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Gross Anatomy > The Shoulder > Flashcards

The Shoulder Flashcards

1
Q

Free limb

A

arm (brachium)
forearm (antebrachium)
wrist (carpus)
hand (manus)

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2
Q

Bones of the shoulder

A

humerus
scapula (shoulder blade)
clavicle (collar bone)

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3
Q

shoulder girdle

A
  • formed by scapula and clavicle

- completed anteriorly by manudrium (not part of shoulder girdle)

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4
Q

Humerus

A
  • 3rd largest bone

- proximal, shaft, and distal ends

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5
Q

Proximal end of humerus

-parts: description

A

-head: glenoid cavity of scapula
-anatomic neck: groove of head separates from greater/lesser tubercles
-site of attachment for shoulder capsule
-all fractures above anatomical neck =
intracapsular
-surgical neck: narrow part distal to head and tubercles (commonly fractured)
-greater tubercle: lateral margin of humerus
-lesser tubercle: projects anteriorly from bone
-intertubercle (bicipital) grooves/sulcus: separate tubercles= passage for the slener tendon of the long head of the biceps muscle

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6
Q

Shaft of humerous

  • posteriorly
  • anteriorly
  • inferiorly
A
  • posteriorly: radial groove (pass for radial nerve)
  • anteriorly:deltoid tuberosity (deltoid attachment)
  • inferiorly: lateral and medial epicondyles
    • medial epicondylar groove: posterior surface of medial epicondyle where ulnar nerve passes (funny bone)
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7
Q

Joints of shoulder

A

AC joint aka Acromioclavicular
Glenohumeral joint “shoulder joint”
scapulothoracic joint
sternoclavicular joint

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8
Q

What is a girdle?

A

skeleton structure connecting apendicular and axial skeleton

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9
Q

Distal end of humerus

parts:descriptions

A

aka condyle

  • medial/lateral epicondyle
  • capitulum (lateral): articulation with radius
  • trochlea (medial): articulate with ulna
  • olecranon fossa (posteriorly): accomodates olecranon of ulna during elbow extension
  • coronoid fossa (anteriorly): host coronoid process of ulna during elbow flexion
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10
Q

Which nerves may be damaged if you fracture humerus…

  • surgical neck
  • radial groove (shaft)
  • distal end of humerus
  • medial epicondyle

what if you fracture anatomical neck?

A
  • axillary nerve
  • radial nerve
  • median nerve
  • ulnar nerve, also avulsion (radial and ulnar nerves)

-avascular necrosis

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11
Q

what is a community fracture

A

multiple breaks

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12
Q

Scapula:

  • location
  • surfaces (2)
  • borders (3)
  • parts (4)
  • angles (3)
A

-overlies ribs 2-7
-anterior/costal: concave, forms subcostal fossa
-posterior: convex, spine creates supra and infrascapular fossae
-lateral (axillary), medial (vertebral), and superior borders-has suprascapular notch
-acromoin process: spine ends here
-spine: divides posterior surface
-suprascapular notch: suprascapular ligament makes fossa
-glenoid process: articulates with head of humerus, junction of sup and lat borders
-caracoid process: projection on sup surface of glenoid process
inferior angle (T7)
superior angle (T2)
glenoid angle (glenoid cavity)

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13
Q

Fractures of scapula

A
  • blade: heal without intervention usually
  • acromoin process
  • coracoid process
  • glenoid neck: force transmitted through humeral head
  • tip of scapula: shoulder forced backward

all cause different inhibition of movement

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14
Q

Clavicle parts

A 
-sternal end: medial epiphysis
   ~lower surface: attach costoclavicular lig
   ~groove for subclavius muscle
-acromial end:
   ~posterior: trapezoid line
   ~anterior: deltoid tubercle
   ~lower surface: conoid tubercle (medial) and trapezoid ridge (lateral)
-shaft
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15
Q

What bone is easily fractured in newborns?

A

clavicle

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16
Q

What is a greenstick fracture? More common in who?

A 
incomplete fracture (one side broken, one bent)
young children
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17
Q

Clavicular fractures are often caused by what in adults? Weakest where?

