L6 MS Flashcards
(173 cards)
1
Q
What are the bones that make up the shoulder complex?
A
sternum clavicle scapula humerus Ribs (indirectly involved in some muscle function
2
Q
Which bone acts as the strut between the axial and appendicular skeleton of the to the upper limb?
A
Clavicle
3
Q
Which shoulder bone provides the only attachment of the shoulder complex to the axial skeleton?
A
Clavicle articulates with the sternum
4
Q
What neurovascular structures does the clavicle protect?
A
Brachial plexus and subclavian artery
5
Q
Which muscles attach to the clavicle?
A
Pectoralis major, sternocliedomastoid and the subclavius
6
Q
What are the four landmarks of the clavicle?
A
Impression for the costoclavicular ligament
Conoid tubercle
Trapezoid line
Subclavian groove
7
Q
T/F The clavicle is susceptible to injury
A
True
8
Q
What are the fossae of the scapula?
A
Supraspinous
Infraspinous
Subscapular
Glenoid
9
Q
What are the processes of the scapula?
A
Acromion
Coracoid
10
Q
What are the borders of the scapula?
A
Superior border
Axillary border
Vertebral border
11
Q
What are the two angles of the scapula?
A
Superior and inferior angle
12
Q
What is the notch found on the scapula? Foramen?
A
Scapular (suprascapular) notch and spinoglenoid foramen (?)
13
Q
What are the three common types of arches made my the acromion process?
A
Flat, curved, hooked
14
Q
What is the tuberosity at the diaphysis of the humerus?
A
Deltoid tuberosity
15
Q
What shape is the ball of the ball and socket joint?
A
Half-sphere, thus unstable
16
Q
What is the frequent site of fracture on the humerus?
A
The neck at the proximal end
17
Q
What are the markings on the humerus bone?
A
Greater tubercle
Lesser tubercle
Deltoid tuberosity
Bicipital groove (intertubercular groove)
18
Q
What are the shoulder complex articulations?
A
Sternoclavicular joint
Acromioclavicular joint
Glenehumeral joint
Scapulothoracic articulation
19
Q
T/F The sternoclavicular joint has an articular disk
A
True
20
Q
What are the ligaments of the sternoclavicular joint?
A
Interclavicular,
Anterior and posterior sternoclavicular ligaments
Costo-clavicular
21
Q
Which clavicular joints have an articular disk?
A
Both the aromioclavicular and the sternoclavicular joints
22
Q
What are the ligaments of the acromioclavicular(AC) joint?
A
Superior and inferior AC ligaments
Trapezoid and conoid coracoclavicular ligaments
Coracoacromial ligament
23
Q
What ligament is considered the roof of the shoulder?
A
Coracoacromial ligament
24
Q
What is the ball and socket joint of the shoulder called?
A
Glenohumeral joint
25
How many degrees of freedom does the glenohumeral joint allow?
3 degrees of freedom
26
What are the ligaments of the glenohumeral (GH) joint?
Inferior, middle, and superior GH ligaments
| Coracohumeral ligament
27
What is the glenoid labrum?
Fibrocartilage disc in the shoulder joint
28
What does the glenoid labrum do?
Increases contact by 75% and acts as a bumper
29
T/F The glenoid labrum has a poor blood supply
True
30
Which tendon attaches to the glenoid labrum?
biceps tendon
31
T/F There are several bursae around the shoulder
True
32
What is the primary bursa of the shoulder? What does it do?
Subacromial bursa. Cushions rotator cuff tendons from bony structures
33
What is the bursa filled with? How does the bursa help the shoulder joint?
Filled with synovial fluid. Helps to reduce joint friction
34
What does the coracoacromial ligament and the subacromial bursa form?
They form an arch above the humeral head
35
The tendons of which two muscles lie below the coracoacromial ligament and the subacromial bursa?
Supraspinatus tendon and long head of the biceps tendon
36
What can happen if the subacromial bursa moves out laterally?
It can pinch the supraspinatus tendon and long head of the biceps tendon
37
Why is the scapulothoracic articulation not a true joint?
