tilt the glenohumeral joint, and also fix the scapula to the thoracic wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the divisions of the deltoid muscle?

A

Anterior, middle and posterior; each can act independently or together when required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the innervation of the deltoid?

A

Axillary nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the action of the anterior and posterior fibres of the deltoid?

A

Anterior fibres flex the arm at the shoulder, posterior fibres extend the arm at the shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the action of the middle fibres of the deltoid?

A

Major abductor of the arm; they take over from the supraspinatus, which abducts the first 15 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the quadrangular space?

A

A gap that the axillary artery and posterior circumflex humeral artery pass through to reach the posterior scapular region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the relevance of the teres major in regard to the quadrangular space?

A

Forms the inferior border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the innervation of the teres major?

A

Lower subscapular nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the action of the teres major?

A

Adduction of the shoulder, and medial rotation of the arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How would you test the deltoid muscle?

A

Examiner resists patients abduction of the limb by the deltoid; if the deltoid is acting normally, contraction of the middle part of the muscle can be palpated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the four rotator cuff muscles?

A

Supraspinatus, infraspinatus, teres minor, and subscapularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which rotator cuff muscle attaches to the lesser tubercle?

A

Subscapularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What purpose does the intertubecular sulcus serve?

A

Tendons of the pectoralis major, teres minor and latissiumus dorsi attach to the lips of the sulcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the name of the landmark of the humerus where the deltoid muscle attaches? Where is it located?

A

Deltoid tuberosity; lateral side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What lies in the radial groove? Describe its location

A

The radial nerve and profunda brachii artery; runs diagonally down posterior surface of humerus, parallel to the deltoid tuberosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Why is the lateral supraepicondylar ridge of the humerus roughened?

A

It is a place of attachment for many of the extensor muscles in the posterior forearm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Where can the ulnar nerve be palpated?

A

Posterior side of the medal epicondyle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What structures are of concern with a fracture to the surgical neck of the humerus?

A

The axillary nerve and the posterior circumflex artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What will damage to the axillary nerve result in?

A

Axillary nerve damage will result in paralysis of the deltoid and teres minor muscles- patient unable to abduct. It also innervates the skin of the regimental badge region (loss of sensation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What structures are at risk with a mid-shaft fracture of the humerus? Why?

A

The radial nerve and profunda brachii artery; they are tightly bound in the radial groove

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is a supraepicondylar fracture? How does it occur?

A

Occurs by falling on a flexed elbow. It is a transverse fracture, spanning between the two epicondyles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which vascular structure is at risk with a supraepicondylar fracture? What can interference of its supply cause?

A

Brachial artery; the resulting ischaemia can cause Volkmann’s ischaemic contracture - uncontrolled flexion of the hand, as flexors become fibrotic and short

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Which nervous structures are at risk with a supraepicondylar fracture?

A

There can be damage to all 3 nerves (median, radial, ulnar)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Which nervous structure can a fracture to the medial epicondyle of the humerus damage? What will result?

A

Damage to the ulnar nerve, resulting in a deformity known as ulnar claw, and loss of sensation over the medial 1 and ½ fingers if the hand, on both the dorsal and palmar surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the rotator cuff?

A

A group of 4 muscles, originating from the scapula which attach to the humeral head, pulling it into the glenoid fossa, providing extra stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the action of the supraspinatus muscle? What is its innervation?

A

It is responsible for the first 15 degrees of abduction at the shoulder, assisting the deltoid for the rest; suprascapular nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the action of the infraspinatus muscle? What is its innervation?

A

Acts to laterally rotate the arm; suprascapular nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the action of the subscapularis muscle? What is its innervation?

A

Acts to medially rotate the arm; upper and lower subscapular nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the action of the teres minor? What is its innervation?

A

Acts to laterally rotate the arm; axillary nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the function of the subacromial bursa?

A

Reduces friction between the supraspinatus tendon and the coracoacromial arch during abduction of the arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Which degenerative changes result in painful arc? What is painful arc?

A

Pain in the middle of abduction; under repetitive use, there are degenerative changes in the subacromial bursa and supraspinatus tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

How is the coraco-acromial arch related to rotator cuff tendonitis?

