3: scapula and pectoral region Flashcards Preview

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Flashcards in 3: scapula and pectoral region Deck (121):
1

what attaches to medial border of scapula

rhomboid major and minor and levator scapulae

2

3 features of lateral border of scapula

glenoid fossa
supraglenoid tubercle
infraglenoid tubercle

3

what is between supraglenoid tubercle and infraglenoid tubercle? also where are they?

glenoid process

lateral border of scapula

4

glenoid process location and importance

lateral border of scapula, where humerus head insertts

5

from medial to lateral, features of superior border of scapula

in the middle of the top border, suprascapular notch. then corocoid process (subscapular nerve!) and then supraglenoid tubercle (but technically that is lateral)

also up there from posterior side, the spine goes up and over superior border and acromion comes off above (and then attaches to clavicle)

6

muscles that attach to inferior angle of scapula

teres major and sometimes latissimus dorsi

7

what attaches to supra glenoid tubercle

bicep

8

what attaches to infraglenoid tubercle

tricep

9

where does humerus articulate

glenoid process

10

what is spinal groove

groove on posterior surface of humerus, caused by arterial pulsation

11

airforce over navy

artery over nerve

12

features of top of humerus

head is the top

anatomical neck (axillary nerve) is above surgical neck (radial nerve)

(air is above sea)

between the necks: greater tubercle (posterior) and lesser tubercle (anterior) with intertubercular groove between (on anterior side)

13

anterior humerus has what features

lesser tubercle and intertubercular groove

14

posterior humerus has what features

greater tubercle (for rotator cuff muscles), spiral groove for deep artery (profunda brachii)

15

layer 1 of back muscles

trapezius, rhomboid major and minor, l dorsi, levator scapulae

16

layer 2 of back muscles

serratus posterior superior and inferior

17

layer 3 of back muscles

erector spinae (spinalis, longisimus, iliocostalis) and multifidus

18

deep neck

splenius (capitis and cervicis), semispinalis capitus, semispinalis cervicus

19

scapular region muscles (7)

deltoid, supraspinatus, infraspinatus, teres minor, teres major, subscapularis and serratus anterior

20

deltoid:

around shoulder, 3 fiber tracks, all insert in deltoid tuberosity, function is to abduct shoulder, axillary nerve

21

deltoid innervation

axillary nerve

22

deltoid insertion

deltoid tuberosity (lateral upper humerus)

23

deltoid origin

3 tracks:

posterior: spine of scapula
lateral: acromion of scapula
anterior: clavicle

24

deltoid fxn

abduction at shoulder, but not past max intrinsic. then scapula required to go past T arm

25

in general, what do posterior fibers of arm do

extend

26

in gerneral, what do anterior fibers of arm do

flex

27

supraspinatus

above spine on posterior scapula, inserts into greater tubercle (posterior), fxn is to initiate abduction, suprascapular nerve

28

origin of supraspinatus

supraspinous fossa

29

insertion of supraspinatus

greater tubercle (posterior)

30

fxn of supraspinatus

INITIATE abduction

31

innervation of supraspinatus

suprascapular nerve

32

infraspinatus

origin is infraspinous fossa, insertion in greater tubercle, fxn is external rotation, suprascapular nerve

33

teres minor

origin is middle lateral aspect of axillary border of scapula; AXILLARY NERVE

34

2 muscles of scapula that might be fused but have different nerve supply

teres minor and infraspinatus

35

infraspinatus nerve

suprascapular

36

infraspinatus origin

infraspinous fossa

37

infraspinatus fxn

external rotation

38

infraspinous insertion

greater tubercle

39

teres minor nerve

axillary

40

teres minor origin

middle part of lateral border of scapula

41

teres minor insertion

greater tubercle

42

teres minor fxn

external rotation

43

external rotation of upper arm is what

lateral rotation, serving platter to side

44

posterior muscles that prevent posterior shoulder dislocation

SIT; supraspinatus (no rotation since above shoulder), infraspinatus, teres minor

45

contract all scapula muscles togetehr

no rotation but pull in with stronger force

46

teres major

origin is inferior border of scapula, inserts to medial lip of intertubercular groove of humerus, lower subscapular nerve, fxn is medial rotation of upper arm/stabilize humerus in joint/assist l.dorsi in shoulder extension (pull back row motion, shoot elbows back)