It lacks a ligament to body connection
38
What sort of connection is between serratus anterior (of ribs) and subscapularis muscles?
Only loose CT
39
How many degrees of elevation does the scapulothoracic articulation contribute to the 180 degrees of shoulder elevation? What joint contributes to the rest of the elevation degrees?
60 degrees. The remaining 120 degrees are contributed by the glenohumeral joint
40
Does the coracoclavicular joint have a capsule? Is it a true joint?
No capsule, but ligaments connect the coracoid process of the scapula to the clavicle. Not a true joint according to Bliven, because of not having a capsule
41
T/F The coracoclavicular joint often develops degenerative changes in elderly populations
True
42
What are the three main muscle groups of the shoulder complex?
Axioappendicular
Scapulohumeral
Arm
43
How many axioappendicular muscles are in the shoulder complex? How many scapulohumeral? How many of the arm?
10 Axioappendicular
6 Scapulohumeral
5 Arm muscles
44
How many anterior axioappendicular muscles are there? What are they?
```
4 Anterior:
Pectoralis Major
Pectoralis Minor
Subclavius
Serratus Anterior
```
45
How many origin heads does the pectoralis major have? What are they?
```
2 heads.
Clavicular head (anterior medial half surface of clavicle)
Sternal head (originates from sternum and costal cartilages)
```
46
Where does the pectoralis major insert?
Humerus
47
What does the action of pectoralis major depend on?
Depends on starting position
48
What are the two actions of pectoralis major?
Humeral adduction
| Horizontal adduction
49
Which nerves innervate pectoralis major? Pectoralis minor?
Both muscles are inntervated by the medial and lateral pectoral nerves
50
What is the origin of pectoralis minor? Insertion?
Ribs 3-5 (Sometimes rib 2 as well)
| Insertion at the coracoid process
51
What does the pectoralis minor act on?
Acts on scapula.
| Pulls shoulder girdle inferior to stabilize it
52
What is the origin of the subclavius? Insertion?
First rib.
| clavicle
53
What is the action of the subclavius muscle?
It is more of a stabilizer of the acromioclavicular joint
54
What is the innervation of the subclavius muscle?
Nerve to the subclavius
55
Where does the serratus anterior originate? Insert?
upper 8 ribs.
| scapula
56
What are the actions of serratus anterior muscle?
Holds scapula to thorax.
| Protracts the scapula
57
What is the innervation of the serratus anterior?
Long thoracic nerve
58
What is the cause of scapular winging?
Paralysis of the serratus anterior typically due to damage to the long thoracic nerve
59
What are the six (6) posterior appendicular muscles?
```
Trapezius
Latissimus Dorsi
Levator Scapulae
Rhomboid Major
Rhomboid Minor
Omohyoid
```
60
What are the attachments of the trapezius?
Cervical and thoracic spines (very general in lecture slides)
Insertion is to the scapular spine and clavicle (also very general)
61
What are the actions of the trapezius?
Scapular retraction and rotation
62
What is the innervation of the trapezius muscle?
Spinal accessory nerve (Cranial XI) and C3 & C4 (sensory)
63
What is the origin of latissimus dorsi?
lower 6 Thoracic vertebrae (T7-T12), thoracolumbar fascia, illiac crest and lower 3-4 ribs
64
What is the insertion of the latissimus dorsi?
humerus
65
What are the actions of latissimus dorsi?
Adduction, extension and internal rotation of arm
66
What is the innervation of the latissimus dorsi?
Thoracodorsal nerve
67
What action are the rhomboids (major and minor) responsible for doing to the scapula? What is the levator scapulae responsible?
For retracting the scapula
| The levator scapulae is responsible for elevating the scapula
68
Which nerve innervates all three of the following: Rhomboids (major and minor) and levator scapulae?
Dorsal scapular nerve
69
Which muscles are immediately deep to the trapezius?
Rhomboid major and minor (Rhomboid minor is above the major, despite what Bliven said in class)
70
Which muscle of the shoulder has two bellies, one of which is actually a neck muscle? What is its innervation?
Omohyoid. Ansa cervicalis of cervical plexus
71
Which two posterior muscles of the shoulder are not innvervated by the brachial plexus?
