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MSK > The Shoulder > Flashcards

The Shoulder Flashcards

1
Q

What are the 5 roots of the Brachial Plexus

A

C5, C6, C7, C8 and T1

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2
Q

What is the order of the parts of the brachial plexus

A 
Roots
Trunks
Divisions
Cords
Branches
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3
Q

What are the 3 Trunks

A

Superior
Middle
Inferior

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4
Q

What root(s) make up the superior trunk

A

C5 and C6

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5
Q

What root(s) make up the middle trunk

A

C7

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6
Q

What root(s) make up the inferior trunk

A

C8 and T1

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7
Q

What happens at division

A

Each trunk divides into an Anterior division and a posterior division

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8
Q

What happens to the posterior divisions

A

They combine and form the posterior cord

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9
Q

What cord is formed from the Anterior division of the inferior trunk

A

The medial cord

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10
Q

What forms the lateral cord

A

Anterior divisions from superior and middle trunks

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11
Q

What roots make up the musculocutaneous nerve

A

C5, C6 and C7

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12
Q

What nerve do the roots C5 and C6 produce

A

Axillary

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13
Q

What two nerves does the posterior cord divide into

A

Axillary and radial

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14
Q

How many of the roots is the radial nerve produced from

A

All 5 (C5,6,7,8 T1)

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15
Q

What roots are part of the median nerve

A

C6, C7, C8 and T1

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16
Q

What roots are part of the ulna nerve

A

C8 and T1

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17
Q

What two nerves does the lateral cord divide into

A

Musculocutaneous and median

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18
Q

What are the bones that join the upper limb to the trunk

A

Scapula and clavicle

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19
Q

What bone does the humorous articulate with at the shoulder joint

A

The scapula

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20
Q

What is the name of the joint where the clavicle and scapula articulates with the trunk

A

The Sterno-clavicular joint

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21
Q

Where is the acromion found

A

It is a projection on the scapula

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22
Q

What is the purpose of the acromion

A

It is where the lateral head of the clavicle articulates with the scapula via the acromio-clavicular joint

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23
Q

Why is the scapula able to do such a wide range of movements

A

It is only attached via the clavicle and muscle

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24
Q

What are the edges of the scapula blade called

A

Upper border
Lateral border
Medial border

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25
Q

Why is the scapula curved

A

To fit the curve of the chest wall

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26
Q

What is the Glenoid Cavity

A

The articulating surface of the shoulder (humorous)

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27
Q

What are found above and below the Glenoid Fossa on the scapula

A

Supraglenoid tubercle
Infraglenoid tubercle
(This is where tendons attach)

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28
Q

What does the spine of the scapula become

A

Acromion

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29
Q

What are the two surfaces of the spine of the scapula (other than acromion)

A

Supraspinatous Fossa

Infraspinatous Fossa

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30
Q

What is the coracoid process

A

Finger like projection medial to acromion

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31
Q

What is the Glenoid labrum and what is its function

A

1) connective tissue around Glenoid cavity

2) creates a larger and deeper surface for articulating

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32
Q

What ligament joins the acromion and the coracoid process

A

Coraco-acromial ligament

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33
Q

What two ligaments join the coracoid process and the clavicle

A 
Trapezoid ligament (Anterior)
Conoid ligament (posterior)
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34
Q

What is the purpose of the Bicipital (intertubercular) Groove on the Anterior surface of the humorous

A

The long head of the biceps (tendon) runs through it

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35
Q

What is on either side of the bicipital groove

A

Greater tubercle

Lesser tubercle

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36
Q

Where does the long head of the biceps originate (tendon)

A

The supraglenoid tubercle

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37
Q

Where does the long head of the triceps originate (tendon)

A

The infraglenoid tubercle

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38
Q

How many short muscles are there that hold the shoulder joint together

A

4

3 posterior, 1 Anterior

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39
Q

What are the names of the small muscles that hold the shoulder joint together (4)

A

1) subscapularis
2) Supraspinatus
3) Infraspinatus
4) Teres Minor

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40
Q

Where does the tendon of the subscapularis muscle insert

A

On the lesser tubercle of the humorous

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41
Q

What movement does subscapularis cause

A

Internal rotation

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42
Q

What is the main function of the 4 small muscles of the shoulder joint

A

Hold the head of the humorous and the Glenoid Cavity together whilst larger muscles are at work

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43
Q

What is the name of the name of the small muscle superior to the spine of the scapula

A

Supraspinatus

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44
Q

Where does the small muscle supraspinatus insert

A

The greater tubercle of the humorous

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45
Q

What movement does Supraspinatus cause

A

Abduction of the humorous

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46
Q

What are the two muscles that arise from the infraspinatous Fossa

A

Infraspinatous,

Teres Minor

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47
Q

Where do the small muscles infraspinatous and Teres Minor insert

A

Back of the greater tubercle

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48
Q

What movement do infraspinatous and Teres Minor cause

A

External rotation

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49
Q

What is the ‘rotator cuff’

A

A cuff of flat supporting tendons produced by the insertion of the 4 short muscles of the shoulder joint

