week 3 movement Flashcards

1
Q

to what point is your arm?

A

from your shoulder to your elbow

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2
Q

What point is your forearm?

A

from your shoulder to your hand

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3
Q

what is your axillia?

A

your arm pits

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4
Q

what is important about Cubital fossa ?

A

region above your elbow where you take blood

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5
Q

what are the two components of the pectoral grindle?

A

scapula and clavicle

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6
Q

what is another name of the shoudler joint and what is its positioning?

A

glenohumeral joint and Located between glenoid fossa of scapula and head of humerus

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7
Q

what does the glenohumural joint hold?

A

holds the upper limb to the trunk of the body

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8
Q

how is the pectorial grindle completed anteriorly?

A

completed by the manubrium-> clavicle articulates with the mandibular of the sternum –> sternoclavicular joint

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9
Q

is the pectorial grindle compeleted anteriorly or posteriorly?

A

anteriorly

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10
Q

what is the sternoclavicular joint?

A

where the pectoral girdle forms a bony attachment with the trunk of the body  only bony attachment

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11
Q

what muscles are involved in stabilising the scapula by attatching it to the trunk?

A

Rhomboids (major and minor)
Levator scapulae
Trapezius
Serratus anterior

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12
Q

what are the three pairs of movements of the pectorial grindle?

A

elevation/depression
protraction/retraction
upwards rotation (lateral) and downwards rotation ( medially)

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13
Q

what is the origion insertion and function of the upper fibres of the trapezius?

A

Origin: external occipital protuberance, superior nuchal line, ligamentum nuchae & spinous process of 7th cervical vertebrae
Insertion: lateral 1/3 of clavicle and acromion process
Function: Elevate scapula

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14
Q

what is the origion insertion and function of the middle fibres of the trapezius?

A

Origin: spinous process of 1st - 5th thoracic vertebrae; Insertion: superior border of spine of scapula (lateral 2/3)
Function: Retract scapula

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15
Q

what is the origion insertion and function of the inferior fibres of the trapezius?

A

Origin: spinous process of 6th to 12th thoracic vertebrae; Insertion: medial 1/3 of spine of the scapula
Function: Depress scapula

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16
Q

what is the innervation of the upper, middle and lower fibres of trapezius?

A

Motor: Accessory nerve (CNXI

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17
Q

what is the origion, insertion. innervation and function of levator scapulae?

A

Origin: Transverse processes C1-C4
Insertion: medial border of scapula superior to root of spine
Function: elevate scapula and rotates scapula medially (downwards)
innervation : dorsal scapular nerve (C5)

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18
Q

what is the origion, insertion, innveration and function of Rhomboid major and minor

A

Origin: Minor – spinous processes C7-T1
Major – spinous processes T2-T5
Insertion: Minor – medial border of scapula at level of spine
Major – medial border of scapula inferior to level of spine
Function: retract the scapula medially and superiorly. Used in squaring the shoulders
innervation: dorsal scapular nerve (C5)

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19
Q

what is the origion, insertion, innveration and function of serratus anterior?

A

Origin: Ribs 1-8

Insertion: Medial border of scapula

Functions:
Protracts scapula (with pectoralis minor) hence sometimes called the “boxers muscle”
Rotates scapula laterally (inferior portion)

Essentially holds scapula flat against the thoracic wall
Innervation: long thoracic nerve (C5-C7

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20
Q

how do you get winged scapula

A

it is caused by damage to the long thoracic nerve –>

the medial border and inferior angle of the scapula moves away from the posterior thoracic wall

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21
Q

what are potential causes of winged scapula?

A

Penetrating injuries when arm abducted e.g. knife wound
Accidentally e.g. insertion of chest drain, during breast surgery (iatrogenic)
Neuritis (inflammation of the nerve)

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22
Q

describe the glenohumeral joint?

A

between the head of the humerus and the glenoid fossa of the scapula

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23
Q

with what percentage of the head of the humurus does the glenoid fossa contract with?

A

1/3rd of the humerus

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24
Q

does the gelnoid fossa and humerus fit well?

A

No the fossa is a shallow depression and the humerus does not connect proeprly and therefore get a lot of flexibility and the weakest point is inferiorly

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25
Q

how is the stability of glenohumeral joint improved?

A

Glenoid labrum
Ligaments,
Biceps tendon,
Rotator cuff muscles

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26
Q

name the 3 glenohumeral ligaments?

A

superior, middle and inferior glenohumeral ligaments

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27
Q

what is the coracohumeral?

A

from the humorous to the scapula ( projection to the front which is coracoid process )

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28
Q

what makes the Coraco-acromial arch?

A

acromion process, coracoid process and the coracoacromial ligament

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29
Q

why is the Coraco-acromial arch important?

A

prevents superior dislocation –> superior support

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30
Q

what is bursa?