The omohyoid (ansa cervicalis of cervical plexus) and trapezius (CN XI and C3, C4)
72
What are the six scapulohumeral muscles?
```
Deltoid
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Teres major
```
73
What is the origin of the deltoid muscle? Insertion?
Clavicle, acromion, scapular spine.
| humerus
74
What are the actions of the anterior, middle, and posterior parts of the deltoid?
Anterior: flexion, abduction
Middle: Abduction
Posterior: Extension, adduction
75
What is the innervation of the deltoid muscle?
Axillary nerve
76
What are the four rotator cuff muscles? How does the attachment of these muscles differ from the two remaining scapulohumeral muscles?
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
They all attach at the neck of the humeral head. The remaining two attach further away from the proximal neck of the humerus
77
```
Which of the following six muscles are not part of the rotator cuff?
Deltoid
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Teres major
```
Deltoid and Teres major.
78
What is the origin of the supraspinatus muscle? Insertion?
scapula.
| humerus
79
What are the actions of the supraspinatus muscle?
Dynamic stabilization of glenohumeral joint. Elevation of arm.
80
What is the innervation of the supraspinatus muscle?
Suprascapular nerve
81
What is the origin of the infraspinatus muscle? What is the insertion?
Scapula.
| Humerus
82
What is the action of the infraspinatus muscle?
External rotation of arm
83
What is the innervation of the infraspinatus muscle?
Suprascapular nerve
84
What is the origin of the teres minor muscle? What is the insertion?
Scapula
| humerus
85
What is the action of the teres minor muscle?
External rotation of arm
86
What is the innervation of the teres minor muscle?
Axillary nerve
87
What is the origin of the subscapularis muscle? What is the insertion?
Subscapular fossa
| humerus
88
What is the innervation of the subscapularis muscle?
Upper and lower subscapularis nerves
89
If someone has a rotator cuff tear, which muscle is most likely to tear?
Supraspinatus.
90
T/F The rotator cuff muscles blend together with the joint capsule.
True
91
What is the origin of the teres major muscle? What is the insertion?
scapula.
| Humerus
92
What is the action of the teres major muscle?
Adduction, extension, and internal arm rotation
93
What is the innervation of the teres major muscle?
Lower subscapular nerve
94
What are the five muscles of the arm?
Biceps brachii
Brachialis
Coracobrachialis
Triceps
Anconus
95
Which three muscles of the arm are in the anterior compartment?What is their innervation?
Biceps brachii, Brachialis, Coracobrachialis
| Innervated by the musculocutaneous nerve
96
Which two muscles of the arm are in the posterior? What is their innervation?
Triceps, Anconeus
| Innervated by the radial nerve
97
What is the origin of the coracobrachialis muscle? What is the insertion?
Coracoid process.
| Humerus.
98
Which muscle has a conjoined tendon with coracobrachialis?
The short head of the biceps brachii
99
What is the action of the coracobrachialis?
Shoulder adduction and flexion
100
What is the origin of the short head of the biceps brachii? What is the insertion?
Coracoid process
| Radius
101
What is the origin of the long head of the biceps brachii? What is the insertion?
Scapula
| Radius
102
What is the action of the biceps brachii?
Flexion of arm (weak) and forearm (weakish); supination of forearm (strong)
103
What is the origin of the brachialis muscle? What is the insertion?
humerus.
| Ulna
104
What is the action of the brachialis?
Elbow flexion (strong)
105
What are the three heads of the triceps brachii?
Long head, lateral head, and medial head
106
Which one of the three triceps brachii does not originate on the humerus? Where does it originate?
Long head of triceps brachii.
| Scapula
107
Which head of the triceps is deepest? Which one crosses shoulder and elbow joints?
Medial head.
| Long head crosses shoulder and elbow joints
108
What is the action of the triceps brachii?
Main extensor of the elbow, however it can do some shoulder extension via the long head of the triceps
109
Where is the insertion of the triceps brachii?
The olecranon of the ulna
110
Which funny little triangular muscle originates from the lateral epicondyle of the humerus and inserts into the lateral surface of the olecranon and the superior part of the ulna distally?