A

indirect force from outstretched hand
direct fall on shoulder
junction of medial and lateral thirds

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18
Q

Shoulder joint:

  • articulating surfaces
  • type
A
  • head of humerus, scapula (glenoid fossa)
  • synovial (freely moving) ball and joint- covered in articulate cartilage, encased in synovial capsule filled with synovial fluid
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19
Q

What does the labrum do? Where is it found? What is attached to it?

A

glenoid cavity
widen/deepen glenoid fossa
biceps muscle tendon

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20
Q

What causes labrum to tear? what often tears with it?

A

injury to shoulder

biceps muscle tendon

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21
Q

what causes catching sensation and pain in shoulder?

A

labrum tear

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22
Q

what is adhesive capsulitis?

A

“frozen shoulder”

inflammation of capsule- painful–> won’t move–> worsen

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23
Q

Ligaments of shoulder

A
  • glenohumeral (joint capsule)- middle, superior, and inferior- weak reinforce inside and ant wall and impede ant dislocation [ant humeral neck and supraglenoid tubercle]
  • coracohumeral ligament- weak reinforce external/sup fibrous capsule and prevent superior dislocation [coracoid process to anatomical neck of humerus]
  • transverse humeral: holds tendon of long head of biceps in intertubercular groove
  • corocacromial: link coracoid process to acromion, forms roof over shoulder joint
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24
Q

Which joint is most freuently dislocated?

A

shoulder (glenohumeral)

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25
Q

Why is the shoulder unstable?

A

shallowness of glenoid fossa, weakness of ligaments

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26
Q

Which muscles reinforce shoulder?

A

anterior: subscapularis
posterior: infraspinatous and teres minor
superior: supraspinatous
inferior: none

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27
Q

which nerves/arteries are usally disrupted during dislocation

A

axillary

28
Q

head of humerus dislocates where?

A

down then pulled by muscles: 95% anterior

29
Q

What articulates to make AC joint?

A

clavicle (acromial) and scapula (medial acromial)

30
Q

what ligaments are associated with AC joint

A

AC ligament: reinforce superior aspect
Coroclavicular: attach clavicle and coracoid process of scapula (2 parts: conoid-medial, and trapezoid-lateral)
coracoacromial: acromion with coracoid process of scapula

31
Q

what force causes acromioclavicular separation of AC joint?

A

external force on shoulder- ligaments tear (separated shoulder)

32
Q

which joint is injured in shoulder separation?

A

AC joint

33
Q

what would be injured with downward force on shoulder

A

AC joint and clavicle

34
Q

What are the ligaments of the sternoclavicular joint? why are they important?

A

interclavicular lig
costoclavicular lig
intr-articular disc lig
capsular lig

all strong- stable joint

35
Q

Where does the sternoclavicular joint articulate?

A

clavicle and sternum

36
Q

what is least commonly dislocated joint? what causes them? which type is more common?

A

SC joint
indirect force hitting shoulder very hard (car)
anterior (clavicle pushed in front of sternum)

37
Q

what makes posterior dislocation of SC joint dangerous?

A

many vital organs located there

38
Q

which joint is false? why?

A

scapulothoracic joint- no bone-to-bone connection, scapula glides over thorax

39
Q

What are the muscles of the shoulder?

A

intrinsic: origin/insertion in shoulder
- supraspinatous
- infraspinatous
- subscapularis
- teres major
- teres minor
- deltoid
extrinsic: attach to axial and appendicular
- trapezius
- latissimus dorsi
- pectoralis major
- pectoralis minor
- levator scapulae
- rhomboid minor
- rhomboid major
- serratus anterior

40
Q

Supraspinatous

  • origin
  • insertion
  • innervation
  • action
A
  • supraspinous fossa and upper scapular spine
  • greater tubercle of humerous (lateral), above infraspinous
  • suprascapular nerve (C5,6)
  • initiate abduction (0-16), help deltoid in abduction (16-90), stabilize shoulder joint (brace head of hum to glenoid fossa)
41
Q

Infraspinatous

  • origin
  • insertion
  • innervation
  • action
A
  • infraspinatous fossa
  • greater tubercle (from posterior), below supraspinatous and teres minor
  • suprascapular nerve (C5,6)
  • lateral rotation of humerous (PM), stabilize shoulder
42
Q

Subscapularis

  • origin
  • insertion
  • innervation
  • action
A
  • subscapular fossa
  • lesser tubercle of humerus (anterior)
  • upper and lower subscapular nerves (C5,6)
  • medial rotation of arm (PM), adduction of arm
43
Q

Which muscles are part of the rotator cuff?