A

Repetitive use of the rotator cuff muscles can cause the head of the humerus and the tendons of the muscles to irritate the coraco-acromial arch, which in turn causes greater inflammation of the rotator cuff tendons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What articulations form the shoulder joint? What is its anatomical name?

A

The glenoid cavity of the scapula with the head of the humerus; the glenohumeral joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Why does the glenohumeral joint have inherent stability?

A

The glenoid cavity is relatively shallow, and the humeral head is large, and it is this disproportion that gives the inherent instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What reduces the disproportion in size between the glenoid cavity and the humeral head?

A

The glenoid fossa is deepened by a fibrocartilaginous rim, called the glenoid labrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Which nerves supply the glenohumeral joint? Where are they derived from?

A

The axillary, suprascapular and subscapular nerves; they are derived from C5 and C6

53
Q

What is the blood supply of the glenohumeral joint?

A

Circumflex humeral arteries and suprascapular arteries

54
Q

Where does the joint capsule of the glenohumeral joint attach? What property of it adds to mobility at the joint?

A

To the anatomical neck of the humerus and the border of the glenoid fossa; it is lax, although this adds to instability

55
Q

What is the function of the inner surface of the joint capsule of the shoulder?

A

Synovial membrane; produces synovial fluid to reduce friction between structures at the joint

56
Q

What occurs at holes in the joint capsule of the shoulder?

A

Synovial membrane protrudes to form bursae; they act to reduce rubbing between the structures around the joint during movement

57
Q

What are the 3 clinically important bursae at the shoulder joint that do not form holes in the joint capsule?

A

Subacromial, subscapular, subdeltoid

58
Q

What is the location of the subacromial bursa? What is its function?

A

Between the acromion of the scapula and the joint capsule and supraspinatus tendon; it allows relatively friction free movement of the tendon under the coracoacromial arch and deltoid

59
Q

What is the location of the subscapular bursa?

A

Between the tendon of the subscapularis muscle and the joint capsule

60
Q

What is the location of the subdeltoid bursa?

A

Between the deltoid and the joint capsule

61
Q

What are the ligaments of the shoulder joint?

A

Superior, middle and inferior glenohumeral ligaments (they appear as one ligament), the coracohumeral ligament, and the transverse humeral ligament

62
Q

Describe the location of the coracohumeral ligament

A

Between the base of the coracoid process and the greater tubercle of the humerus

63
Q

Describe the location of the transverse humeral ligament

A

Between the two tubercles of the humerus, holding the tendon of the long head of the biceps in the intertubecular groove

64
Q

Describe the location and function of the coracoacromial ligament

A

Joins the acromion and coracoid process of the scapula in a protective arch, that lies over the humeral head; this prevents superior displacement of the humeral head

65
Q

Which muscles perform extension at the shoulder joint?

A

The posterior deltoid, latissimus dorsi, and teres major

66
Q

Which muscles perform flexion at the shoulder joint?

A

Biceps brachii (both heads), pectoralis major, anterior deltoid and coracobrachialis

67
Q

Which muscles perform abduction at the shoulder joint?

A

Initially, by the supraspinatus, then the middle fibres of the deltoid take over; past 90 degrees, the scapula is rotated by the trapezius and serratus anterior

68
Q

Which muscles perform adduction at the shoulder joint?

A

Pectoralis major, latissimus dorsi, teres major and anterior deltoid

69
Q

Which muscles perform medial rotation at the shoulder joint?

A

Subscapularis, pectoralis major, latissimus dorsi, teres major and anterior deltoid

70
Q

Which muscles perform lateral rotation at the shoulder joint?

A

Infraspinatus and teres minor

71
Q

What factors contribute to mobility at the shoulder joint?

A

It is a ball and socket joint; the disproportion of size between the glenoid cavity and humeral head

72
Q

What factors contribute to stability at the shoulder joint?

A

Rotator cuff muscles (attach to tubercles of the humerus, pulling the humeral head into the glenoid cavity), the glenoid labrum (deepens cavity, reducing risk of dislocation), and the ligaments

73
Q

How is an anterior dislocation of the shoulder joint usually caused?

