Week 5 Flashcards
What are the bones of the posterior shoulder/deltoid region?
- Clavicle
- Scapula
- Humerus
The shaft of the clavicle is the ___ of it
The shaft of the clavicle is the middle 1/3 of it
An injury through the clavicle, usually fractures the ___
An injury through the clavicle, usually fractures the shaft
The articular surface of the clavicle on the acromion end faces ___ as opposed to the articular surface of the acromion which faces ___
The articular surface of the clavicle on the acromion end faces down as opposed to the articular surface of the acromion which faces up
Why is the conoid tubercle important?
It is where the coracoclavicular ligaments attach and helps to support the AC joint
____ ligament joins the clavicle to the 1st rib
Costoclavicular ligament joins the clavicle to the 1st rib
The most lateral and superior part of the scapula is the ___
The most lateral and superior part of the scapula is the acromion
The inferior angle of the scapula is at what costal/rib level?
7th costal/rib level
What are the anatomical descriptions of the acromion?
- Bigliani type 1: straight
- Bigliani type 2: curved
- Bigliani type 3: hooked
What does a curved acromion do?
It lowers the space between the acromion and the glenoid cavity, which will result in impingement issues as the shoulder is moved
The radial groove is for ____
The radial groove is for the radial nerve to pass from behind the shoulder to an anterior position
The ulnar groove is the opening to the ___
The ulnar groove is the opening to the cubinal tunnel
When is the ulna nerve stretched?
When you flex the elbow
The supraspinalis outlet is positioned where?
Between the glenoid fossa (superior) and the undersurface of the acromion
What is the origin of the deltoid?
Lateral third of clavicle, acromion and spine of the scapula
What is the insertion of the deltoid?
Deltoid tuberosity of humerus
What innervates the deltoid/
Axillary nerve
Where does the axillary nerve come from?
Posterior cord of the brachial plexus
What is the action of the anterior part of the deltoid?
Flexes and medially rotates
humerus.
What is the action of the middle part of the deltoid?
Abducts humerus
What is the action of the posterior part of the deltoid?
Extends and laterally rotates
humerus
___ is the outer surface muscle of the shoulder
The deltoid is the outer surface muscle of the shoulder
What passes through the quadrangular space?
Axillary n.
Post circumflex humeral artery
What passes through the triangular space?
Circumflex scapular artery
What do you see when you look through the triangular interval?
Radial nerve
Profunda brachii artery
What are the boundaries of the quadrangular space?
- Teres minor superiorly
- Humerus laterally
- Teres major inferiorly
- Long headed triceps medially
What are the boundaries of the triangular space?
- Teres minor superiorly
- Long headed triceps laterally
- Teres major inferiorly
What are the boundaries of the triangular interval?
- Teres major superiorly
- Long headed triceps medially
- Lateral head of the triceps laterally
The suprascapular nerve passes underneath the ____ to get into the supraspinous fossa and then go around the spinal-glenoid notch to innervates the structures in the ____
The suprascapular nerve passes underneath the suprascapular ligament to get into the supraspinous fossa and then go around the spinal-glenoid notch to innervates the structures in the infraspinous fossa
The suprascapular artery passes __ the suprascapular ligament
The suprascapular artery passes over the top the suprascapular ligament
The suprascapular ligament converts the scapular notch into a ___
The suprascapular ligament converts the scapular notch into a scapular/suprascapular foramen
The axillary artery gives off the ___, which then gives off the circumflex scapular artery
The axillary artery gives off the subscapular artery, which then gives off the circumflex scapular artery
Where does the clavicular head of the pectoralis major come from? (origin 1)
Anterior half of medial aspect
of clavicle
Where does the sternocostal head of the pectoralis major come from? (origin 2)
Sternum, upper 6 costal cartilages, aponeurosis of external oblique
What is the insertion of the pectoralis major?
Lateral lip of intertubercular groove of humerus
What is the innervation of the pectoralis major?
Lateral and medial pectoral nerves
What is the action of the pectoralis major?
Adducts and medially rotates humerus
Where does the lateral pectoral nerve come from?
The lateral cord of the brachial plexus
Where does the medial pectoral nerve come from?