Anconeus
111
What are the likely actions of the anconeus?
Some extension of the elbow and is also thought to hold the joint capsule out of the way during elbow extension
112
What are the three bones involved in the elbow? What are the three articulations of the elbow?
Humerus, ulna, and radius
Humero-radial joint
Humero-ulnar joint
Proximal Radioulnar joint
113
What are the two articular surfaces of the humerus at the elbow?
Capitelum (lateral) and Trochlea (medial)
114
What are three important fossae of the humerus at the elbow?
Olecranon fossa
Coronoid fossa
Radial fossa
115
What is the long bone of the elbow that decreases in size distally?
Ulna
116
What does the ulna have at the proximal end?
```
Muscles and ligaments attach
Coronoid process
Ulnar tuberosity (brachialis insertion)
Radial notch
Trochlear notch
Olecranon
```
117
What does the ulna have at the distal end?
Ulnar head - styloid process
Articulates with the ulnar notch of radius
Separated from carpal bones by the triangula fibrocartilage complex (TFCC)
118
What is the long bone of the forearm that increases in size distally?
Radius
119
What is at the proximal end of the radius?
Radial tuberosity (biceps insertion)
Cylindrical head with narrow neck
Articular fovea articulates with capitellum of humerus
Head articulates with radial notch of ulna
Annular ligament
120
What is at the proximal end of the radius?
Radial styloid process on lateral side
Palpable in snuff box
Ulnar notch
Lister's tubercle (dorsal)
121
What kind of joint is the humeroradial joint? What joint is it anatomically?
Modified hinge joint.
| Ball and socket joint anatomically
122
What actions does the humeroradial joint allow?
Allows flexion and extension of elbow
123
Which part of the humeroradial joint acts like a buttress to lateral compression?
Capitellum of the humerus
124
T/F The humeroradial joint absorbs lateral compression and rotational forces with rapid forearm movements
True
125
What ligament is at the lateral aspect of the humeroradial joint?
Radial (lateral) collateral ligament
126
What kind of force does the Radial (lateral) collateral ligament resist?
Varus (inward) force at elbow
127
Is the Radial (lateral) collateral ligament a strong ligament?
No, it is weak. Most of the lateral stability comes from joint structure
128
Which elbow joint is the true hinge joint, humeroradial or humerulnar?
Humeroulnar.
129
What does the assymetry of the trochlea of humerus result in?
Results in carrying angle (5-15 degrees away from body) of the elbow. This allows hands to swing clear of the hips as during walking
130
Which elbow ligament is the primary stabilizer for valgus (outward) stress?
Ulnar (medial) collateral ligament
131
How many bands does the ulnar (medial) collateral ligament have? What are they?
Three.
| Anterior oblique, Posterior, and Transverse bands
132
Which elbow ligament receives a lot of stress during a throwing motion?
Ulnar collateral ligament
133
What shape is the proximal radioulnar joint? What does this joint allow?
Ellipsoid. Allows pronation and supination of the forearm
134
What does the annular ligament do?
Holds radial head against ulna
135
Where does the u-shaped annular ligament originate and insert?
Originate and inserts back on unto the ulna
136
What action does the annular ligament allow?
Pronation and supination
| The distal segment acts as restraint to traction
137
How many bones are in each row of the wrist?
Four in each row
138
What are the three joints of the wrist?
Distal radioulnar joint
Radiocarpal joint
Midcarpal joint
139
What bones are in the proximal row of the carpal bones?
Scaphoid, Lunate, Triquetrium, and Pisiform
| Mnemonic: Some lovers try positions
140
What tunnel does the pisiform and hamate form?
Tunnel of Guyon (different from carpal tunnel)
141
What passes through the tunnel of Guyon?
Ulnar nerve
142
What bones are in the distal row of the carpal bones?
Trapezium, trapezoid, capitate, hamate
| Mnemonic: That they can't handle
143
What is the most commonly fractured carpal bone? Where is this bone palpable in?
```
Scaphoid bone (aka navicular)
Anatomic snuff box (radial side at base of thumb)
```
144
What are the ligaments of the hand and fingers?