A

Trauma to a fully abducted arm usually from a posterior direction

74
Q

Which nerves may be damaged with an anterior dislocation of the shoulder?

A

Axillary nerve as it runs in close proximity to the joint (causes paralysis of deltoid, regimental badge), and radial nerve damage can also occur, as it is tightly bound in the radial groove

75
Q

Which structures, other than nerves, may tear during an anterior dislocation of the shoulder?

A

Rotator cuff muscles and joint capsule

76
Q

How many muscles are in the anatomical arm? What are they (anterior and posterior)?

A

4; Anterior: biceps brachii, brachialis, coracobrachialis Posterior: triceps brachii

77
Q

What is the action of the biceps brachii?

A

Supination of the forearm; flexion of the arm at the shoulder and elbow

78
Q

What is the innervation of the biceps brachii?

A

Musculotaneous nerve

79
Q

Which spinal cord segment is tested by tapping the biceps tendon?

A

C6

80
Q

What is the bicipital aponeurosis?

A

A connective tissue sheath given off the biceps tendon as it enters the forearm

81
Q

What is the significance of the bicipital aponeurosis?

A

Forms the roof of the cubital fossa, blending with the deep fascia of the forearm

82
Q

What is a popeye sign? What is it suggestive of?

A

Bulge of upper arm during flexion at the elbow; rupture of the tendon of the long head of the biceps brachii

83
Q

Why would a patient not notice much weakness in the upper limb with a rupture of the tendon of the long head of the biceps brachii?

A

Action of brachialis and supinator compensate

84
Q

What is the action of the coracobrachialis? What is its innervation?

A

Flexion of the arm at the shoulder; musculotaneous nerve

85
Q

What forms the base of the cubital fossa?

A

The brachialis muscle

86
Q

Which muscle is the main flexor of the elbow?

A

The brachialis

87
Q

What is the action of the brachialis muscle?

A

Flexion at the elbow

88
Q

What is the innervation of the brachialis muscle?

A

Musculotaneous nerve (small lateral portion is innervated by the radial nerve)

89
Q

What are the three heads of the triceps brachii? Which one lies deeper than the other two?

A

Medial, lateral, and long; the medial head is deeper than the other two

90
Q

What is the action of the triceps brachii?

A

Perform extension of the arm at the elbow

91
Q

What is the innervation of the triceps brachii?

A

Radial nerve

92
Q

Which spinal segment does a tap on the triceps tendon test?

A

C7

93
Q

How does Erbs palsy usually occur?

A

Difficult birth or blow to the shoulder

94
Q

Which nerves are affected with Erbs Palsy?

A

Those derived from solely C5 or C6 roots; musculotaneous, axillary, suprascapular and nerve to subclavius

95
Q

Which muscles are paralysed with Erbs palsy?

A

Supraspinatus, infraspinatus, subclavius, biceps brachii, brachialis, corachobrachialis, deltoid and teres minor

96
Q

Which movements are lost or greatly weakened in people with Erbs palsy?

A

Abduction at the shoulder, lateral rotation of the arm, supination of the forearm, and flexion at the shoulder

97
Q

What are the characteristic signs of Erbs palsy?

A

Affected limb hangs limply medially rotated by unopposed action of the pectoralis major, forearm pronated due to loss of biceps brachii; known as waiters tip

98
Q

Which muscles does the musculotaneous nerve innervate? What actions does it hence control?

A

Biceps brachii, brachialis, coracobrachialis; flexion of the upper arm at the shoulder and elbow, and the biceps brachii also performs supination of the forearm

99
Q

How would damage to the musculotaneous nerve likely occur?

A

It is uncommon as relatively protected, but a stab wound could damage it

100
Q

Which muscles would be paralysed by a lesion to musculotaneous nerve?

A

Biceps brachii, brachialis, coracobrachialis

101
Q

What actions would be compromised by a lesion to the musculotaneous nerve?

A

Flexion at shoulder weakened but still performed by the pectoralis major; flexion at the elbow affected but still performed by the brachioradialis; supination greatly weakened, but still produced by the supinator

102
Q

Which muscles and hence which actions does the axillary nerve contribute to?

