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1st Trimester > Gross Exam 2 > Flashcards

Gross Exam 2 Flashcards

1
Q

Shoulder Muscles

A

-These muscles cover the upper part of the anterior thoracic region and spread posteriorly to cover most of the posterior thoracic region

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2
Q

Shoulder muscles distinct groups of origins and insertions (3)

A
  • One group originates on the vertebral column or skull and insert on the shoulder girdle or humerus
  • One group originates on the thoracic wall and inserts on the shoulder girdle or humerus
  • One group originates on the scapula and inserts on the Humerus
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3
Q

Muscles that originate on the Vertebral Column or Skull

A
  1. Trapezius
  2. Rhomboid Major
  3. Rhomboid Minor
  4. Levator Scapula
  5. Latissimus Dorsi
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4
Q

Trapezius

A
  • A large muscle which covers the posterior cervical and thoracic region
  • The muscle is named because the right and left muscles form a four sided figure known as a trapezoid
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5
Q

Trapezius Origin

A
  1. External Occipital Protuberance
  2. Superior Nuchal Line
  3. Ligamentous Nuchae
  4. Spines of the thoracic vertebrae (C7-T12)
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6
Q

Trapezius Insertion

A
  1. Clavicle

2. Acromion Process and spine of the scapula

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7
Q

Trapezius Actions

A
  1. Stabilizes the scapula (holds it in anatomical position)
  2. Upper portion: Elevates the scapula
  3. Middle and lower portions: ADduct and depress the scapula
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8
Q

Trapezius Nerve Supply

A
  1. Motor innervation: Spinal Accessory Nerve (XI Cranial)

2. Sensory innervation: C3 and C4

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9
Q

Trapezius Palsy

A
  1. A deepening of the shoulder on the affected side

2. Shoulder drops on the affected side

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10
Q

Whiplash injury

A

The superior portion of the Trapezius muscle is frequently involved in neck injuries during an auto accident

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11
Q

Test for Cranial Nerve XI

A

Ask the patient to elevate their shoulders (shrug) against resistance on both sides and should be tested at the same time, so weakness of one side can be evaluated to the other side

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12
Q

Rhomboid Major Origin and Insertion

A

O: Spines/ upper thoracic vertebrae
I: Vertebral border/ scapula

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13
Q

Rhomboid Minor Origin and Insertion

A

O: Spines/lower cervicals and first thoracic vertebrae
I: Superior angle/ scapula
Proximal medial border/ scapula

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14
Q

Levator Scapula Origin

A

Transverse processes/ upper cervical vertebrae

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15
Q

Rhomboid Major, Minor and Levator Scapula Nerve Supply

A

Dorsal Scapular Nerve (C5)

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16
Q

Damage to the Dorsal Scapular Neve and/or C5

A
  1. Difficulty in completely adducting the scapula

2. Scapula on the affected side is further from the midline

17
Q

Latissimus Dorsi Origin

A
  1. Spines/lower thoracic and lumbar vertebrae
  2. Thoracodorsal fascia
  3. Crest/Ilium
  4. Lower Ribs
18
Q

Latissimus Dorsi Insertion

A

Intertubercular groove (Lesser tubercle)/ Humerus

19
Q

Levator Scapula Insertion

A
  1. Superior angle/scapula

2. Proximal medial border/scapula

20
Q

Levator Scapula Action

A
  1. Elevates Scapula
  2. Adducts scapula
  3. Stabilizes scapula
21
Q

Latissimus Dorsi Action

A
  1. Extends, adducts and medially rotates the humerus

2. Involved with forced expiration

22
Q

Latissimus Dorsi Nerve Supply

A

Thoracodorsal nerve (C6,C7, and C8)

23
Q

Weakness or Damage to the Latissimus Dorsi

A

Results in forward displacement of the shoulder

24
Q

Lumbar Triangle

A
  • A depression found at the lower portion of the latissimus dorsi
  • Bounded by the Latissimus dorsi, crest of the ilium and the external oblique muscle
  • Clinical significance is that a hernia of the posterior abdominal wall may develop here
25
Q

Triangle of Ascultation

A

-A depression found at the superior border of the latissimus dorsi (medial to the inferior angle of the scapula)
-Bounded by the Latissimus dorsi, trapezius and vertebral border of the scapula
Clinical significance: The relatively thin layer of tissue here allows lungs sounds to be more easily heard with a stethoscope
-Can be enlarged by having the patient aBduct their scapula

26
Q

Serratus Anterior Origin

A

Upper 8 or 9 ribs

27
Q

Serratus Anterior Insertion

A

Vertebral border of the scapula

28
Q

Serratus Anterior Actions

A
  1. ABducts the scapula
  2. Stabilizes the scapula
  3. Involved with forced inspiration, but only when the humerus is Abducted
29
Q

Serratus Anterior Nerve Supply

A

Long thoracic Nerve (C5, C6, and C7)

30
Q

**Long Thoracic Nerve Palsy (Winged Scapula)

A

-Condition in which the serratus anterior muscle is weakened due to damage to the long thoracic nerve or its segmental innervation

31
Q

**Clinical Signs for Long thoracic nerve Palsy

A
  • Patient will have difficulty keeping the vertebral border and inferior angle of the scapula against the posterior thoracic wall when carrying out aBduction against resistance, “Winging of the Scapula)
  • Patients may experience difficulty in abducting their scapula and thus have problems in raising the extremity over their head
  • May have pain in shoulder region
32
Q

**Causes of Long Thoracic Palsy (Winged Scapula)

A
  1. Trauma/Subluxation
  2. Traction injuries involving the shoulder joint
  3. Recumbency for a long period of time (laying on back)
33
Q

Rotator Cuff Muscles

A
  1. Supraspinatus
  2. Infraspinatus
  3. Subscapularis
  4. Teres Minor
    Tendon of insertion must contribute to forming a cuff around the proximal part of the humerus and they participate in either lateral or medial rotation of the humerus
34
Q

Deltoid Origin

A
  1. Clavicle (anterior portion)
  2. Acromion process (middle portion)
  3. Spine of scapula (posterior)
35
Q

Deltoid Insertion

A

Deltoid Tuberosity/ Humerus

36
Q

Deltoid Actions

A
  1. Anterior portion: Flexes and Medially rotates the Humerus
  2. Middle portion: Abducts humerus
  3. Posterior portion: Extends and laterally rotates the humerus
37
Q

Deltoid Nerve Supply

A

Axillary Nerve (C5 and C6)

38
Q

Atrophy of the Deltoid (Crutch Paralysis)

A

-This is due to an injury to the axillary nerve
Causes:
1. Fracture of the surgical neck of the humerus (injury to the nerve may be immediate or occur during the healing process)
2. Dislocation of the shoulder joint
3. Pressure of a crutch in the axilla
-Muscle will have a flattened appearance
-Loss of sensation on lateral aspect of the arm ( lateral brachial cutaneous branch of the axillary nerve is compromised)
-Abduction of the arm is greatly impaired

1st Trimester (4 decks)

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