Pectoral region and shoulder Flashcards
(135 cards)
1
Q
What does the pectoral fascia overly?
A
Pec major and the serratus anterior
2
Q
What is the retromammary space?
A
Loose connective tissue between the breast and the pectoral fascia. It allows the breast some degree of movement.
3
Q
What is the axillary process or tail (of Spence)?
A
An extension of the mammary gland extending toward the axillary fossa
4
Q
What attaches the mammary gland to the dermis?
A
Suspensory ligaments (of Cooper). They help support the mammary gland lobules.
5
Q
What is the scapulothoracic (ST) articulation?
A
Not a true joint… ventral surface of the scapula and the posterior thoracic wall
6
Q
What is the GH joint?
A
Glenohumeral. Joint between the head of the humerus and the scapula
7
Q
What is the SC joint?
A
Sternoclavicular. Manubrium of sternum and clavicle
8
Q
What is the AC joint?
A
Acromioclavicular. Scapula (acromion) and clavicle
9
Q
What is scapulohumeral rhythm?
A
The functional relationship between the GH and ST joints to create motion in the shoulder.
10
Q
What does the 3:2:1 ratio of the shoulder mean?
A
For every 3 degrees of elevation, 2 degrees occurs at the GH joint and 1 degree at the ST joint
11
Q
What are extrinsic muscles and what are they also called?
A
Axioappendicular. Muscles that originate in the axial skeleton and insert on the pectoral girdle.
12
Q
What are the posterior extrinsic muscles?
A
Trapezius
Latissimus dorsi
Levator scapulae
Rhomboid major/minor
13
Q
What are the anterior extrinsic muscles?
A
Pectoralis major and minor
Subclavius
Serratus anterior
14
Q
What is the coracobrachialis muscle?
A
z
15
Q
What are the intrinsic muscles of the shoulder?
A
Deltoid Teres major Teres minor Supraspinatus Infraspinatus Subscapularis
16
Q
What muscles make up the rotator cuff?
A
SITS
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
17
Q
What do ITS of “SITS” muscles do?
A
Provide downward force on the gelnoid to prevent upward translation during abduction
18
Q
What muscle(s) are injured due to repetitive use such as throwing and swimming?
A
Inflammation of the supraspinatus tendon among others
19
Q
What are the fibrous joints?
A
Suture, Syndemosis, Gomphosis
20
Q
What are the cartilaginous or fibrocartilaginous joints?
A
Synchrondosis, Symphysis
21
Q
What makes a joint biaxial?
A
Can conduct motion in 2 planes
22
Q
The Atlanto-Occipital joint is the ____ joint.
A
Yes
23
Q
The Atlanto-Axial joint is the ____ joint.
A
No
24
Q
What are the attachments of the pectoralis major muscle?
A
Claviuclar head (medial half) Sternocostal head (upper 6 costal cartilages) Intertubercular groove of humerus
25
What is the action of pec major?
Adducts and medially rotates humerus
26
What is the innervation of pec major?
Lateral and medial pectoralis nerves
27
What are the attachments of pec minor?
Ribs 3-5 and corocoid process of scapula
28
What is the innervation of pec minor?
Medial pectoral nerve?
29
What is the action of pec minor?
Stabilize scapula
30
What are the attachments of the serratus anterior?
Lateral parts of ribs 1-8
| Medial border of scapula
31
What is the innervation of the serratus anterior?
Long thoracic nerve
32
What is the action of the serratus anterior?
Protract ands upwardly rotates the scapula
**holds the scapula against the thoracic wall** thus damage to this muscle or long thoracic nerve will cause scapular winging
33
What is the attachment of the subclavius?
Junction of the first rib and costal cartilage
| Inferior surface of clavicle
34
What is the action of the subclavius?
Anchors and depresses clavicle
35
What is the innervation of the subclavius?
Nerve to subclavius
36
What is the attachment of the coracobrachialis?
Tip of coracoid process on scapula
| Medial, mid-shaft of humerus
37
What is the action of the coracobrachialis?
Flex and adduct the shoulder
38
What is the innervation of the coracobrachialis?
musculocutaneous nerve
39
What is the innervation of the deltoid muscle?
Axillary nerve
40
What are the attachments of the deltoid?
Spine of scapula
Acromion
Lateral 1/3 of clavicle
Deltoid tuberosity of humerus
41
What are the THREE actions of the deltoid?
1. Anterior: shoulder flexion
2. Middle: shoulder abduction
3. Posterior: shoulder extension
42
What is the attachment of the teres major?
Inferior lateral aspect of scapula
| Intertubercular groove of humerus
43
What is the action of the teres major?