The medial cord of the brachial plexus
Which is more medially placed out of the medial and pectoral nerves in reference to the body?
The lateral pectoral nerve is more medially placed than the medial pectoral nerve in reference to the body
The fibers of the pectoralis major coming from the clavicle, tend to insert more ____ along the lateral lip of the intertubercular groove of the humerus
The fibers of the pectoralis major coming from the clavicle, tend to insert more distally along the lateral lip of the intertubercular groove of the humerus
The fibers of the pectoralis major coming from the sternum and costal cartilages, tend to insert more ____ along the lateral lip of the intertubercular groove of the humerus
The fibers of the pectoralis major coming from the sternum and costal cartilages, tend to insert more proximally or superiorly along the lateral lip of the intertubercular groove of the humerus
The pectoralis major can sometimes be known to have an ____ head
The pectoralis major can sometimes be known to have an abdominal head
Where is the pectoralis minor in reference to the pectoralis major?
It is deep to it
Where is the origin of the pectoralis minor?
Ribs 3 to 5 near costal cartilages (deep to pectoralis major)
Where is the insertion of the pectoralis minor?
Coracoid process of scapula
Where is the innervation of the pectoralis minor?
Medial pectoral nerve
What is the action of the pectoralis minor?
Stabilizes scapula against thoracic wall
What is the origin of the subclavius muscle?
Rib 1 and costal cartilage
What is the insertion of the subclavius muscle?
Inferior surface of middle third of clavicle
What is the innervation of the subclavius muscle?
Nerve to subclavius
What is the action of the subclavius muscle?
Anchors and depresses the clavicle
Where does the nerve to subclavius come from?
The brachial plexus
What other muscles does the subclavius work with to when doing pull ups to stabilize the scapula and depress the clavicle?
- Pectoralis minor
- Pectoralis major
- Serratus anterior
What are the 2 arteries that the long thoracic nerve travels with?
The superior thoracic artery and when it gets to the inferior part of the axilla, it travels with intimately with the lateral thoracic artery
What is the origin of the serratus anterior?
Upper 9 ribs
What is the insertion of the serratus anterior?
Anterior surface of the medial border of the scapula
What is the innervation of the serratus anterior?
Long thoracic nerve
What is the action of the serratus anterior?
Protracts and upwardly rotates scapula
The axilla is the ____
The axilla is the armpit
What is the medial border of the axilla?
Serratus anterior
What is the posterior border of the axilla?
Subscapularis muscle
What is the anterior border of the axilla?
Pectoralis major on the outside and pectoralis minor on the inside
What are the borders of the quadrangular space anteriorly?
- Humerus
- Subscapularis (superior border)
- Long head triceps
- Teres major
What are the anterior borders of the triangular space?
- Subscapularis
- Long headed triceps
- A combination of latissimus dorsi and teres major
What travels through the triangular interval anteriorly?
Radial nerve with the profunda brachii muscle
What is the apex of the axilla?
- Inlet formed between the clavicle, superior border scapula and first rib.
What is the anterior wall of the axilla?
Pectoralis major and minor
What is the posterior wall of the axilla?
Subscapularis, teres major and latissimus dorsi
What is the medial wall of the axilla?
Serratus anterior
What is the lateral wall of the axilla?
Humerus, coracobrachialis and long head of biceps
What is the base of the axilla?
Axillary fascia
What are the contents of the axilla?
- Axillary vessels & branches
- Parts of brachial plexus & branches
What are the passage ways for neurovascular structures to pass superiorly in the axilla?
Cervico-axillary canal to (and from) the root of the neck
What are the passage ways for neurovascular structures to pass anteriorly in the axilla?
Clavipectoral triangle to the pectoral region
What are the passage ways for neurovascular structures to pass inferiorly and laterally in the axilla?
Into the upper limb through the base of the axilla
What are the passage ways for neurovascular structures to pass posteriorly in the axilla?
Quadrangular space to the scapular region
What are the passage ways for neurovascular structures to pass inferiorly and medially in the axilla?
Along the thoracic wall to the
inferiorly placed axioappendicular muscles (serratus anterior and latissimus dorsi)
What is the fascia between pec major and minor called?