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50
Q

Where does Teres Major arise from

A

Lower lateral border of scapula

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51
Q

Where does Teres Major insert

A

Posterior lip of the bicipital groove

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52
Q

What is the function of Teres Major

A

Powerful ADductor of the humorous

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53
Q

What muscle arises from the coracoid process and inserts on the humorous

A

Coraco-brachialis

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54
Q

What movement does the coracoid-brachialis help with

A

Flexion of the shoulder joint

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55
Q

How many muscles hold the scapula in place and move it in relation to the trunk

A

6 in total

4 posteriorly, 1 Anteriorly and 1 underneath

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56
Q

What is the muscle that is anterior to the scapula and inserts posterior to the chest wall

A

Serratus Anterior

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57
Q

Where does the Serratus Anterior arise from

A

Front and sides of first 8 ribs

58
Q

Where does the Serratus Anterior insert on the Scapula

A

Medial border

59
Q

What movement does the whole of the Serratus Anterior perform

A

Protrusion

60
Q

When split into the superior half and interior half what movements does the Serratus Anterior perform

A

Superior and inferior rotation

61
Q

What are the three small muscles that lie deep to the trapezius

A

(From superior to inferior)
Levator Scapulae,
Rhomboid Minor,
Rhomboid Major

62
Q

Where does the Levator Scapulae arise from

A

Lateral part of first three cervical vertebrae

63
Q

Where does the Levator Scapulae insert

A

Upper medial corner of the scapula

64
Q

What movement does Levator Scapulae help with

A

Elevation of the scapula

65
Q

Where do the Rhomboid muscles arise from

A

C4-T5 Vertebrae

66
Q

Where do the Rhomboid muscles insert

A

The medial border of the scapula

67
Q

What movements do the Rhomboid muscles perform

A

Elevate and retract

68
Q

Where does the upper part of the trapezius arise from

A

From the Occiput to T3 vertebrae

69
Q

Where does the upper part of the trapezius insert

A

Along the superior edge of the spine of the scapula,
Along the acromion,
and 1/3of supero-lateral edge of clavicle

70
Q

Where does the lower part of the trapezius muscle arise

A

T4-T12 vertebrae

71
Q

Where does the lower part of the trapezius muscle insert

A

Posterior edge of spine of scapula

72
Q

What happens when the whole of the scapula contracts

A

The scapula retracts powerfully

73
Q

What happens when only the upper part of the trapezius contracts

A

The scapula is powerfully elevated

74
Q

Where does the Pectoralis Minor muscle arise

A

From 2nd to 4th rib

75
Q

Where does the pectoralis Minor insert on the scapula

A

Coracoid process

76
Q

What does Contraction of the Pectoralis Minor cause

A

Depression of the scapula

77
Q

What muscle arises from the first rib and inserts on the clavicle

A

Subclavius

78
Q

Where does the omohyoid bone arise and insert

A

Hyoid bone,

Superior edge of spine of Scapula

79
Q

What are the muscles that hold the scapula in place and move it in relation to the trunk

A

1) Serratus Anterior
2) Levator Scapulae
3) Rhomboid Minor
4) Rhomboid Major
5) Trapezius
6) Pectoralis Minor

80
Q

What is the function of the omohyoid muscle

A

Depress the hyoid bone and the larynx

81
Q

What is similar about Pectoralis Major and Latissimus Dorsi

A

They both arise from the trunk and insert on the Humorous bypassing scapula
They form the Anterior and Posterior walls of the Axilla

82
Q

Where does Pectoralis Major arise

A

Medial 1/3 of clavicle,
Anterior side of sternum,
Front of first 6 costal cartilages

83
Q

Where does Pectoralis Major insert

A

Anterior edge of bicipital groove

84
Q

What movement does the Pectoralis Major cause

A

Powerful ADduction of the humorous

Can also cause internal rotation

85
Q

Where does the Latissimus Dorsi originate from

A

T7 down to sacrum and along posterior Iliac crest

Some from lower 4 ribs and tip of the scapula

86
Q

Where does the Latissimus Dorsi insert

A

Floor of the bicipital groove

87
Q

What movements does the Latissimus Dorsi cause

A

Powerful ADduction of the humorous

Powerful depression of the shoulder

88
Q

Where does the deltoid arise

A

Spine of the scapula, acromion, lateral 1/3 of clavicle

89
Q

Where does the deltoid insert

A

Deltoid tuberosity of the Humorous

90
Q

What is special about the deltoid muscle

A

It acts almost as 3 different muscles

91
Q

What does the anterior part of the deltoid do

A

Powerful Flexion of humorous

92
Q

What does the posterior part of the deltoid do

A

Powerful extensor

93
Q

What does the lateral part of the deltoid do

A

Powerful ABduction

94
Q

What are the anterior and middle scalene muscles attached to

A

First rib

95
Q

What blood vessel runs behind the anterior scalene muscle

A

Subclavian Artery

96
Q

What blood vessel runs Anterior to the anterior scalene muscle

A

The subclavian vein

97
Q

What vein is found in the groove between Pectoralis Major and deltoid

A

Cephalic vein

98
Q

What vein passes behind Pectoralis Minor

A

Subclavian vein

99
Q

What vein do subclavian and internal jugular combine to form

A

Brachiocephalic

100
Q

Where does the Right subclavian Artery and Right common carotid artery arise from

