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Anatomy Exam 2 > Lecture 8 > Flashcards

Lecture 8 Flashcards

Shoulder Complex and Joint

1
Q

Deltopectoral triangle boundaries

A

-Ant border of deltoid -Superior border of pec major -middle third of clavicle

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2
Q

Deltopectoral triangle contents

A

cephalic v deltopectoral lymph nodes deltoid branch of thoracoacromial artery

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3
Q

Clavipectoral fascia 1) invests what muscles? 2) attached to clavicle by ______ 3) Pierced by: 4) Becomes _________ of axilla

A

1) subclavius and pectoralis minor 2) anterior thoracic wall 3) Cephalic v, thoracoacromial a, lateral pectoral n 4) suspensory ligament

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4
Q

What provides sensory supply to shoulder complex?

A

Supraclavicular nerves => C3 - C4 (cervical plexus) Cutaneous branches of DORSAL rami

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5
Q

What are the (1)articulating bones, (2)structural and (3)functional classification, and (4)ligaments of the sternoclavicular joint?

A

1) Articular notch of sternum, sternal end of clavicle, first costal cartilage 2) Synovial, shallow/saddle, articular disc (fibrocartilage meniscus) 3) diarthrotic, triaxial 4) - Ant/post Stcl (sternoclavicular), Cocl (costoclavicular), Incl (interclavicular)

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6
Q

What are the (1)articulating bones, (2)structural and (3)functional classification, and (4)ligaments of the acromioclavicular joint?

A

1) Acromion process, lateral end of clavicle 2) synovial, plane (joint surfaces are flat) 3) triaxial, diarthrotic, gliding and roation of scapula on clavicle 4) Accl (acromioclavicular), Cocl (coracoclavicular) (Trap, Con)

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7
Q

What are the (1)articulating bones, (2)structural and (3)functional classification, and (4)ligaments of the glenohumeral joint?

A

1) Glenoid fossa of scapula, head of humerus 2) Synovial, ball and socket (3 degrees of freedom) 3) Triaxial, diarthrotic - Flex/Exten, Abd/Adduction, Circumduction, Lat/med rotation of arm 4) Glenohumeral (SGHL, MGHL, IGHL), CCL (coracohumeral), CAL (coracoacromial)

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8
Q

What structure is the glenoid labrum associated with?

A

Glenohumeral joint - it is a fibrocartilage meniscus that deepens the articulating surface of glenoid fossa

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9
Q

What are the superficial extrinsic muscles of the UE? What are they innervated by?

A

Trapezius Lat dorsi Levator scapulae Rhomboid major and minor - ventral rami of or CN XI (spinal accessory n) - connect upper limb to axial skeleton (extrinsic = any m. have to cut in order to remove UE)

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10
Q

Trapezius: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) CN XI & ventral rami of 3rd and 4th cervical n
2) -Upper: occipital protuberance, sup nuchal line, spinous process CV 7
- Middle: spinous process TV 1-6
- Lower: spinous process of TV 7-12
3) -Upper: lat 3rd of clavicle
- Middle: acromion
- Lower: tubercle of scapular spine
4) -Upper: elevates scapula
- Middle: adducts scapula
- Lower: depresses scapula
5) Dorsal Scapular A

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11
Q

Latissimus Dorsi: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Thoracodorsal n (C6-8) 2) Spines of TV 7-12 and lumbar and sacral vertebrae 3) Intertubercular (bicipital) groove 4) Extends, adducts and internally rotates humerus 5) Thoracodorsal A and branch of subscapular A

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12
Q

Levator Scapulae: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Cervical nerves C3-5 and dorsal scapular n (C5) 2) Transverse process of CV 1-4 3) Medial border of scapula near spine 4) Elevates scapula and helps in downward rotation 5) Dorsal scapular A

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13
Q

Rhomboids: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Dorsal scapular n (C5) 2) Spines of CV 7, TV 1, and lower ligamentum nuchae (minor) spines of TV 2-4 (major) 3) Medial border of scapula inferiorly to inferior angle 4) Adducts scapula, rotates glenoid fossa down, fixes scapula to thoracic wall

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14
Q

Subclavius 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Nerve to subclavius (C5, 6) 2) jxn of 1st rib 3) inferior surface of middle 3rd of clavicle 4) Anchors and depresses clavicle 5) Clavicular A

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15
Q

Pectoralis Major: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Lateral and medial pectoral n; clavicular head C5, 6; sternal head (C7, 8, T1)
2) - Ant surface of med half of clavicle (clavicular head)
- ant surface of manubrium and sternal body (sternal head) 3) Intertubercular groove (bicipital groove) = crest of greater tubercle
4) -Adducts and medially rotates arm
- flexes arm (clavicular head)
- extends arm (sternal head)
- draws scapula anteriorly and inferiorly
5) pectoral arteries

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16
Q

Pectoralis Minor: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Medial pectoral n (C8, T1) 2) Ribs 3-5 3) Coracoid process 4) Stabilizes scapula (inferiorly and anteriorly against thoracic wall)

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17
Q

What is considered the Scapulohumeral Musculature? (collectively)

A

-Deltoid, Teres major, and serratus anterior -Rotator cuff muscles

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18
Q

Serratus Anterior: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Long thoracic n (C5, 6, 7) 2) Lateral parts of ribs 1-8 3) Anterior surface of medial border of scapula 4) Protracts scapula, fixes scapula to thoracic wall, rotates scapula 5) Lateral thoracic A

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19
Q

Deltoid: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Axillary n (C5-6) 2) -Lateral 1/3 of clavicle - acromion - spine of scapula 3) Deltoid tuberosity of humerus 4) Flexes, medially rotates, abducts, extends, and laterally rotates humerus 5) Deltoid branch of thoracoacromial A

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20
Q

Teres Major: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Lower subscapular nerve (C5, 6) 2) Posterior surface of inferior angle of scapula 3) Medial lip of intertubercular (bicipital) groove 4) Adducts and medially rotates humerus 5) Circumflex scapular A

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21
Q

What are the 3 components of the shoulder complex?