Shoulder medial/internal rotation
44
What is the innervation of the teres major?
Lower subscapular nerve
45
What are the attachment of the supraspinatus?
```
Supraspintus fossa
Greater tubercle (posterior of humeral head)
```
46
What are the attachments of the infraspinatus?
```
Infraspinous fossa
Greater tubercle (posterior of humeral head)
```
47
Which of the SITS muscles attach the greater tubercle?
SIT
48
What are the attachments of the teres minor?
```
Middle part of the lateral border of the scapula
Greater tubercle (posterior of humeral head)
```
49
What are the attachments of the subscapularis?
```
Subscapularis fossa (anterior surface of scapula)
Lesser tubercle (anterior humeral head)
```
50
What is the action of the suprasinatus?
Abduction of humerus (first 15 degrees before deltoid takes over)
51
What is the innervation of the supraspinatus?
Suprascapular nerve
52
What is the inntervation of the infraspinatus?
Suprascapular nerve
53
What is the action of the infrasinatus?
Lateral rotation
54
What is the action of the teres minor?
Shoulder lateral rotation
55
What is the innervation of the teres minor?
Axillary nerve
56
What is the innervation of the subscapularis?
upper and lower subscapular nerves
57
What is the action of subscapularis?
Shoulder medial rotation
58
What prevents elevation of the humerus when the deltoid pulls to abduct the arm?
Rotator cuff muscles pull down
This avoids impingement of the suprapinatus tendon under the coracoacromial arch
59
Rupture of the supraspinatus tendon causes...
a high-riding humerus
60
The brachial plexus is formed by the _____ rami of spinal nerves ___ - ____.
Ventral
C5-T1
61
The brachial plexus innervates all muscles that function in the upper extremity except _______.
The trapezius
62
Each spinal nerve gives rise to ______ and ______ ______.
Anterior and posterior rami
63
What nemonic can be used to remember the "breakdown" of the brachial plexus
Remember To Drink Cold Beer
Roots Trunks(+) Divisions(-) Cords(+) Terminal Branches(-)
64
How many roots of the brachial plexus exist?
5
65
How many trunks?
3
Superior Middle Inferior
66
How does each trunk divide?
Anterior and posterior of each
67
What are the cords of the brachial plexus?
Medial
Lateral
Posterior
68
Each brachial plexus cord divides into _____ nerves
2
69
What parts of the brachial plexus do supraclavicular branches come off?
Roots and trunks
70
What kind of joint is the the SC joint?
Saddle synovial joint w/ a fibrocartilage disc
71
What are the ligaments of the SC joint?
Sternoclavicular
Interclavicular
Costoclavicular
72
What kind of joint is the AC joint?
Synovial joint with a coracoacromial ligament
73
What kind of joint is the GH joint?
Ball and socket
74
What are the non-contractile structures of GH stability?
```
Glenoid labrum
Glenhoumeral ligaments
Coracohumeral ligament
Coracoacromial ligament
Transverse humeral ligament
```
75
What are the attachments of the glenohumeral ligaments?
Scapula to head of the humerus. Superior, middle, inferior
76
What is the transverse humeral ligament?
A bridge between the greater and lesser tubercles
77
What stabilizes the tendon of the long head of the biceps?
Transverse humeral ligament
78
What muscle passes under the coracoacromial arch? What is the significance?
Tendon of the supraspinatus, often impinged in rotator cuff injuries
79
What is the coracoacromial arch?
Space between the coracoacromial ligament and the head of the humerus below
80
What is the scapulohumeral rhythm?
Shoulder abduction does not occur solely in the GH joint. After a certain point of abduction, the scapula also begins to rotate. Maintains articular contact
81
What are the attachments of the trapezius?
Superior nuchal line, external occipital protuberance, nuchal ligament, spinous processes C7-T12
Scapula spine, acromion, lateral 1/3 of clavicle
82
What are the actions of the trapezius?
Upper: elevates and upward rotates scapula
Middle: retracts
Lower: depresses and upward rotates scapula
83
What is the innervation of the trapezius?
Spinal accessory nerve (CN XI)
84
What are the attachments of the latissimus dorsi?
Spinous processes T7-T12, iliac crest, thoracolumbar fascia
Intertubercualar groove of humerus
85
What is the action of the latissimus dorsi?
Shoulder extension, adduction, and IR
86
What is the innervation of the latissimus dorsi?
Thoracodorsal nerve
87
What are the attachments of the levator scapulae?
Transverse processes of C1-C4
Superior medial border of scapula
88
What is the action of the levator scapulae?
Elevation and downward rotation of scapula
89
What is the innervation of the levator scapulae?