A

The brachiocephalic trunk

101
Q

Where does the left subclavian Artery arise from

A

The arch of the Aorta

102
Q

What 2 branches does the now axillary Artery produce

A

Thoracic-acromial,

Lateral Thoracic

103
Q

What nerve (that supplies muscles of the shoulder) comes from the medial cord

A

Medial pectoral nerve

104
Q

How many nerves arise from the lateral cord that supply the muscles of the shoulder region

A

2

105
Q

What nerves (that supplies muscles of the shoulder) come from the lateral cord

A

Lateral pectoral nerve

Musculocutaneous nerve

106
Q

What muscles does the Axillary nerve supply

A

Deltoid and teres Minor

107
Q

What do the upper and lower subscapular nerves supply

A

Subscapularis and Teres Major

108
Q

What muscle does the Thoraco-dorsal muscle supply

A

Latissimus Dorsi

109
Q

Where does the suprascapular nerve arise from

A

Superior trunk

110
Q

What muscles does the Suprascapular nerve supply

A

Supraspinatous

Infraspinatous

111
Q

Where does Dorsal Scapular nerve arise from

A

C5 root, runs through the middle scalene muscle

112
Q

What nerve supplies the Rhomboid muscles

A

Dorsal Scapular nerve

113
Q

Where does the Long Thoracic Nerve arise from

A

C5, C6, C7 roots

114
Q

What muscle does the Long Thoracic Nerve supply

A

Serratus Anterior

115
Q

What nerve supplies the Trapezius

A

Spinal accessory nerve

116
Q

Where is the Transverse Humeral Ligament found

A

Lies across greater and less tubercles and holds in the long head of the biceps

117
Q

What 3 ligaments hold the humeral head to the Glenoid cavity

A

Superior Glenohumeral ligament
Middle Glenohumeral ligament
Inferior Glenohumeral ligament

118
Q

What ligament joins the proximal humorous to the coracoid process

A

Coracohumeral ligament (runs superior to Glenohumeral ligaments)

119
Q

What is the subacromial bursa

A

Fluid filled sac that reduces friction between humorous and acromion

120
Q

What is the rough size of the subacromial bursa

A

1-1.5cm

121
Q

What joint allows the first 90% do abduction of the shoulder

A

Gleno-humeral joint

122
Q

What shoulder muscle is responsible for abduction of 0-15 degrees

A

Supraspinatous

123
Q

What shoulder muscle is responsible for 15-90 degrees of abduction

A

Deltoid

124
Q

What joint allows for over 90degrees of abduction

A

Scapula-Thoracic joint

125
Q

What muscles allow over 90degree abduction of the shoulder

A

Serratus Anterior and upper trapezius

126
Q

What muscles cause adduction of the shoulder joint

A

Pectoralis Major
Latissimus Dorsi
Teres Major

127
Q

What muscles cause Flexion of the shoulder

A

Anterior fibres of deltoid,
Coracobrachialis,
Pectoralis Major,
Biceps Brachii

128
Q

What muscles cause extension of the shoulder

A

Posterior fibres of deltoid,
Latissimus Dorsi
Teres Major

129
Q

What muscles cause internal rotation of the shoulder

A

Subscapularis,
Teres Major,
Pectoralis Major,
Latissimus Dorsi

130
Q

What muscles cause external rotation of the shoulder

A

Infraspinatous,

Teres Minor

131
Q

What does the coracoacromial arch stop

A

Superior dislocation

132
Q

What might cause a posterior dislocation of the shoulder

A

Electric shock or seizures

133
Q

What is significant about posterior dislocations at the shoulder compared to other dislocations

A

They can be easily missed clinically and on X-rays

134
Q

How many types of dislocation can the Acromioclavicular joint undergo

A

6

135
Q

What is a clinical risk with surgery after clavicular fractures

A

K-wires can migrate and enter spine/chest/heart

136
Q

What is calcific Tendinitis

A

Deposits of calcium hydroxyapatite,
Causes subacromial impingement if large,
If bursts, then causes calcific tendinitis

137
Q

What has happened if a patient’s arm looks like popeye’s

A

Rupture of the long head of the biceps

138
Q

What are clinical tests to see if a patient has a rotator cuff tear

A

Supraspinatous, infraspinatous and subscapularis push off test would be weak

139
Q

What can be done to cease the symptoms of acromioclavicular osteoarthritis

A

Excision lateral clavicle (remove about 1cm of lateral clavicle)

140
Q

What are treatments for Glenohumeral Osteoarthritis (3)

A

1) Analgesia and exercise
2) Steroids
3) eventual joint replacement

141
Q

What is the clinical name for ‘frozen shoulder’

A

Adhesive capsulitis

MSK (4 decks)

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