47

teres major nerve

lower subscapular nerve

48

teres major origin

lateral inferior scapular border

49

teres major insertion

medial lip of intertubercular groove

50

teres major fxn

extend humerus, medial rotation, (extend shoulder joint), pull elbows back in row motion

51

subscapularis

anterior side of scapula, origin is subscapular fossa, inserts into less tubercle (anterior side), fxn is interal rotation and protect against anterior dislocation, upper and lower subscapular nerve

52

subscapularis nerve

upper and lower subscapular nerve

53

subscapularis origin

subscapular fossa

54

subscapularis insertion

lesser tubercle (anterior)

55

subscapularis fxn

internal rotation and protection agsint anterior dislocation

56

subscapularis is not visible when you look at anterior scapula because...

serratus anterior

57

muscles that internally rotate upper extremity

teres major and subscapularis. both insert anterior, at intertubercular groove and lesser tubercle

58

teres major and minor, subscapularis and infraspinatus -- which are antagonistic to which

t minor and infraspinatus externally rotate (both insert at greater tubercle) also so does supraspinatus

t major and subscapularis internally rotate; t major inserts intertubercular groove and subscapularis to lesser tubercle

59

serratus anterior

above subscapularis on anterior scapula, origin is 9-10 slips of muscle from ribs 1-8 (or 9), inserts at anterior surface of scapula on medial border (goes all the way across it), maintains scapula against body wall (protraction of scapula, antagonistic to rhomboid), long thoracic nerve, lateral rotation and abduction of scapula, winging of scapula if it is paralyzed

60

serratus anterior origin

9-10 slips of muscles from ribs 1-8 or 1-9

61

serratus anterior insertion

medial border of anterior scapula

62

serratus anterior nerve

long thoracic nerve

63

serratus anterior function

maintain scapula against body wall; protaction/lateral rotation/abduction of scapula; antagonist to rhomboids, winging of scapula if this muscle paralyzed

64

rotator cuff

SITS: supraspinatus, infraspinatus, teres minor, subscapularis

SIT: greater tubercle, posterior

subscapularis: lesser tubercle

65

nerves of SIT of rotator cuff

supraspinatus and infraspinatus: suprascapular never

teres minor: axillary

66

rotator cuff does what

SIT prevents posterior dislocation

S prevents anterior dislocation

67

supraspinatus is part of SITS but does not rotate upper arm...what is fxn

initiation of abduction

68

artery with axillary nerve

posterior humoral circumflex

69

blood source to scapula

3 sources. originates from anterior sources.

1. transverse cervical or dorsal scapular: feeds rhomboids along medial scapula border but has branches that go under infraspinatus

2. suprascapular artery: under supraspinatus and then to infraspinatus too

3. subscapular circumflex: to inferior parts (comes opposite to the branch of dorsal scap/transverse cervical) that goes under infraspinatus, would crash

70

blood to scapula: transverse cervical

artery from thyrocervical trunk to trapezius; often divides into superficial branch (to trapezius) and deep branch (to rhomboids and collateral shoulder circulation) --- 50% time, deep branch artery is lacking, so dorsal scapular artery

71

dorsal scapula artery

blood to scapula when transverse cervical artery does not split into deep branch artery. independent branch from subclavian to rhomboids, levator scapula, collateral shoulder circulation

72

suprascapular artery

blood to scapula. from thyocervical trunk to supra and infraspinatus mm. and collateral shoulder circulation

73

subscapular artery

from 3rd portion of axillary artery, divides into circumflex scapular and thoracodorsal aa. to infraspinatus, teres major and minor, collateral circulation and latissimus dorsi

74

collateral circulation in shoulder

anastomoses between arteries that supply scapula (superficial branch of transverse cervical has little contribution, it goes to trapezius)

75

anastomoses

reconnecting of vessels that have branched out

76

posterior upper arm

triceps; all radial nerve innervation; extension

77

triceps

radial nerve, posterior upper arm, extends elbow, 3 heads (all insert ulna)

long head: cross joint from infraglenoid tubercle and extends elbow AND shoulder

lateral head: origin is lateral to spiral groove

medial head: origin is inferior third of posterior humerus

78

long head of triceps

-origin is infraglenoid tubercle
-fxn is extension of shoulder and elbow because crosses joint
-radial nerve
-medial side of posterior humerus

79

lateral head of triceps

-origin is lateral side of spinal groove on posterior surface of humerus
-elbow extension
-radial nerve

80

medial head of triceps

-origin is bottom third of humerus, only seen if you incise and separate long and lateral heads
-fibers go straight up and join other 2 heads