Dorsal scapular nerve
90
What are the attachments of the rhomboid minor muscle?
Spinous processes C7 and T1
| Medial scapular at the scapular spine
91
What are the attachments of the rhomboid major muscle?
Spinous processes T2-T5
Medial scapular border
92
What is the action of the rhomboid muscles?
Retract and downwardly rotate scapula
93
What is the innervation of the rhomboid muscles?
Dorsal scapular nerve
94
What are the origins of the axilary artery?
Aorta -> BT -> subclavian -> axillary
95
When does the subclavian artery become known as the axillary artery?
The lateral border of the 1st rib
96
When does the axillary artery become known as the brachial artery?
Inferior border of the teres major
97
What defines the regions of the axillary artery?
The pec minor muscle (I is proximal, II is deep, III is distal
98
What branches off Axillary I?
Superior thoracic artery
99
What branches off Axillary II?
Thoracoacromial trunj
| Lateral thoracic artery
100
What branches of Axillary III?
Subscapular artery ->
Circumflex scapular artery
Anterior humeral circumflex
Posterior humeral circumflex
101
What is the origin of the suprascapular artery?
Subclavian -> thyrocervical trunk -> suprascapular
102
What is the origin of the dorsal scapular artery
Subclavian -> dorsal scapular artey
103
What is the major branch of the brachial artery?
Brachial profunda artery
104
What happens when the brachial artery hits the elbow?
Divides into the radial artery and the ulnar artery (anterior and posterior interosseus arteries)
105
What are the margins of the axillary vein?
Union of brachial and basilic veins at the inferior border to the teres major. Drain into subclavian
106
What are the relative locations of the basilic and cephalic veins?
Basilic is more medial. Cephalic is more lateral
107
When looking at the distal end of the humerus, what is the most bony process called?
The medial epicondyle
108
What are the articulations of the arm and forearm?
Capitulum: H and radius
Trochlea: Trochlea and ulna
CRTU
109
Which joint is more stable/articulated? radius or ulna with humerus? How does this other joint stay stable?
Ulnahumeral joint
thus annular ligament needed to stabilize the radius
110
What is nursemaids elbow?
Radius dislocation from annular ligament
111
What is a Monteggia fracture?
Dislocation of the proximal radioulnar joint in conjunction with a forearm fracture
112
What is the lateral collateral ligament?
Ligament that blends with the annular ligament to prevent medial deviation
113
What is of collateral ligament?
Prevents lateral deviation of elbow
114
What is Tommy John syndrome?
Ulnar collateral ligament (aka medial collateral ligament) is replaced (e.g. in pitchers)
115
Supination/pronation of the elbow is created solely by what?
Movement of the radius around the fixed ulna
116
What are the muscles in the anterior compartment of the arm?
```
Biceps brachii (short and long head)
Brachialis
```
117
What are the attchments of the biceps brachii?
Short: coracoid process of scapula
Long: supraglenoid tubercle
Both originate on radius
118
What is the innervation of the biceps brachii?
musculocutaneous nerve
119
What are the attchments of the brachialis?
Distal anterior humerus
| Coronoid process of ulna
120
What is the innervation of the brachialis?
musculocutaneous nerve
121
What are the muscles of the posterior compartment?
Triceps brachii
| Brachioradialis
122
What are the attachments of the triceps brachii?
Long head: infraglenoid tubercle
Lateral head: posterior superior humerus
Medial head (deep): posterior inf. humerus
All heads: olecranon of the ulna
123
What is the innervation of the triceps?
Radial nerve
124
What are the attachments of the brachioradialis?
Lateral supracondylar ridge
Lateral distal radius
125
What is the action of the brachioradialis?
Flexes elbow
126
What is the innervation of the brachioradialis? Why is this unique?
Radial nerve. This is the only muscle innervated by the radial nerve that FLEXES rather than extends
127
What are the attachments of the supinator?
Lateral epicondyle of humerus, crest of ulna
Lateral posterior and anterior surface of radius
128
What does the supinator do?
Supinates forearm
129
What is the innervation of the deep branch of the radial nerve?
Deep branch of radial nerve
130
What are the actions of the biceps brachii?
Flexes elbow AND supinates the forearm
131
What are the attachments of the pronator teres?
Coronoid process AND medial epicondyle (two heads)
Lateral surface of radius
132
What is the action of the pronator teres?
Pronation of forearm and weak flexor of forearm
133
What is the innervation of the pronator teres?
Median nerve
134
What is the innervation of the pronator quadratus?
Anterior interosseus nerve (from median nerve)
135
What are the attachments of the pronator quadratus?
Distal anterior ulna and distal anterior radius