A

it is a synovial fluid filled sac that reduces the friction between the tissues and bones

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31
Q

what is the importance of Subscapular bursa?

A

reduces the friction between the bursa and the carcoid process

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32
Q

what ist he importance of Subacromial bursa?

A

it reduces the friction bteween the bursa and acromial process

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33
Q

what is the significance of inflammation and damage of the bursa?

A

causes pain and limits movement of the joint, the subacromial bursa is usually affected –> subacromial bursitis. Inflammation of the bursa can lead to calcification –> calcification bursitis –> stones–> painful

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34
Q

what is the painful arc syndrome?

A

typical develops in males over 50
caused by inflammation after excessive use of glenohumeral joint
very painful between 50-130° of abduction – painful arc
subacromial bursa is in contact with the inferior surface of thea acromion

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35
Q

what does the pain reduce after 130 degrees in the painful arc syndrome?

A

the rotation of the scapula relieves pressure of the subacromial bursa

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36
Q

name the 4 rotator cuff muscles

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

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37
Q

what do the rotator cuff muscles do?

A

stabalise the joints –> Tendons act as a “ligament”
keeping head of humerus
pressed into glenoid fossa

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38
Q

what three of the rotator cuff muscles visible on the back of the scapula and what do they attatch to?

A

suprasinatus
teres minor
infraspinatus
attatch to the greater tubercle

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39
Q

what is the subscapularis attached too?

A

the lesser tubercle

40
Q

what is the action, origin, innervation and test of Supraspinatus?

A

Origin: Supraspinous fossa of scapula

Action: Initiates abduction of arm (first 15°)
Stabilize glenohumeral joint

Innervation: Suprascapular nerve

Test: Abduct arm against resistance (from 0°)

41
Q

what is the action, origin, innervation and test of infraspinatus?

A

Infraspinatus
Origin: Infraspinous fossa of scapula

Action : Lateral rotator of humerus
Stabilize glenohumeral joint

Innervation: Suprascapular nerve

Test: Laterally rotate arm against resistance
(With elbow flexed and arm adducted)

42
Q

what is the action, origin, innervation and test of teres minor?

A

Teres minor
Origin: Middle part of lateral border of scapula

Action: Laterally rotates and adducts humerus (with infraspinatus)
Stabilize glenohumeral joint

Innervation: Axillary nerve

Test: Same as infraspinatus

43
Q

what is the action, origin, innervation and test of subscapular neve?

A

Subscapularis
Origin: Subscapular fossa

Action: Medial rotator and adductor of humerus
Stabilizes glenohumeral joint

Innervation: Upper and lower subscapular nerves (C5-C6).

Test: Place the dorsum of hand to the mid-lumbar spine, then lift the dorsum of the hand off of the back.

44
Q

does teres major contribute to the rotator cuff muscle?

A

no it does not

45
Q

what is the action, origin, innervation and test of teres major?

A

Origin: Inferior angle of scapula

Insertion: Medial lip of intertubercular of humerus

Function: Adducts and medially rotates humerus

Innervation: Lower subscapular nerve (C5 – C6)

46
Q

what is rotator cuff tear?

A

when one or more of the tendons rupture commonly supraspinatous tendon. Symptoms is pain and weakness when arm is above the head

47
Q

how do you test for rotator cuff tear?

A

you life the arm above the head and ask for it to be moved slowly down. When the arm reaches 90 degrees it will fall suddenly –> this is mainly a test of supraspinatous tendon

48
Q

what is the usual cause of dislocation of the glenohumeral joint?

A

Most often seen in young adults

Usual cause: excessive extension and lateral rotation of humerus

49
Q

what is the most common direction of glenohumeral dislocation?

A

95% –> anteroinferior direction –> movement of the fossa

50
Q

how can the axillary nerve get damaged during glenohumeral dislocation?

A

it occurs in 3%. Due to the axillary nerve wrapping around the inferior border of the glenohumeral joint –> neck of the humures –> stretch and damage the nerve

51
Q

what muscle is affected by the damage of axillary nerve?

A

the deltoid muscle is affected –> will get atrophy and wastage of the muscle –> flattened muscle

52
Q

give examples of shoulder movement

A

flexion/extension
adduction/abduction
medial roation and lateral roation
put them all together circumduction

53
Q

why is supraspinatous important for abduction?

A

it initates the first 10-15 degress of abduction

54
Q

What role does deltoid muscle take place in abduction?

A

it is strong enough to move the arm above the head

55
Q

what muscles are invovled when the arm is abducted greater than 90 degrees and what is the action?

A

Laterally rotate humerus
teres minor

  1. Rotate scapula laterally
    trapezius
    serratus anterior
    As well as the deltoid muscle
56
Q

what is the consequence of paralyzed Supraspinatus ?

A

In this case patient can produce first 10-15 degrees of abduction by leaning to one side and letting joint abduct passively

57
Q

what is the consequence of paralyzed deltoid ?