Clavi-pectoral fascia
The lateral superficial vein of the arm that enters the clavi-pectoral fascia and drains into the subclavian vein is called the ____
The lateral superficial vein of the arm that enters the clavi-pectoral fascia and drains into the subclavian vein is called the cephalic vein
What vein supplies the undersurface of pectoralis major?
Pectoral branches of the thoraco-acromial artery, coming off the axillary artery
Where does the lateral pectoral nerve come from?
The lateral cord of the brachial plexus
Where does the long head biceps lie?
Between pectoralis major and teres major with latissimus dorsi
What does the bicipital aponeurosis wrap around and what does it do?
It wraps around the flexor compartment of the forearm. So when you flex your biceps, it squeezes the muscles to help make more of a fist with the flexer compartment of the arm
What is the nerve point of the neck?
A point just behind the SCM, where a lot of nerves come out from.
The subclavian artery and vein becomes the ____ after it passes under the clavicle
The subclavian artery and vein becomes the axillary artery and vein after it passes under the clavicle
What artery comes out just medial to pectoralis minor?
Thoraco-acromial artery
Where does the 1st part of the axillary artery pass?
From the first rib to the superior border of the pectoralis minor muscle
Where does the 2nd part of the axillary artery pass?
From the superior border of the pectoralis minor the to inferior border of the pectoralis minor
Where does the 3rd part of the axillary artery pass?
From the inferior end of the pectoralis minor to the superior border of the Teres Major.
How many branches comes off the 1st part of the axillary artery?
1
What is/are the branch that comes off the 1st part of the axillary artery called?
Superior/supreme thoracic artery
How many branches comes off the 2nd part of the axillary artery?
2
What is/are the branch(es) that comes off the 2nd part of the axillary artery called?
- Thoraco-acromial artery
- Lateral thoracic artery
How many branches comes off the 3rd part of the axillary artery?
3
What is/are the branch(es) that comes off the 3rd part of the axillary artery called?
- Subscapula artery
- Anterior circumflex humeral artery
- Posterior circumflex humeral artery
What does the subscapula artery give off?
- Circumflex scapular branch
- Thoraco-dorsal artery
What is the axillary artery called once it leaves the axilla?
Profunda brachii artery
The cephalic vein drains into the ____ vein, through the ____, via the deltopectoral
triangle
The cephalic vein drains int o the axillary vein, through the clavi-pectoral fascia, via the deltopectoral triangle
What are the 2 superficial veins of the axilla?
Basilic and cephalic vein
____ is much larger and greater supplier of blood to the sub-deltoid region than the anterior circumflex humeral artery
Posterior circumflex humeral artery is much larger and greater supplier of blood to the sub-deltoid region than the anterior circumflex humeral artery
What is the origin of the teres major?
Dorsal surface of the inferior angle of the scapula
What is the insertion of the teres major?
Medial lip of the intertubercular groove of the humerus
What is the innervation of the teres major?
Lower subscapular n.
What is the action of the teres major?
Adducts and medially rotates, extends arm
What is the origin of the supraspinatus?
Supraspinatus fossa of the scapula
What is the insertion of the supraspinatus?
Greater tubercle of the humerus, superior facet
What is the innervation of the supraspinatus?
Suprascapular n.
What is the action of the supraspinatus?
Abducts the arm and assist with humerus position within the glenoid fossa
What is the origin of the infraspinatus?
Infraspinatus fossa of the scapula
What is the insertion of the infraspinatus?
Greater tubercle of the humerus, middle facet
What is the innervation of the infraspinatus?
Suprascapular n.
What is the action of the infraspinatus?
Lateral rotator
What is the origin of the teres minor?
Superior part of the lateral border of the scapula
What is the insertion of the teres minor?
Greater tubercle of the humerus, inferior facet
What is the innervation of the teres minor?
Axillary n
What is the action of the teres minor?
Lateral rotator
What is the origin of the subscapularis?
Subscapular fossa
What is the insertion of the subscapularis?
Lesser tubercle of the humerus
What is the innervation of the subscapularis?
Upper and lower subscapular n.
What is the action of the subscapularis?
Medially rotates and adducts
Where do the suprascapular nerve and artery join together?
