Lecture 8 Flashcards
(51 cards)
1
Q
What are the two sensory nerves that supply the shoulder?
A
The supraclavicular and the cutaneous branches of the dorsal rami
2
Q
What does the supraclavicular nerve innervate?
A
From the c3/c4
innervates the skin over the clavicle and superior lateral aspect of the pectoralis major
3
Q
What does the cutaneous branch of the dorsal rami innervate?
A
the skin on either side of the midline of the back
4
Q
What are the articulating bones of the sternoclavicular joint?
A
- articular notch on the sternum
- sternal end of the clavicle
- first costal cartilage
5
Q
What are the ligaments that are involved in the sternoclavicular joint?
A
- anterior and posterior sternoclavicular ligament (ant movements of the clavicular head)
- costoclavicular ligament (elevation and depression, pro and retraction, main check elevation
- interclavicular
6
Q
What are the functional types of the sternoclavicular joint?
A
diarthrotic and triaxial
7
Q
What is the structural type of the sternoclavicular join?
A
- synovial
- shallow saddle
- articular disc (attached to superior clavicle and manubirum and the first costal cartilage)
8
Q
What are the articulating bones of the acromioclavicular joint?
A
- concave facet on the acromion process
2. concave facet on the lateral end of the clavicle
9
Q
What are the structural types of the acromioclavicular joint?
A
- synovial
2. plane
10
Q
What are the functional types of the acromioclavicular joint?
A
triaxial
diarthrotic
gliding and rotation of the scapula on the clavicle
11
Q
What are the movements of the acromioclavicular joint?
A
- scapular rotation (AP axis)
- winging of the vertebral border of the scapula (vertical axis)
- tipping of the interior angle of the scapula (coronal axis)
12
Q
What are the ligaments that are involved in the acromioclavicular joint?
A
- acromioclavicular- superior and inferior movement, reinforce the joint capsule
- coracoclavicular ligament (trapezoid and conoid)
13
Q
What are the articulating bones of the glenohumeral joint?
A
- glenoid fossa of the scapula
2. head of the humerus
14
Q
What are the structural types of the glenohumeral joint?
A
- synovial
2. ball and socket
15
Q
What are the functional types of the glenohumeral joint?
A
- triaxial
- diarthrotic
- flexion and extension
- abduction and adduction
- circumduction
- lateral and medial rotation
16
Q
What are the ligaments that are involved in the glenohumeral joint?
A
- glenohumeral
- coracohumeral
- coracoacromial
17
Q
What are the movements of the glenohumeral joint?
A
flexion and extension of the brachium
abduction and adduction of the brachium
lateral and medial rotation of the brachium
(triaxial)
18
Q
Describe the following muscle in terms of
- origin/insertion (or prod and distal attachments)
- action
- innervation
SUBCLAVIUS
A
- o-junction of the first rib and the first costal cartilage
insertion-inferior surface of the middle third of the clavicle - action: anchors and depresses the clavicle
- innervation- nerve to the subclavius (c5/c6)
19
Q
Describe the following muscle in terms of
1. origin/insertion (or prod and distal attachments)
2. action
3. innervation
PECT MAJOR
A
- origin:
-anterior surface of the medial half of the clavicle
-anterior surface of the manubrium and body of the sternum
-aponeurosis of the external oblique
insertion:
-lateral lip of the inter tubercular groove and crease of the greater tubercle - action:
-adducts and medial rotates the arm (humerus)
-extends the arm
-flexes the arm
-draws the scapula inferiorly and anteriorly - innervation:
-lateral and medial pectoral nerves
clavicular head (c5/c6)
sternal head (c7/c8/t1) `
20
Q
Describe the following muscle in terms of
- origin/insertion (or prod and distal attachments)
- action
- innervation
PECT MINOR
A
- origin- ribs near the 3-5 costal cartilage
insertion- coracoid process - action: draws the scapula inferiorly and anteriorly against thoracic wall
- innervation: medial pectoral nerve
21
Q
Describe the following muscle in terms of
- origin/insertion (or prod and distal attachments)
- action
- innervation