A

Deltoid; flexion and extension of the arm at the shoulder, major abductor of the arm past 15 degrees; Teres minor; lateral rotation of arm

103
Q

How is the axillary nerve commonly injured?

A

Anterior dislocation of the humerus at the glenohumeral joint, or a fracture of the surgical neck

104
Q

What functional loss will occur with an injury to the axillary nerve?

A

Paralysis of the deltoid and teres minor; patient will be unable to abduct the affected limb

105
Q

What can be palpated in long standing cases of axillary nerve damage? Why?

A

Greater tuberosity of the humerus; deltoid rapidly atrophies

106
Q

Describe how the radial nerve could be damaged in the axilla

A

Dislocation of humerus at glenohumeral joint, or fractures of proximal humerus; can also happen via excessive pressure on the axilla

107
Q

What is the cubital fossa?

A

Area of transition between the anatomical arm and forearm, on the anterior surface if the elbow

108
Q

What are the lateral, medial, and superior borders of the cubital fossa?

A

Lateral: medial border of the brachioradialisMedial: lateral border of pronator teresSuperior: imaginary line between condyles of humerus

109
Q

What is the floor and roof of the cubital fossa?

A

Floor: brachialis, and more distally the supinatorRoof: skin, fascia, reinforced by bicipital aponeurosis

110
Q

What are the contents of the cubital fossa? (lateral to medial)

A

Radial nerve, biceps tendon, brachial artery, median nerve

111
Q

Which pulse can be palpated in the cubital fossa?

A

Brachial pulse; palpate medial to biceps tendon

112
Q

What important structure runs superficial to the cubital fossa?

A

Median cubital vein, common site for venepuncture

113
Q

Which arteries arise at the level of the humeral surgical neck from the axillary artery?

A

Posterior and anterior circumflex humeral arteries, and the subscapular artery

114
Q

What does the brachial artery give rise to immediately distal to the teres major?

A

Profunda brachii artery; runs in radial groove, supplies triceps brachii

115
Q

Describe the location of the brachial artery relative to the median nerve as it descends down the arm

A

Immediately posterior

116
Q

Where does the brachial artery bifurcate to give the radial and ulnar nerves?

A

As it crosses the cubital fossa, under the brachialis muscle

117
Q

What is a possible clinical manifestation of an occluded brachial artery?

A

Volkmanns contracture; necrosis and paralysis of muscles makes them fibrotic and contractious, causing the flexion deformity

118
Q

What are then two main veins of the upper limb?

A

Cephalic (antero-lateral) and basilica (medial)

119
Q

Which vessel connects the basilic and cephalic veins, superficial to the cubital fossa?

A

The median cubital vein (venepuncture)

120
Q

Which muscles perform scapular retraction?

A

Both rhomboids, middle trapezius

121
Q

Which muscles perform scapular protraction?

A

Serratus anterior, pectoralis minor

122
Q

Which muscles perform scapular elevation?

A

Upper trapezius, levator scapulae

123
Q

Which muscles perform scapular depression?

A

Lower trapezius, pectoralis minor, subclavius, latissimus dorsi

124
Q

Which muscles perform scapular lateral rotation (upward)?

A

Lower and upper trapezius, serratus anterior

125
Q

Which muscles perform medial scapular rotation? (downward)

A

Pectoralis minor, rhomboids, levator scapulae

126
Q

Describe the location of the brachial artery in relation to the median nerve in the upper arm and cubital fossa

A

Upper arm it is medial to the median nerve; in the cubital fossa it lies lateral

127
Q

What lies immediately anterior to the brachial artery and median nerve in the cubital fossa?

A

Bicipital aponeurosis; collagen from distal radial tendon, passing obliquely across cubital fossa and merging with fascia of flexors

128
Q

What is the most common direction of humeral dislocation at the glenohumeral joint?

A

Weakest at inferior aspect, so dislocates in this direction but ends up anterior due to pull of muscles

129
Q

What would be seen in clinical examination as a result or a torn supraspinatus tendon?

A

Failure of abduction in first 15 degrees, when lowering fully abducted arm slowly and smoothly, the limb suddenly drops

MSK (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions