Lecture 29 Shoulder Flashcards
1
Q
What does the brachial plexus consist of?
A
- ventral rami of C5, C6, C7, C8, T1
2
Q
what provides the motor innervation to the trapezius?
A
- CN11
3
Q
What provides the sensory innervation to the trapezius?
A
- C3 and 4
4
Q
What innervates the latissimus dorsi?
A
- thoracodorsal nerve
5
Q
What makes up layer one of posterio axio appendicular muscles?
A
- trapezius and latissimus dorsi
6
Q
What makes up layer 2 of posterio axio appendicular muscles?
A
- levator scapulae
- rhomboid minor
- rhomboid major
7
Q
What makes up layer 3 of posterior axio-appendicular muscles
A
- serratus posterior superior and inferior
8
Q
what nerve innerates the rhomboid major and minor?
A
- dorsal scapular nerve
9
Q
What nerves innervate levator scapulae?
A
- 3rd and 4th cervical spinal nerves and dorsal scapular nerve
10
Q
What is the proximal attachment of the trapezius?
A
- external occipital protuberance of skull, nuchal ligament, spinous processes of C7-T12 vertebrae
11
Q
What is the distal attachment of the trapezius?
A
- lateral third of clavicle (anterior), acromion, and spine of scapula
12
Q
What is the function of the trapezius?
A
- elevates, depresses, and retracts scapula, rotates glenoid fossa superiorly
13
Q
What is the motor innervation of the trapezius?
A
- CN 11
14
Q
What is the sensory innervation of trapezius?
A
- C3 and C4
15
Q
Where is the anterior attachment of trapezius?
A
- lateral 1/3 of clavicle
16
Q
What is the posterior attachment of trapezius?
A
- spine and acromion of scapula
17
Q
what movements can the trapezius facilitate on the scapula?
A
- elevation/depression
- retraction
- upward rotation
18
Q
What is the proximal attachment of the latissimus dorsi?
A
- spinous processes of inferior 6 thoracic vertebrae, thoracolumbar fascia, iliac crest and inferior 3 ribs
19
Q
What is the distal attachment of the latissimus dorsi?
A
- floor of intertubercular sulcus (bicipital groove) of humerus
20
Q
_____ muscle extends, adducts, and medially rotates the humerus; raises torso towards arms during climbing
A
- latissimus dorsi
21
Q
What innervates the latissimus dorsi?
A
- thoracodorsal nerve (from brahcial plexus)
22
Q
What are the actions of the latissimus dorsi on the arm?
A
- extends humerus
- adducts humerus
- medially rotates humerus
23
Q
How does the latissimus dorsi act during a pull up?
A
- raises torso towards arms when climbinh or doing a pull up (raises or pulls torso up when hands/arm is fixed)
24
Q
What does the latissimus dorsi do when the torso is fixed?
A
- pulls humerus down
25
Where is the origin of rhomboid major and minor?
- spinous process of C7-T5
26
Where is the proximal attachment/origin of rhomboid major?
- T2-T5
27
Where is the proximal attachment/origin of rhomboid minor?
- C7-T1
| - nuchal ligament
28
Where is the distal attachment of r. major?
- medial border of scapula from level of spine to inferior angle
29
Where is the distal attachment for r. minor?
- medial end of scapular spine
30
what are the actions of r. minor and major?
- BOTH retract, elevate, and rotate scapula downward as well as fix it to thoracic wall
31
What innervates the r. major and minor muscle?
- Dorsal scapular nerve
32
What are the main muscles in shoulder shrug?
- trapezius
| - levator scapulae
33
Where is the proximal attachment of the levator scapulae?
- posterior tubercules of transverse processes of C1-4
34
Where is the distal attachment of the levator scapulae?
- medial border of scapular, superior part of scapular spine
35
______ muscle elevates scapula and tilts glenoid fossa inferiorly by rotating scapula
- levator scapulae
36
What innervates the levator scapulae?
- dorsal scapular nerve and cervical spinal nerves (C3-C4)
37
Can the levator scapulae retract the scapula?
- NOPE
38
What actions do the rhomboid major and minor have on the scapula?
- elevate
- retract
- downward rotation
39
What actions does the levator scapulae have on the scapula?
- elevates
| - downward rotation
40
What innervates the pec major, minor, subclavius, and serratus anterior?
- brachial plexus
41
What is the proximal attachment of the pectoralis major?
- clavicular and sternocostal attachments
- - ant. surface of medial 1/2 of clavicle
- an. surface of sternum and superior 6 costal cartilages
42
What is the distal attachment of the pec. major?
- lateral lip of intertubercular sulcus
43
what are the actions of the pec major?
- adducts and medially rotates humerus
- draws scapula anteriorly and inferiorly (via clavicle)
- clavicular portion flexes humerus
- sternal portion can extend humerus while it is in this flexed position
44
What portion of the pec major extends humerus?
- sternal portion
45
What portion of pec major flexes humerus?
- clavicular portion
46
What muscle is innervated by the lateral and medial pectoral nerves?
- pectoralis major
47
Where does the pectoralis minor attach proximally?
- 3rd - 5th ribs near costal cartilages
48
Where is the distal attachment of the pec minor?
- coracoid process of scapula
49
What are the actions of the pec minor?
- stabilizes scapula by pulling it anteriorly and inferiorly against posterior thoracic wall
50
What innervates the pec minor?
- medial pectoral nerve (usually pierced by this nerve)
51
Where is the proximal attachment of the serratus anterior?
- external surfaces of lateral parts of ribes 1-9
52
Where is the distal attachment of serratus anterior?
- anterior surface of medial border of scapula
53
What are the actions of serratus anterior?
- protracts scapula
- rotates scapula
- holds scapula against thorax
54
What innervates the serratus anterior?
- long thoracic nerve
55
What are the actions of the serratus anterior on scapula?
- protraction and upward rotation of scapula
- allows full abduction of humerus; arms raised above head
- holds scapula against thorax
56
What causes a medial wining of scapula?
- damage to long thoracic nerve
- serratus anterior affected
- protrudes
57
Where is the proximal attachment of subclavius?
- junction of 1st rib and its costal cartilage
58
Where is the distal attachment of subclavius?
- inferior surface of middle 1/3 of clavicle
59
What does the subclavius do?
- anchors and depresses clavicle
| - does not move it stabilizes clavicle
60
what is the innervation of subclavius?
- nerve to subclavius
| - off of superior trunk