A 
supraspinatous
infraspinatus
subscapularis
teres minor
(SSIT)
44
Q

Which muscles are involved in shoulder flexion?

A 
anterior deltoid
pectoralis major (clavivular portion)
45
Q

Which muscles are involved in shoulder extension?

A 
posterior deltoid
latissimus dorsi
teres major (weak)
triceps brachii (in arm)
46
Q

which muscles are involved in shoulder abduction?

A

initiate (0-15): supraspinatous, deltoid
16-90: deltoid
>90*:trapezius and serratus anterior

47
Q

which muscles are involved in shoulder adduction?

A

arm extended: pec major
arm flexed: latissimus dorsi
together=adduction

48
Q

which muscles are involved in shoulder medial (internal rotation)?

A 
SUBSCAPULARIS
latissimus dorsi
teres major
pectoralis major
deltoid (anterior fibers)
49
Q

which muscles are involved in lateral rotation of the shoulder?

A

infraspinatous
teres minor
deltoid (posterior fibers)

50
Q

which muscles are involved in circumduction?

A 
subscapularis
supraspinatous
infraspinatus
latissimus dorsi
teres major
teres minor
pectoralis major
deltoid
coracobrachialis
biceps brachii
triceps (long head)
51
Q

which muscles are involved in upward rotation of scapula? (inferior angle moved laterally, coracoid process moved superiorly)

what does this motion do?

A

trapezius
serratus anterior

prevents greater tubercle from striking acromion process during abduction or flexion

52
Q

which muscles are involved in downward rotation of scapula? (inferior angle moved medially, coracoid process moved inferiorly)

what does this movement do?

A

rhomboids
pectoralis minor

increases range of glenohumeral adduction and extension

53
Q

which muscles are involved in protraction (move away from midline) of scapula?

what does this movement do?

A

serratous anterior
pectoralis minor

increase reach during flexion or adduction

54
Q

which muscles are involved in retraction (move towardfrom midline) of scapula?

A

rhomboid major
rhomboid minor
trapezius (middle fibers)

55
Q

which muscles are involved in elevation of scapula?

A

rhomboid major
rhomboid minor
trapezius (upper fibers)
levator scapulae

56
Q

which muscles are involved in scapular depression?

A

trapezius (lower fibers)

pectoralis minor

57
Q

the suprascapular nerve innervates which muscles?

A

supraspinatus

infraspinatus

58
Q

what causes rotator cuff injury? why is it serious?

A

overload
fatigue: use over and over=accelerate degeneration
tendonitis
tears

little blood supply to tendons (slow healing), subject to degradation

59
Q

what are bursae? where are they situated?

A

tissue sacs lined with synovial membrane

between structures requiring much freedom (near joints-where muscle/tendon moves over bone

60
Q

what is bursitis?

which bursae is commonly affected?

A

increased fluid secretion to bursae (inflammation of synovial membrane)

swelling–>pressure on bursae–>pain

subacromial bursae often affected

61
Q

what are the muscular borders of the quadrangular space?

what does it contain?

A

inferior: teres major
medial: triceps muscle (long head)
lateral: humerus surgical neck
superior: subscapularis

axillary nerve
posterior circumflex humeral artery and vein

62
Q

what is impingement syndrome?

A

decreases subacromional space–> swelling and bone spurs

63
Q

what are the borders of the triangular interval?

what does it contain?

A

superior: teres major
medial: triceps (long head)
lateral: humerus

radial nerve

64
Q

what are the borders of the triangular space?

what does it contain?

A

superior: subscapularis
inferior: teres major
lateral: triceps (long head)

circumflex scapular artery

65
Q

what is the triangle of auscultation?

A

right on shoulder blade: not much muscle so you can hear lung sounds

Gross Anatomy (8 decks)

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