A: Pectoral region, back, arm

Question 1

Trapezius (origin, insertion, action, nerve supply)

Answer 1

• Occipital bone of skull, ligament over vertebrae of neck, spine of 7th cervical and all thoracic vertebrae
• lateral 1/3 clavicle, acromion of scapula, spine of scapula
• Elevates shoulder, retracts scapula on thoracic wall, upwards rotation of scapula
• Motor = accessory nerve. Sensory = upper cervical nerves

Question 2

Levator sculpae

Answer 2

• Upper cervical vertebrae
• Medial border of scapula above root of scapular spine
• Elevates scapula
• Cervical nerves

Question 3

Rhomboid minor

Answer 3

• Lower cervical + upper thoracic vertebrae
• Medial margin of scapula at root of scapular spine
• Retracts and elevates scapula
• Brachial plexus

Question 4

Rhomboid major

Answer 4

• Upper thoracic vertebrae
• Medial border of scapula below root of scapular spine
• Retracts and elevates scapula
• Brachial plexus

Question 5

Serratus anterior

Answer 5

• Slips from lateral surface of 1st to 8th ribs
• Medial border of scapula
• Protracts scapula, rotates scapula upwards, holds medial border of scapula against thoracic wall
• Long thoracic nerve from brachial plexus

Question 6

Pectoralis minor

Answer 6

• Anterior surface of upper ribs
• Coracoid process of scapula
• Protracts scapula
• Medial pectoral nerve of brachial plexus

Question 7

Subclavius

Answer 7

• 1st rib
• Inferior surface of clavicle
• Pulls clavicle towards sternum, stabilizes sternoclavicular joint
• Nerve to subclavius from brachial plexus

Question 8

Pectoralis major

Answer 8

• Medial clavicle, sternum, upper ribs, aponeurosis of external oblique muscle of abdomen
• Bicipital groove
• Shoulder joint: adduction, medial rotation, flexion, extends flexed arm.
• Medial + lateral pectoral nerves

Question 9

Latissimus dorsi

Answer 9

• Spinous processes of lower thoracic vertebrae, lower ribs, lumbodorsal fascia, iliac crest.
• Bicipital groove
• Adduction, extension, medial rotation
• Thoracodorsal nerve

Question 10

Deltoid

Answer 10

• lateral 1/3 clavicle, acromion of scapula, spine of scapula
• Deltoid tuberosity of humerus
• Abduction, flexion and medial rotation, extension, lateral rotation
• Axillary nerve

Question 11

Supraspinatus

Answer 11

• Supraspinous fossa of scapula
• Blend with capsule of shoulder joint and greater tubercle of humerus.
• Stabilization of shoulder joint, initiates of arm
• Brachial plexus

Question 12

Infraspinatus

Answer 12

• Infraspinous fossa of scapula
• Blend with capsule of shoulder joint and greater tubercle of humerus.
• Stabilization of shoulder joint, lateral rotation
• Brachial plexus

Question 13

Teres minor

Answer 13

• Posterior surface scapula near lateral border
• Blend with capsule of shoulder joint and greater tubercle of humerus.
• Stabilization of shoulder joint, lateral rotation
• Axillary nerve

Question 14

Subscapularis

Answer 14

• Anterior surface of scapula
• Blend with capsule of shoulder joint and lesser tubercle of humerus.
• Stabilization of shoulder, medial rotation
• Brachial plexus

Question 15

Teres major

Answer 15

• Posterior surface inferior angle of scapula
• Bicipital groove
• Adduction, extension, medial rotation
• Brachial plexus

Question 16

Axillary nerve journey

Answer 16

• Exits axilla with posterior cirumflex humeral artery, passes through quadrangular space.
  Passes posteriorly around surgical neck of humerus deep to deltoid. Supplies deltoid, teres minor and skin over upper part of lateral arm.

Question 17

How can axillary nerve be damaged

Answer 17

Inferior dislocation of head of humerus or fracture of surgical neck of humerus.

Question 18

Quadrangular space syndrome

Answer 18

Compression of axillary nerve as it passes through, can occur from enlargement of muscles bounding space.
Causes weakness in teres minor and deltoid.

Question 19

Cubital fossa boundaries

Answer 19

Superior = Imaginary line connecting medial and lateral epicondyles
Lateral = brachioradialis muscle
Medial = pronator teres
Floor = brachialis and supinator
Roof = bicipital aponeurosis

Question 20

Contents of cubital fossa

Answer 20

TAN
Brachii Tendon
Brachial Artery
Median nerve

Question 21

Bicep long head

Answer 21

Supraglenoid tubercle of scapula
Radial tuberosity
Flexion of elbow, supination, flexion of arm
Musculocutaneous

Question 22

Bicep short head

Answer 22

Coracoid process
Radial tuberosity
Flexion of elbow, supination, flexion of arm
Musculocutaneous

Question 23

Coracobrachialis

Answer 23

Coracoid process
Medial side of middle of humeral shaft
Flexion of arm at shoulder joint
Musculocutaneous

Question 24

Brachialis

Answer 24

Distal half of anterior surface of humerus
Coronoid process & tuberosity of ulna
Flexion of forearm at elbow
Musculocutaneous

Question 25

Tricep long head

Answer 25

Infraglenoid tubercle of scapula Olecranon process of ulna Extension of forearm, extension + adduction arm. Radial Resists dislocation of humerus

Question 26

Tricep lateral head

Answer 26

Posterior surface of humerus superior to spinal groove Olecranon process of ulna Extension of forearm, extension + adduction arm. Radial

Question 27

Tricep medial head

Answer 27

Posterior surface of humerus inferior to spinal groove Olecranon process of ulna Extension of forearm, extension + adduction arm. Radial

Question 28

Musculocutaneous nerve path

Answer 28

Leaves axilla passes through coracobrachialis Passes distally between biceps + brachialis Supplies BBC Emerges on lateral aspect of tendon of biceps brachii and continues as lateral cutaneous nerve

Question 29

Median nerve

Answer 29

Leaves axilla and passes through anterior compartment Lies lateral to brachial artery in proximal arm Lies medial to brachial artery in distal arm Passes through cubital fossa

Question 30

Ulnar nerve

Answer 30

Leaves axilla and passes through anterior compartment medial to brachial artery In middle of arm, pierces medial intermuscular septum and enters posterior compartment Passes posterior to medial epicondyle of humerus + then into anterior compartment

Question 31

Radial nerve

Answer 31

In axilla, posterior to axillary artery Enters posterior compartment medial to humerus between long head of triceps and brachial artery Goes from medial to lateral and enters spiral groove When reaches lateral border of humerus, it enters anterior compartment of arm and lies deep to brachioradialis Divides anterior to lateral epicondyle into terminal branches

Question 32

Supracondylar fracture of humerus

Answer 32

- Transverse fracture of distal humerus above two epicondyles - Distal bone fragment displaced posteriorly, damaging cubital fossa contents - Brachial artery may be obstructed

Question 33

Consequences of loss of function of trapezius

Answer 33

Drooping of shoulder (shoulder held in lower position than opposite) Unable to shrug shoulder (raise tip of shoulder) Difficulty raising arm above the head / abduction above horizontal (rotating scapulae upwards) Difficulty retracting shoulder (retraction of scapula)

Question 34

Identify this bony feature

Answer 34

Suprascapular notch of right scapula