Lecture 14: UE pt 2

Question 1

Name the 5 MSK sections of the UE

Answer 1

1) Shoulder complex
2) Axilla: brachial plexus, vessels, lymphatics
3) Arm
4) Forearm
5) Wrist and Hand

Question 2

1) What are the two bones of the pectoral (shoulder) girdle?
2) Is it incomplete? Explain.

Answer 2

1) Scapula & clavicle
2) Incomplete posteriorly; muscular articulation.
-Completed anteriorly at SC joint

Question 3

List the 3 shoulder “joints”

Answer 3

1) Scapulothoracic muscle articulation
2) Glenohumeral/ shoulder joint
3) Acromioclavicular/ AC joint

Question 4

1) What does the pectoral group do?
2) What are the 4 members of this group?

Answer 4

1) Move the pectoral girdle
2) Pectoralis major and minor, subclavius, serratus anterior

Question 5

Deltopectoral groove borders the clavipectoral triangle for ___________ vein. to join the axillary v

Answer 5

cephalic vein.

Question 6

1) What muscle covers superior anterior thorax?
2) List the 3 parts of its medial attachments and which inferiorly forms the ant. axillary fold

Answer 6

1) Pectoralis major
2) Clavicular head
-Sternocostal head
-Abdominal part: inferiorly forms anterior axillary fold

Question 7

1) Where is the lateral attachment of the pectoralis major?
2) What innervates the pec. major?

Answer 7

1) Lateral lip of intertubercular groove
2) Pectoral nerves

Question 8

1) What are the two primary jobs of the pectoralis major?
2) What two things does it assist in? Via what parts?

Answer 8

1) ADDucts and medially rotates shoulder
2) Forward flexion via clavicular head
-Extension via abdominal part

Question 9

1) Where does the pectoralis minor lie? (layers-wise)
2) Where does it go to and from?
3) What does it stabilize and what innervates it?

Answer 9

1) Anterior wall of axilla
2) Medial attachment at thoracic wall (ribs 2-5) > attach. at coracoid process of scapula
3) Scapula; pectoral n.

Question 10

What 3 things can you find at the coracoid process?

Answer 10

1) Pec. minor
2) Short head [of] biceps
3) Coracobrachialis

Question 11

1) Describe where the subclavius muscle is and runs to and from.
2) What innervates the subclavius?

Answer 11

1) Almost horizontal; medial from rib 1, to lateral on inf. clavicle
2) Subclavian n.

Question 12

1) What does the subclavius muscle do in the event of a clavicle Fx?
2) What does it tend to favor and override?

Answer 12

1) Provides some protection to underlying structures
2) Tends to favor distal fracture; override proximal fracture

Question 13

1) Where does the serratus anterior go to and from?
2) What does it form?
3) What condition does nerve injury result in?

Answer 13

1) Overlies lateral thorax (rib 2-9 lateral aspect) to medial scapular margin
2) Medial wall of axilla
3) Winging scapula

Question 14

1) What does the serratus anterior anchor? What does this accomplish?
2) What innervates it?

Answer 14

1) Scapula to posterior thorax, thereby providing fixed point for movement of arm
2) Long thoracic n.

Question 15

1) “Winging scapula” is related to the dysfunction of what muscle?
2) What are the two potential causes of this dysfunction?

Answer 15

1) Serratus anterior
2) Long thoracic nerve injury or muscle injury

Question 16

What are the two groups of posterior axio-appendicular muscles? (extrinsic back muscles)
Include the two members of each group

Answer 16

1) Superficial posterior: Trapezius and latissimus dorsi
2) Deep posterior: Levator scapulae and rhomboids

Question 17

List the 3 parts of the trapezius

Answer 17

1) Descending (superior)
2) Middle
3) Ascending (inferior)

Question 18

What posterior muscle does direct attachment of pectoral girdle to trunk?

Answer 18

Trapezius

Question 19

1) Describe how the trapezius attaches to the midline
2) Describe how it attaches to the lateral side

Answer 19

1) Midline from occipital protuberance to spinous processes of T12
2) Lateral 1/3 of clavicle, acromion, and spine of scapula

Question 20

1) What innervates the trapezius with motor?
2) What does weakness in this muscle cause?

Answer 20

1) Spinal Accessory n., CN XI
2) Drooping shoulder

Question 21

List what each part of the trapezius muscle does

Answer 21

1) Descending: elevates scapula
2) Middle: pulls it back
3) Ascending: depresses scapula + lowers shoulders

Question 22

1) Where does the latissimus run to and from?
2) What nerve innervates it?
3) What fold does the latissimus form? What else forms this fold?