SERRATUS ANTERIOR
A
- proximal attachment: external surface of the lateral parts of ribs 1-3
distal attachment: anterior surface of the medial border of the scapula - action: protracts the scapula, fixes the the thoracic wall, rotates the scapula
- innervation: long thoracic (5,6,7)
22
Q
Describe the following muscle in terms of
- origin/insertion (or prod and distal attachments)
- action
- innervation
TRAPEZIUS COMPLEX
A
- proximal attachment:
upper: external occipital protuberance, superior nuchal line and ligament nuclear, spinous process c7
middle: spinous process TV 1-6
lower: spinous process TV 7-12
distal attachment:
upper: lateral third of the clavicle
middle: acromion and the crest of the scapular spine
lower: tubercle of the scapula - action:
upper: elevates the scapula (shrug)
middle: adducts (retracts) the scapula
lower: depresses the scapula
upper and lower work together to rotate the scapula - innervation: CN XI and the ventral rami of the 3rd and 4th cervical nerves
23
Q
Describe the following muscle in terms of
- origin/insertion (or prod and distal attachments)
- action
- innervation
LATISSIMUS DORSI
A
- proximal attachment:
-spines of the TV 7-12 and lumbar and sacral vertebrae via the thoracolumbar fascia; posterior iliac crest and ribs 9-12
distal attachment:
-floor of the inter tubercular groove - action: extends, adducts, and internally rotates the humerus
- innervation: thoracodorsal nerve (c6-c8)
24
Q
Describe the following muscle in terms of
- origin/insertion (or prod and distal attachments)
- action
- innervation
- blood
LEVATOR SCAPULAE
A
- proximal attachment: transverse process CV 1-4
distal attachment: medial border of the scapula at the level above the spine - action: elevates the scapula at the superior angle and assists in the downward rotation of the scapula
- innervation: cervical nerves (c3-c5) and the dorsal scapular nerve
- blood: dorsal scapular artery
25
Describe the following muscle in terms of
1. origin/insertion (or prod and distal attachments)
2. action
3. innervation
4. blood
RHOMBOID MAJOR
1. proximal- spines of TV 2-4 (sometimes 5)
distal: medial border of the scapula from the spine inferiorly to the inferior angle
2. action: adducts the scapula; rotates the glenoid process and the fossa down, fixes the scapula to the thoracic wall
3. innervation: dorsal scapular nerve
4. blood: dorsal scapular artery
26
Describe the following muscle in terms of
1. origin/insertion (or prod and distal attachments)
2. action
3. innervation
4. blood
RHOMBOID MINOR
1. proximal attachment: spines of the CV7 and TV1 and the lower end of the ligaments nuchae
distal: medial border of the scapula from the spine inferiorly to the inferior angle
2. action: adducts the scapula; rotates the glenoid process and the fossa down, fixes the scapula to the thoracic wall
3. innervation: dorsal scapular nerve
4. blood: dorsal scapular artery
27
Describe the following muscle in terms of
1. origin/insertion (or prod and distal attachments)
2. action
3. innervation
4. blood
DELTOID
1. proximal: lateral 1.3 of the clavicle; acromion and spinal scapulae
distal: deltoid tuberosity of the humerus
2. action: flexes, medially rotates, abducts, extends, and laterally rotates the humerus
3. innervation: axillary nerve (C5C6)
4. blood: deltoid branch of the thoracoacromial artery
28
What muscles are in charge of elevating the scapula?
Levator scapulae and the rhomboids
29
What muscles are in charge of depressing the scapula?
lat dorsi
30
What muscles are in charge of scapular abduction?
serratus anterior
31
What are the muscles that are in charge of upwards rotation of the scapula?
serratus anterior and the upper and lower trapezius
32
What are the muscles that are in charge of downwards rotation of the scapula?
rhomboid and the levator scapulae
33
What are the muscles that are in charge of the abduction of the shoulder?
mid deltoids and the biceps with the assist
34
Describe the movement of the scapulothoracic joint
sliding of the scapula against the thoracic wall
35
What are the 3 components of the coracoacromial arch?