Both the nerve and artery join together at or near the scapular notch
The suprascapular nerve enters the scapular region by passing through the scapular notch bound down by the ____
The suprascapular nerve enters the scapular region by passing through the scapular notch bound down by the suprascapular ligament.
What are the rotator cuff muscles?
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
The suprascapular artery enters the ____ by passing superficial to the suprascapular ligament.
The suprascapular artery enters the posterior scapular region by passing superficial to the suprascapular ligament.
The suprascapular nerve innervates the supraspinatus and then travels through the ___ to reach the infraspinatus muscle.
The suprascapular nerve innervates the supraspinatus and then travels through the spinoglenoid notch to reach the infraspinatus muscle.
The suprascapular artery supplies the __, travels through the spinoglenoid notch and supplies the infraspinous fossa and anastomoses with the ___ and the dorsal scapular artery.
The suprascapular artery supplies the supraspinous fossa, travels through the spinoglenoid notch and supplies the infraspinous fossa and anastomoses with the circumflex scapular artery and the dorsal scapular
artery.
____ is open to all passage of vessels
Apex of the axilla is open to all passage of vessels
What are the nerves supplying innervation to the shoulder and the upper extremity?
Brachial plexus
What forms the brachial plexus?
It is formed by the ventral primary rami of C5-C8 and part of T1
The upper trunk of the brachial plexus is formed by the ___
The upper trunk of the brachial plexus is formed by the rami C5 and C6
The middle trunk of the brachial plexus is formed by the ___
The middle trunk of the brachial plexus is formed by the rami C7
The lower trunk of the brachial plexus is formed by the ___
The lower trunk of the brachial plexus is formed by the rami C8 and T1
Each trunk in the brachial plexus divides into ___ and ___ division
Each trunk in the brachial plexus divides into 3 anterior and 3 posterior division
The 3 posterior divisions of the brachial plexus forms the ____
The 3 posterior divisions of the brachial plexus forms the posterior cord
The anterior division of the ___ and ____ form the lateral cord
The anterior division of the upper trunk and anterior division of the middle trunk form the lateral cord
The anterior division of the lower trunk forms the ___ of the brachial plexus
The anterior division of the lower trunk forms the medial cord of the brachial plexus
Cords of the brachial plexus are named according to their relationship with the ____
Cords of the brachial plexus are named according to their relationship with the axillary artery
What nerves does the lateral cord of the brachial plexus give off?
- Musculocutaneous nerve
- Lateral root of the Median nerve
What nerves does the medial cord of the brachial plexus give off?
- Ulnar nerve
- Medial root of the Median nerve
What nerves does the posterior cord of the brachial plexus give off?
- Axillary nerve
- Radial nerve
What nerves rise from the ventral primary rami?
a. Phrenic nerve
b. Dorsal scapular nerve
c. Long thoracic nerve
What is/are the nerve roots of the phrenic nerve?
C3, C4, C5
What is/are the nerve roots of the dorsal scapluar nerve?
C5
What is/are the nerve roots of the long thoracic nerve?
C5, C6, C7
What nerves rise from the branches of the trunk?
- Suprascapular nerve - upper
- Nerve to the subclavius – upper
What nerves comes off the medial cord of the brachial plexus?
- Medial pectoral nerve
- Medial brachial cutaneous
- Medial antebrachial cutaneous
What nerves comes off the lateral cord of the brachial plexus?
Lateral pectoral nerve
What nerves comes off the posterior cord of the brachial plexus?
- Upper subscapular nerve
- Lower subscapular nerve
- Thoracodorsal nerve
The axillary artery is the continuation of the ___
The axillary artery is the continuation of the subclavian
When does the axillary artery becomes the axillary artery?
It becomes the axillary after it crosses over the first rib.
What does the superior/supreme artery supply?
It supplies the first two intercostal spaces.
The thoracoacromial artery divides into ___
The thoracoacromial artery divides into the clavicle, pectoral, acromial and deltoid branches
The lateral thoracic supplies the ___
The lateral thoracic supplies the anterolateral thoracic wall
Anterior and Posterior humeral circumflex arteries which pass around the surgical neck of the ____
Anterior and Posterior humeral circumflex arteries which pass around the surgical neck of the Humerus