Answer 22

1) Trunk to humerus on medial lip of intertubercular groove
2) Thoracodorsal n.
3) Posterior axillar fold; teres major m.

Question 23

1) What does the latissimus dorsi act on?
2) What does it do?

Answer 23

1) Directly on the GH (shoulder)joint
2) ADDucts humerus from over head position (pull down in gym)

Question 24

1) What is the medial attachment of the levator scapulae muscles?
2) What is the lateral attachment?

Answer 24

1) Posterior tubercles of transverse processes of upper C-vertebrae
2) To just below the superior angle of scapula

Question 25

What innervates the levator scapulae muscles?

Answer 25

Dorsal scapular n.

Question 26

1) The levator scapulae acts with the _________________ muscle to elevate scapula. 2) What effects does the levator scapulae have on the neck?

Answer 26

1) Descending (superior) trapezius m. 2) Bilaterally extend and unilaterally side flex

Question 27

1) What are the both the major and minor rhomboids deep to? 2) Where do they run to/ from? 3) What nerve innervates them?

Answer 27

1) Deep to trapezius 2) Midline @ vertebral spinous processes to medial border of scapula (C7-T5) 3) Dorsal scapular n.

Question 28

1) What do the rhomboids do? 2) What do they assist in? 3) Give an example of when these muscles are used

Answer 28

1) Retract and rotate scapula (with levator scapulae) depresses glenoid cavity 2) Assist serratus anterior in fixing & holding scapula against thoracic wall 3) Rowing in the gym

Question 29

[Nerves of the UE] What does each innervate?: 1) Dorsal scapular n 2) Thoracodorsal n. 3) Long thoracic n. 4) Spinal accessory n. ***Important****

Answer 29

1) Rhomboids, levator scapulae 2) Latissimus dorsi 3) Serratus anterior 4) Trapezius

Question 30

[Nerves of the UE] What innervates each of the following?: 1) Rhomboids & levator scapulae 2) Latissimus dorsi 3) Serratus anterior 4) Trapezius ***Important***

Answer 30

1) Dorsal scapular n 2) Thoracodorsal n. 3) Long thoracic n. 4) Spinal accessory n.

Question 31

List the 6 scapulohumeral muscles; incl. which are rotator cuff muscles

Answer 31

1) Deltoid 2) Teres major 3) Supraspinatus* 4) Infraspinatus* 5) Teres minor* 6) Subscapularis* * SITS = rotator cuff muscles

Question 32

1) What are the 3 parts of the deltoid that act separately or together? 2) What is their action together as the deltoid? When does this occur? 3) What nerve innervates the deltoid?

Answer 32

1) Spinal (scapula) part, acromial (scapula) part, clavicular part 2) ABDuct shoulder; fully involved after 1st 15 degrees ABD 3) Axillary n.

Question 33

1) Where does the teres major come from medially? 2) Where does it go laterally? What muscle is this just posterior to?

Answer 33

1) Inf. lateral border & inf. angle of scapula 3) To medial lip of intertubercular sulcus -Latissimus dorsi m.

Question 34

1) What does the teres major do? 2) What does it assist in? What 2 other things assist in this? 3) What nerve innervates teres major?

Answer 34

1) ADDucts and internally rotates arm 2) Stabilizing shoulder joint during movement; rotator cuff mm. and deltoids 3) Lower subscapular n.

Question 35

1) What do the rotator cuff muscles form? 2) What does it insert on? 3) What do the tendons blend with?

Answer 35

1) Musculocutaneous rotator cuff around shoulder joint 2) (Posterior aspect of) greater tubercle 3) Joint capsule

Question 36

What also assists the deltoid w ABduction of the arm What part does it assist in?

Answer 36

Supraspinatus m.; initial 15-degrees

Question 37

Of the rotator cuff muscles: 1) What does the suprascapular nerve innervate? 2) What does the axillary n. innervate? 3) What does the subscapular n innervate?

Answer 37

1) (S)upraspinatus & (I)nfraspinatus) 2) (T)eres minor 3) (S)ubscapularis

Question 38

1) What makes up the anterior axillary fold? 2) What abt the posterior axillary fold?

Answer 38

1) Lat. edge of the pectoralis major m. 2) Lat. edges of the latissimus dorsi and teres major.

Question 39

What 3 nerves innervate the rotator cuff muscles?

Answer 39

1) Suprascapular n. - SI 2) Axillary n. - T 3) Subscapular n. – S