Lecture 8 Flashcards
(30 cards)
Describe the sensory nerve distribution to the shoulder that is contributed by the suprascapular nerves.
come from the cervical plexus (C3-4) to supply the skin over the clavicle and over the superior-lateral aspect of the pectoralis major
Describe the sensory nerve distribution to the shoulder that is contributed by the cutaneous branches of the dorsal rami.
supply skin on either side of the midline of the back ; penetrate deep and superficial back muscles
Describe articulating bones, structural and functional classification, and ligaments of the sternoclavicular joint.
Articulating bones:
Articular notch on sternum
Sternal end of the clavicle
First costal cartilage
Structural Type: synovial
Shallow, saddle
Articular disc
Functional Type: Diarthrotic ; Triaxial Ligaments: Anterior/Posterior sternoclavicular ligaments Costoclavicular ligament Interclavicular ligament
Describe articulating bones, structural and functional classification, and ligaments of the acromioclavicular joint.
Articulating bones:
Concave facet on acromion process (scapula)
Convex facet on lateral end of clavicle
Structural Type: Synovial ; plane
Functional Type:
Triaxial ; Diarthrotic (gliding and rotation of scapula on clavicle)
Ligaments:
Acromioclavicular
Coracoclavicular (trapezoid and conoid ligaments)
Describe articulating bones, structural and functional classification, and ligaments of the glenohumoral joint.
Articulating bones:
Glenoid fossa of scapula
Head of humerous
Structural Type: Synovial ; ball and socket
Functional Type:
• Triaxial
• Diarthrotic
• Up to 1 inch of passive distraction
Ligaments:
Glenohumoral (superior, middle, and inferior portions)
Coracoacromial
Describe innervation, attachments, and actions of the Latissimus Dorsi Muscle
Innervation: Thoracodorsal Nerve (C6-C8)
Proximal Attachments: Spines of TV7-12 and lumbar sacral vertebrae via thoracolumbar fascia ; posterior iliac crest and ribs 9-12
Distal Attachments: Floor of intertubercular (bicipital) groove
Actions: extends, adducts, and internally rotates the humerus
Describe innervation, attachments, and actions of the Levator scapulae muscle
Innervation: C3-C5 and Dorsal scapular nerve (from C5)
Proximal Attachments: Transverse processes of CV1-4
Distal Attachments: Medial border of scapula at level of and above the spine
Actions: Elevates scapula at the superior medial angle and assists in the downward rotation of the scapula
Describe innervation, attachments, and actions of the Rhomboid muscles
Innervation: Dorsal Scapular nerve (C5)
Proximal Attachments: Spines of CV 7 and TV 1 and lower ligamentum nuchae (minor)
Distal Attachments: medial border of scapula from level of the spine inferiorly to the inferior angle
Actions: Adducts scapula ; rotates glenoid fossa downward ; fixes scapula to thoracic wall
Describe innervation, attachments, and actions of the subclavious muscles
Innervation: Nerve to subclavious (C5, C6)
Proximal Attachments: Junction of 1st rib and costal cartilage 1
Distal Attachments: Inferior surface of middle third of clavicle
Actions: anchors and depresses clavicle
Describe innervation, attachments, and actions of the pectoralis major muscles.