Capsular ligaments.
| Ulnar and radial collateral ligaments
145
What are the three groups of muscles of the flexor compartment of the forearm? Which nerve innervates the flexors of the forearm?
Superficial, Intermediate, Deep
| All innervated by the median nerve, except one and a half muscles which are innervated by the ulnar nerve.
146
What are the four superficial group muscles of the forearm flexors?
Pronator teres,
flexor carpi radialis,
palmaris longus
flexor carpi ulnaris (ulnar innervation)
147
What is the single muscle of the intermediate group of forearm flexors?
Flexor digitorum superficialis
148
What does the flexor digitorum superficialis attach to?
Medial epicondyle of humerus
Anterior radius
Four long tendons into the middle phalanx of each of the 4 most medial fingers (2-5)
149
What is the action of the Flexor digitorum superficialis?
Flexion of proximal interphalangeal joints and metacarpal joints
150
What are the three muscles of the deep group of forearm flexors?
Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus
151
Which muscle of the deep group of forearm flexors is innervated half by the median nerve and half by the ulnar nerve?
Flexor digitorum profundus
Median nerve is to digits 2 and 3
Ulnar nerve is to digits 4 and 5
152
What are the four extensor groups of the forearm? How many muscles in each group? What nerve innervates all of them?
Lateral, medial, outcropping, and miscellaneous groups.
Three muscles are in each group.
All innervated by radial group
153
What are the three muscles of the lateral muscle group of forearm extensors?
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
154
What are the three muscles of the MEDIAL muscle group of forearm extensors?
Extensor carpi ulnaris
Extensor digitorum
Extensor digiti minimi
155
What are the three muscles of the OUTCROPPING muscle group of forearm extensors?
Extensor pollicis longus
Extensor pollicis brevis
Abductor pollicis longus
156
The movement of what finger does the outcropping muscle group control?
Thumb
157
What are the three muscles of the MISCELLANEOUS muscle group of forearm extensors?
Extensor indicis (1)
Supinator
Anconeous
Mnemonic 1 soup now
158
What is the palmar aponeurosis? Which muscle attaches to it?
It is a type of thick, tenacious fascia in the palm of the hand. Palmaris longus muscle attaches to it.
159
What is Dupuytren's Contracture?
Thickening of palmar fascia that results in the ulnar two fingers being stuck in a flexed position
160
What is the carpal tunnel formed by?
Hook of hamate and pisiform on the ulnar side and the tubercle of scaphoid and crest of trapezium on radial side
161
What are the ten structures of the carpal tunnel?
```
Flexor digitorum superficialis (4 tendons)
Flexor digitorum profundus (4 tendons)
Flexor pollicis longus (1 tendon)
Median nerve (1)
```
162
What nerve is involved in the carpal tunnel?
Median
163
What are the tendons of the hand covered in?
Bursae from the synovial sheath
164
What is tenosynovitis?
Inflamed/irritated tendon in the synovial sheath
165
What is carpal tunnel syndrome?
Distention (swelling) of synovial sheath around tendons caused by infection or irritation
166
What can happen if synovial sheath pressure is not relieved in someone suffering from carpal tunnel syndrome?
Tendons could die. Median nerve can suffer damage in short time
167
What is the trigger finger condition?
Finger gets stuck because a swollen tendon cannot slide through the pulleys
168
What are the three groups of hand muscles?
Thenar eminence
Hypothenar eminence
Muscles of digits 2-5
169
What nerve innervates all muscles of the hand, except four)?
Ulnar
170
What four muscles of the hand are not innervated by the ulnar nerve?
Superficial head of flexor pollicis brevis
Abductor pollicis brevis
Opponens pollicis
Lateral two lumbricals
171
What are the four muscles of the thenar eminence group of hand muscles?
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Adductor pollicis
172
What are the three muscles of the hypothenar eminence group of hand muscles?
Abductor digiti minimi
Flexor digiti minimi
Opponens digiti minimi
173
What are the muscles of digits 2-5?
Lumbricals
Palmar interossei
Dorsal interossei