1. acromion process
2. coracoid process
3. coracoacromial ligament
36
What is the function of the coracoacromial joint?
to prevent superior dislocation of the humeral head and protect it from a blow from above
37
What are the 4 rotator cuff muscles?
1. supraspinatus
2. infraspinatus
3. teres minor
4. subscapularis
38
Describe the following muscle in terms of
1. origin/insertion (or prod and distal attachments)
2. action
3. innervation
4. blood
SUPRASPINATUS
1. proximal: supraspinous fossa of the scapula
distal: superior facet of the greater tubercle of the humerus
2. works with the deltoid in the abduction of the humerus, acts with the others to stabilize the joints
3. innervation: supra scapular nerve
4. blood: suprascapular artery
39
Describe the following muscle in terms of
1. origin/insertion (or prod and distal attachments)
2. action
3. innervation
4. blood
INFRASPINATUS
1. proximal: infraspinatus fossa of the clavicle
distal: middle facet of the greater tubercle of the humerus
2. action: lateral rotates the humerus; holds the humerus head in place
3. innervation: suprascapular nerve (c5/c6)
4. blood: suprascapular artery
40
Describe the following muscle in terms of
1. origin/insertion (or prod and distal attachments)
2. action
3. innervation
4. blood
TERES MINOR
1. proximal attachment: middle part of the lateral border of the scapula
distal: inferior facet of the greater tubercle of the humerus
2. action: laterally rotates the humerus; holds the humerus in place
3. innervation: axillary nerve (c5/c6)
4. blood: circumflex scapular artery
41
Describe the following muscle in terms of
1. origin/insertion (or prod and distal attachments)
2. action
3. innervation
4. blood
SUBSCAPULARIS
1. proximal: subscapular fossa of the scapula
distal: lesser tubercle of the humerus
2. action: medially rotates and adducts the humerus, hold the humerus head in place
3. innervation: upper and lower subscapular nerves (c5,c6,c7)
4. blood: suprascapular artery
42
Describe the following muscle in terms of
1. origin/insertion (or prod and distal attachments)
2. action
3. innervation
4. blood
TERES MAJOR
1. Proximal: posterior surface of inferior angle of scapula
Distal: medial lip of intertubercular (bicipital) groove of humerus
2. Action: adducts and medially rotates humerus
3. Innervation: lower subscapular nerve (C5,C6)
4. Blood: circumflex scapular artery
43
Shoulder Complex Components
Scapulothoracic joint, coracoacromial arch, and subacromial/subdeltoid bursae
44
What are the boundaries of the quadrilateral space?
Inferior glenohumeral capsule, teres major, triceps longus, surgical neck of humerus
45
What are the contents of the quadrilateral space?
Axillary nerve and posterior circumflex humeral artery
46
What are the ligaments of the shoulder complex?
Anterior/posterior sternoclavicular ligaments, costoclavicular ligament, superior and inferior acromioclavicular ligaments, and coracoclavicular ligament
47
What is the range of motion for the shoulder and how much is contributed by each joint?
Full abduction of 180 degrees; 120 contributed by glenohumeral joint, 60 contributed by scapulothoracic movement (40 by sternoclavicular joint and 20 by acromioclavicular joint)
48
What are the steps in arm abduction?
1. Movement of scapula
2. Snubbing of head of humerus into glenoid fossa
3. First few degrees of abduction
4. External rotation of humerus
49
Which nerve is injured in deltoid paralysis?
Axillary nerve
50
Which nerve is injured in serratus anterior paralysis?
long thoracic nerve
51
Which muscle is most often torn when injuring the rotator cuff?
Supraspinatus muscle
