Back And Shoulder Region

Question 1

superficial and deep

Name the muscles of the back:

Answer 1

Superficial
1. Trapezius
2. Latissimus dorsi

Deep
1. Levator scapulae
2. Rhomboid minor
3. Rhomboid major

Question 2

Outline the surface landmarks of the back.

Question 3

Discuss Trapezius stating its attachments, innervation and action.

Answer 3

Origin-
1. Skull; superior nuchal line and external occipital protuberance
2. Ligamentum nuchae
3. Spines of all thoracic vertebrae and C7

Instertion-
1. Clavicle
2. Acromion
3. Spine of scapula

Nerve- spinal accessory nerve
Action- elevation, depression, retraction of scapula

Question 4

Discuss Latissimus dorsi stating its attachments, innervation and action.:

Answer 4

Origins-
1. Inferior angle of scapula
2. Lower 6 thoracic spines
3. thoracolumbar fascia
4. Iliac crest and last three ribs

Insertion-
Floor of bicipital groove

Nerve- thoracodorsal nerve from posterior chord of BP
Action- elevation, depression, retraction

Question 5

Deep layer: levator scapulae, rhomboids minor and major

Answer 5

Origin- vertebral column
Insertion- medial border of scapula
Nerve- dorsal scapular (nerve to rhomboids) C5
Action- LS elevation, Rhomboids retraction of scapula

Question 6

Discuss Serratus anterior stating its attachments, innervation and action.

Answer 6

Origin- upper 8 ribs
Insertion- inner lip of medial border of scapula
Nerve- long thoracic (C5,6,7)
Action- protraction and upward rotation of scapula

Question 7

Discuss Winging of scapula

Answer 7

Paralysis of serratus anterior
Due to injury of long Thoracic nerve (C5,6,7)
May occur during breast surgery

Question 8

List the Muscles of the shoulder

Answer 8

1.Deltoid
2.Teres major
3. Rotator cuff muscles (SITS)
-supraspinatus
-infraspinatus
-teres minor
-subscapularis

Question 9

Discuss Supraspinatus stating its attachments, innervation and action.

Answer 9

O- supraspinous fossa
I- upper part of greater tuberosity
N-suprascapular nerve
A- initiation of abduction (0-15)

Question 10

Discuss Infraspinatus stating its attachments, innervation and action.

Answer 10

O-infra spinous fossa
I- greater tuberosity
N- suprascapular nerve
A- adduction and lateral rotation of arm, helps steady shoulder joint

Question 11

Discuss Teres minor stating its attachments, innervation and action.

Answer 11

O- lateral border of scapula
I- lower impression of greater tuberosity
N- axillary nerve
A- adduction and lateral rotation of the arm, helps steady the shoulder joint

Question 12

Discuss Subscapularis stating its attachments, innervation and action.

Answer 12

O- subscapular fossa
I- lesser tuberosity
N- upper and lower subscapular nerves
A- abduction and medial rotation of the arm

Question 13

Discuss Teres major stating its attachments, innervation and action.

Answer 13

O- lower third of lateral border of scapula
I- lateral lip of bicipital groove
N- lower subscapular nerve
A- extension and lateral rotation

Question 14

Describe attachments and movements of scapula

Question 15

Discuss Deltoid stating its attachments, innervation and action.

Answer 15

Origins
1.clavicle
2.Acromion
3. Crest of spine

Insertion- deltoid tuberosity
Nerve- axillary nerve
Action- abduction of arm from 15-90(middle fibers) , flexion and medial rotation (anterior), extension and lateral rotation (posterior)

Question 16

Discuss Injury of axillary nerve

Answer 16

Causes
1. Dislocation of shoulder
2. Fracture of surgical neck of humerus

Deformity
Flat shoulder due to paralysis and atrophy of deltoid muscle

Question 17

Name the boundaries and contents of the Quadrangular space.

Answer 17

Axillary nerve
Posterior circumflex humeral artery

Question 18

Name the boundaries and contents of the Triangular space .

Answer 18

Circumflex scapula artery

Question 19

Triangular space between long head of triceps and humerus

Answer 19

Radial nerve
Profunda brachii artery