81

radial nerve

TRICEPS, posterior upper extremity

on humerus in SPIRAL GROOVE (under profunda brachii), very easy to damage if break in bone

posterior -- extension

damage = drop wrist, only flexion

82

Axillary nerve

DELTOID and TERES MINOR

artery is posterior circumflex

83

# ribs

12

84

parts of sternum

manubrium, (sternal angle), body, xiphoid process

85

bones of pectoral region

scapula, ribs, clavicle, sternum

86

true ribs

1-7; articulate with vertebrae and sternum

87

false ribs

8-12; articulate with vertebrae and 8-10 attached to sternum through costal cartilage and 11-12 float

88

floating ribs

11 and 12. insert into muscle, no attachment to sternum

89

breast lobes

around 15

90

lactiferous ducts

ducts of breast, one per lobe, come together like tributaries running into river before nipple

91

lactiferous sinus

deep to areola ducts

92

retinacula cutis

separates adjacent lobes of glandular tissue in breast. we saw this
(aka suspensory ligaments of cooper?)

connective tissue toward surface that is bigger and thicker

93

suspensory ligaments of cooper

attach breast to overlying dermis

94

lymphatic drainage from breast

axillary lymph node (75%)

parasternal lymph node (deep drainage)

subcutaneous (minor drainiage, big in spreading disease -- cross midline)

95

75% of breast lymph drained via.,,

axillary lymph node

96

deep lymph drainage from breast

parasternal lymph node

97

cancer spreading, little lymph drainage from breast

subcutaneous lymphatic

98

subcutaneous lymphatic

cross midline, drain to costal margin adn axilla of opposite side, contributes to spread of cancer and often blocks ducts

99

orange peel

lymph block up causes swelling and dimpling of skin around nipple

100

pectoralis major

origin - medial third of clavicle (upper), sternum and upper ribs (lower fibers)

inserts into crest of greater tubercle of humerus

medial adn lateral pectoral nerve

fxn= adduction, flexion of arm & medial rotation

101

pectoralis major origin

upper fibers from clavicle
lower from ribs and sternum

102

pectoralis major insertion

greater tubercle of humerus

103

pectoralis major nerve

lateral and medial pectoral nerves

104

pectoralis major function

primary abductor of arm
flex arm, medial (internal) rotation

105

pectoralis minor

origin is ribs 3-5 (deep to pectoralis major); inserts on coracoid process of scapula

medial pectoral nerve

depress and downward rotation of scapula

106

pectoral nerves (medial, lateral)

both for pec major

medial for pec minor

107

quadrangular space

top = joint capsule of shoulder
lateral = surgical neck of humerus (below anatomical)
medial = long head of triceps brachii muscle
inferior = teres major

CONTAINS AXILLARY NERVE and POSTERIOR HUMORAL CIRCUMFLEX ARTERY

108

triangular interval

top = teres major
lateral = humerus shaft
medial = long head of triceps brachii m

CONTAINS RADIAL NERVE AND PROFUNDA BRACHII ARTERY

109

triangular space

bordered by: teres major, teres minor, and long head of triceps

CIRCUMFLEX SCAPULAR ARTERY in it

110

quadrangular space

inside = axillary nerve and posterior humeral circumflex artery

top = joint capsule of shoulder
bottom = teres major
distal = surgical neck of humerus
medial = long head triceps

111

quadrangular space contains waht

axillary nerve and posterior humeral circumflex

112

quadrangular space top adn bottom

top is shoulder joint
bottom is teres major

113

quadrangular space medial and lateral

medial is long head triceps
lateral is surgical neck of humerus

114

triangular SPACE

contains circumflex scapular artery (from subscapular artery of 3rd segment of axillary artery)

medial = teres minor
lateral = long head of triceps
bottom = teres major

115

triangular SPACE contains

circumflex scapular artery (which is from the subscapular artery from the 3rd segment of axillary artery)

116

triangular SPACE has a top or bottom?

bottom; teres major

117

triangular SPACE sides

medial = teres minor; lateral = long head triceps

118

triangular INTERVAL

contains radial nerve and profunda brachii artery

top = teres major
lateral = humeral shaft
medial = long head triceps

119

triangular interval contains

radial nerve and profunda brachii artery

120

tri. interval top or bottom?

top is teres major

121

tri. interval sides

long head triceps is medial and humeral shaft is lateral