A

Cannot go above 90 as deltoid is strong abducted muscle

58
Q

what are the boundaries of quadrilateral space?

A

Lateral – surgical neck of humerus
Medial - long head of tricpes brachii
Inferior – Teres major
Superior – Teres minor

59
Q

what is the content of the quadrilateral space?

A

the axillary nerve and

posterior circumflex artery and vein

60
Q

what is the Quadrangular Space Syndrome?

A

growth of fibrous bands in the space –> will damage the nerve –> get pain and weakness of the delta muscle –> also block the posterior circumflex artery –> parasethesia of the arm/hand

61
Q

what muscles are involved in the elevation of the pectoral girdle?

A

trapezius ( superior), levator scapula, rhomboids

62
Q

what muscles are involved in the depression of the pectoral girdle?

A

trapezius (inferior), latimuss dorsi, serratus anterior, pectoralis minor and major, gravity

63
Q

what muslces are invovled in the protraction of the pectoral girdle?

A

serratus anterior, pectoralis minor and major

64
Q

what muscles are invovled in the retraction of the pectoral girdle?

A

latimuss dorsi, trapezius ( middle) and rhomboids

65
Q

what muscles are invovled in upwards rotation (lateral) of the pectoral girdle?

A

trapezius inferior and superior, seratus anterior

66
Q

what muscles are invovled in downards rotation (medial) of the pectoral girdle?

A

levator scapula, latismuss dorsi, rhomboids, pectoralis minor and major and gravity

67
Q

what is the glenoid fossae/cavity surrounded by?

A

glenoid labrium

68
Q

what is the acromioclavicular joint?

A

joint between the acromion process of the scaupula and the clavicle

69
Q

what happens when there is damage to the axillary nerve?

A

deltoid atrophy

70
Q

how is the axillary nerve damaged?

A

by inferior dislocation of the glenohumeral joint –> 3%

71
Q

what is the symptoms of damage to the axillary nerve –> deltoid atrophy?

A

prominant acromion process
prominant humeral head
flattened shoulder

72
Q

what are all the terminal branches of the brachial plexus?

A
musculocutaneous
ulna
radial
median
axillary
73
Q

what is the nerve root for musculocutaneous?

A

C5-C7

74
Q

what is the nerve root for median nerve?

A

C6-T1

75
Q

what is the nerve root for axillary?

A

C5-C6

76
Q

what is the nerve root for ulna?

A

C7-T1

77
Q

what is the nerve root for radial?

A

C5-T1

78
Q

how is subscapularis paralyzed ?

A

by scapula fracture

79
Q

how is deltoid mscle parlayzed?

A

by shoulder dislocation -> surgical neck of the humerus is fractures and this damages the axillary nerve –. C5-C6

80
Q

what ribs does the scapula sit between?

A

the 2nd and 7th rib

81
Q

what positions can the inferior angle of the scapula move?

A

because of the free movement of the scapula over the chest wall –> inferior angle can be moved lateral and cranially from the anatomical possition

82
Q

where doe the long head of the bicep attach to on the scapula?

A

the supraglenoid tubercle

83
Q

what attaches to the infraglenoid tubercle on the scapula?

A

the long head of the tricep

84
Q

what does the long head of tricep brachi attach to on the scapula?

A

infraglenoid tubercle

85
Q

which compartment of the flexor and extensor attach to the scapula ?

A

long head of bicep brachii

long head of tricep

86
Q

what is the lateral border of the axillia?

A

the intertubercular sulcus

87
Q

what is the medial border of the axillia?

A

rib 4, serratus anterior and upper thoracic wall

88
Q

what is the anterior border of axillia?

A

pectoralis minor and major, subclavius and clavicopectorial fascia

89
Q

what is the posterior border of axillia?

A

teres major, latismuss dorsi, subscapularis and scapula

90
Q

what is the inferior border of axillia?

A

the skin and fascia of armpit

91
Q

what is the route in which the neurovascular bundle enters the arm?

A

via the apex of the axillia after running between the 1st rib and clavicle?

92
Q

what does the neurovascular bundle contain?

A

the brachail plexus, axilliary artery and vein, lymph nodes

93
Q

what is the importance of the lymph nodes passing through the axillia?

A

they drain around 75% of the lymph in the breast

94
Q

of the 75% of draining of the breast by lymph node what group of nodes is mainly drained?

A

anterior pectoral group drains most of the 75% but there is posterior pectorial, central and apical nodes.

95
Q

what part of the breast is drained by the pectoral lymph nodes?

A

the lateral part of the breast

96
Q

what part of the breast is drained by the central lymph nodes?

A

the tail of the breast and collects lymph from other groups

97
Q

what part of the breast is drained by the apical lymph nodes?

A

recieves lymph from all other groups and sits in the apex of the axilla