A
  • Scapulothoracic joint ( not a true joint, sliding of scapula on thoracic cage) - Coracoacromial arch ( acromion process, coracoid process, coracoacromial ligament) -Subacromial/subdeltoid bursae
22
Q

What are the 1) boundaries and 2)contents of quadrilateral space?

A

1) inferior glenohumeral capsule teres major triceps longus surgical neck of humerus 2) axillary n and posterior circumflex humeral A

23
Q

Shoulder Movements Elevation of scapula occurs by:

A

levator scapulae and rhomboids

24
Q

Shoulder Movements Depression of scapula occurs by:

A

Latissimus dorsi

25
Q

Shoulder Movements Abduction of scapula occurs by:

A

Serratus anterior

26
Q

Shoulder Movements Abduction of SHOULDER occurs by:

A

Middle deltoid and biceps brachii (assists)

27
Q

Shoulder Movements Upward rotation of scapula occurs by:

A

Serratus anterior Upper and lower trapezius (force couple)

28
Q

Shoulder Movements Downward rotation of scapula occurs by:

A

Rhomboids

Levator scapulae

29
Q

What does the coracoacromial arch prevent?

A

Superior dislocation of humeral head and protects head of humerus from downward blow

30
Q

Name the four rotator cuff muscles

Define snubbing

A

S - supraspinatous I - infraspinatous T - teres minor S - subscapularis

Snubbing = holding head of humerus in place

31
Q

Supraspinatous: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Suprascapular n (C4, 5, 6) 2) Supraspinous fossa 3) Superior facet of greater tubercle 4) Helps with abduction of humerus & stabilizing shoulder joint 5) Suprascapular A

32
Q

Infraspinatous: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Suprascapular n (C5, 6) 2) Infraspinous fossa 3) Middle factet of greater tubercle 4) Laterally rotates humerus & helps hold humeral head in place 5) Suprascapular A

33
Q

Teres Minor: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Axillary n (C5, 6) 2) Middle part of lateral border of scapula 3) Inferior facet of greater tubercle 4) Laterally rotates humerus & helps hold humeral head in place 5) Circumflex scapular A

34
Q

Subscapularis: 1) Innervation 2) Proximal Attachments 3) Distal Attachements 4) Actions 5) Blood supply

A

1) Upper and lower subscapular nerves (C5, 6, 7) 2) Subscapular fossa (ant surface) 3) Lesser tubercle 4) Medially rotates and adducts humerus 5) Suparacapular A

35
Q

What is snubbing?

A

Holding humerus head in place = performed by rotator cuff muscles

36
Q

What is force couple?

A

2 parallel forces equal in magnitude, but move in opposite direction, acting on different points of the body a distance apart from each other

37
Q

How do the upper and lower trapezius muscles work as a force couple to upwardly rotate the scapula?

A

Upper trapezius pulls scapula up and lower trapezius pulls scapula down, in order to upwardly rotate the scapula

38
Q

What are the major characteristics of Glenohumeral Joint?

A

-Ball and socket -Synovial -Components = head of humerus and glenoid fossa of scapula -Glenoid Labrum (GL) = fibrocartilage meniscus – deepens articulating surface of glenoid fossa - Joint capsule – very lax and up to an inch of passive distraction

39
Q

Name ligaments of the shoulder region

A

5 total

40
Q

What does the sternoclavicular ligament do?

A

Reinforce the capsule & check AP movement of clavicular head

41
Q

What does the costoclavicular ligament do?

A

Axis for elevation and depression

Protraction and retraction

main check for evaluation of clavicle

42
Q

What is the job of the superior and inferior acromioclavicular ligaments?

A

Weak

Reinforce joint capsule

43
Q

What does the coracoclavicular ligaments do?

A

Provide joint stability (stronger than clavicle itself)

Lateral portion = trapezoid

Medial portion = conoid

44
Q

Define scapulohumeral rhythm?

A

Uninterrupted movement of UE from depended position to full abduction

requires simultaneous and coordinated movements of glenohumeral joint, scapulothoracic – sternoclavicular and acromoioclavicular joints

45
Q

What contributes full ROM (full abduction - 180 degrees) of scapula

A

Glenohumeral joint = 120 degrees

Scapulothoracic = 60 degrees

  • sternoclavicular = 40
  • acromioclavicular = 20

Ratio of GH to ST = 2:1

46
Q

What are the steps in arm abduction? (regarding scapulohumeral rhythm)

A

1) Movement/Searching of scapula
- serratus ant clamps scapula to thoracic wall
2) snubbing of humeral head into glenoid fossa
- rotator cuff m
3) First degree of abduction
- supraspinatous
4) external rotation of humerus
- infraspinatous

47
Q

What provides extension of shoulder?

A

posterior deltoid and latissiums dorsi

48
Q

What provides flexion of shoulder complex?

A

Anterior deltoid

49
Q

1) Adduction of shoulder:
2) Adduction of the scapula:

A

1) Clavicular head of pectoralis major and latissimus dorsi
2) middle trapezius

50
Q

Rotation of scapula downward:

rotation of scapula upward:

A
  • rhomboids and levator scapula
  • serratus anterior and force couple of the upper/lower trap
51
Q
  • Deltoid paralysis due to defect in what nerve?
  • serratus anterior paralysis due to defect in what nerve?
  • tears in rotator cuff occur in what m most often?
A
  • axillary nerve
  • long thoracic nerve
  • supraspinatus

Anatomy Exam 2 (6 decks)

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