Innervation: lateral and medial pectoral nerves ; Clavicular head (C5, C6) ; Sternal head (C7, C8, T1)
Proximal Attachments: anterior surface of the medial half of the clavicle ; anterior surface of the manubrium/body of the sternum ; costal cartilages (2-6)
Distal Attachments: Crest of the greater tubercle of the humerus
Actions: adducts and medially rotates the humerus ; flexes clavicular head ; extends sternal head from flexed position ; draws scapula anteriorly and inferiorly (bc of it’s connection to the clavicle)
Describe innervation, attachments, and actions of the pectoralis minor muscles
Innervation: MP nerve (C8, T1)
Proximal Attachments: Ribs 3-5 near costal cartilages
Distal Attachments: Coracoid process
Actions: Draws scapula inferiorly and anteriorly against thoracic wall
Describe innervation, attachments, and actions of the serratus anterior muscles
Innervation: LTN (C5-C7)
Proximal Attachments: external surface of the lateral parts of ribs1-8(9)
Distal Attachments: Anterior surface of media border of scapula
Actions: Protracts, fixes, and rotates scapula
Describe innervation, attachments, and actions of the trapezius complex muscles
Innervation: CN XI, C3, and C4
Proximal Attachments:
external occipital protuberance, superior nuchal line, ligamentum nuchae, and spinous process of CV7
• Spinous processes of TV1-6
• Spinous processes of TV7-12
Distal Attachments
Lateral 3rd of clavicle
Acromion and crest of scapular spine
Tubercle of scapular spine
Actions: elevates, adducts (retracts), and depresses scapula
Describe innervation, attachments, and actions of the deltoid muscles
Innervation: Axillary Nerve (C5, C6)
Proximal Attachments: Lateral 1/3rd of clavicle, acromion, and scapula
Distal Attachments: Deltoid tuberosity of humerus
Actions: Flexes, medially and laterally rotates, abducts, and extends humerus
Define “snubbing” in relation to movement of the humerus.
Pulling the humerus into the glenoid fossa, basically preventing it from coming out of the joint
List the 4 rotator cuff muscles
Supraspinatous
Infraspinatous
Teres Minor
Subscapularis
“SITS”
Identify the innervation and spinal cord levels, proximal/distal attachment(s) , actions, and vascular supply for the supraspinatous
Innervation and spinal cord levels: Suprascapular Nerve (C4, C5, C6)
Proximal attachment: Supraspinatous fossa of the scapula
Distal attachment: Superior facet of the greater tubercle of the humerus
Action(s): Works with deltoid in abduction of the humerus; acts with other rotator cuff muscles to stabilize the shoulder joint
Vascular supply: Suprascapular Artery
Identify the innervation and spinal cord levels, proximal/distal attachment(s) , actions, and vascular supply for the infraspinatous.
Innervation and spinal cord levels: Supracapular Nerve (C5, C6)
Proximal attachment: Infraspinatous fossa of the scapula
Distal attachment: Middle facet of the greater tubercle of the humerus
Action(s): Laterally rotates the humerus and helps hold the humeral head in place
Vascular supply: Suprascapular artery
Identify the innervation and spinal cord levels, proximal/distal attachment(s) , actions, and vascular supply for the teres minor
Innervation and spinal cord levels: Axillary Nerve (C5,C6)
Proximal attachment: Middle part of the lateral border of the scapula
Distal attachment: Inferior facet of the greater tubercle of the humerus
Action(s): Laterally rotates the humerus and helps hold the humeral head in place
Vascular supply: Circumflex scapular artery
Identify the innervation and spinal cord levels, proximal/distal attachment(s) , actions, and vascular supply for the subscapularis.
Innervation and spinal cord levels: Upper and lower subscapular nerves (C5, C6, C7)
Proximal attachment: Subscapular fossa of scapula (anterior surface)
Distal attachment: Lesser tubercle of the humerus
Action(s): medially rotates and adducts the humerus ; helps hold humeral head in place
Vascular supply: suprascapular artery
Explain how the upper and lower trapezius work to form a force couple that is capable of rotating the scapula
The upper and lower trapezius work to form a force couple that upwardly rotates the scapula
Describe and explain the function of the glenoid labrum.
The glenoid labrum is a fibrocartilage meniscus that serves to deepen the articulating surface of the glenoid fossa
Describe and explain the function of the Anterior/Posterior sternoclavicular ligaments:
reinforce the capsule and check anterior-posterior movement of the clavicular head
Describe and explain the function of the Costoclavicular ligament:
serves as the axis for elevation and depression and for the protraction and retraction of the shoulder
It is the main check for elevation
