Pectoral Region & Shoulder Flashcards

1
Q

Deltopectoral groove

A

Surface of pectoral and shoulder
Furrow between deltoid and pectorals major muscles
Carries cephalic vein (towards axillary vein) -
Drains entire upper limb

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2
Q

Cephalic vein

A

Drains entire upper limb

Runs along deltopectoral groove

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3
Q

Anterior axillary fold

A

On pectorales major muscle

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4
Q

Interdigitations of serratus anterior

A

Seen anterolaterally at origin, ribs 1-8 or 9

Heart beat is clearest at 5th intercostal space

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5
Q

Sternal angle

A

At level of intervertebral disc between T4-T5

At level of second costal cartilage

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6
Q

Mammary gland

A

Modified sweat glands
Have numerous ducts
Found in hypodermic superficial to pec major
Involved in lympatic drainage to axillary and parasternal nodes

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7
Q

Lympathic drainage

A

From mammary glands to axillary lymph nodes and parasternal nodes

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8
Q

Axillary lymph nodes

A

Main lymphatic drainage path
Cancer cells can lodge here and produces metasteses
These nodes communicate head and neck

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9
Q

Parasternal nodes

A

Lymphatic drainage
Communicate with other breast, liver, heart, and lungs
Cancer cells may spread to cranial cavity and brain via communication between:
intercostal venous vein and
vertebral venous plexus

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10
Q

Cutaneous innervation for pectoral and shoulder region

A

Ventral rami of thoracic spinal nerves

Supraclavicular nerves

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11
Q

Ventral rami of thoracic spinal nerves

A
Mixed nerves (sensory & motor)
Starting with T1
Lateral cutaneous branches and
Anterior cutaneous branches
Supply thoracic wall
(continues to become intercostal nerve as it passes into ribs)
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12
Q

Supraclavicular nerves

A

C3 and C4 from cervical plexus

Supply skin over clavicular region, shoulder, and thoracic wall above T2

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13
Q

Pectoral region fasciae

A

Pectoral fascia
Clavipectoral fascia
Costocoracoid membrane

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14
Q

Pectoral fascia

A

Envelopes pec major and attaches to clavicle and sternum

Continuous with axillary & abdominal fascia, which becomes superficial back fascia

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15
Q

Clavipectoral fascia

A

Deep to pec major
Envelopes subclavius muscle and pec minor muscle
Attaches laterally to coracoid process
Attaches superiorly to the clavicle
Medially known as “costcoracoid membrane”

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16
Q

Costocoracoid membrane

A

Medial specialization of the clavipectoral fascia
Attaches laterally to coracoid process
Attaches medially to clavicle and first rib

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17
Q

Pectoral region muscles

A

Pec major
Pec minor
Subclavius

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18
Q

Shoulder region muscles

A
Deltoid
Supraspinatus
Infraspinatus
Teres major
Teres minor
Subscapularis
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19
Q

What sits deep to pec minor muscle?

A

Axillary artery and brachial plexus cords

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20
Q

Cutaneous innervation of shoulder region

A

Superior shoulder:
supraclavicular nerves from cervical plexus
Inferior Deltoid:
branch from axillary nerve supplies skin

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21
Q

Which muscles are part of the rotator cuff?

A
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Teres major
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22
Q

Spaces of pectoral/shoulder region

A

Triangular space

Quadrangular space

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23
Q

Triangular space

A
Borders:
Teres minor (superior)
Teres major (inferior)
Long head of Triceps Brachii (lateral)
Contains:
Scapular circumflex artery
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24
Q

Quadrangular space

A
Borders:
Teres minor (superior)
Teres major (inferior)
Long head of Triceps Brachii (medial)
Diaphysis of the humerus (lateral)
Contains:
Posterior humeral circumflex artery and axillary nerve
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25
Arteries supplying pectoral/shoulder region
Suprascapular artery Posterior humeral circumflex artery Scapular circumflex artery Scapular anastomosis
26
Supscapular artery
Branch of subclavian a. Passes posteriorly deep to trapezius Passes superiorly to transverse scapular lig. Passes deep to supraspinatus
27
Posterior humeral circumflex artery
Branch of axillary a. Winds medially around surgical neck of humerus Emerges through quadrangular space with axillary n.
28
Scapular circumflex artery
Branch of axillary a. | Passes posteriorly through axilla to emerge through the triangular space
29
Scapular anastomosis
``` Supplies rotator cuff muscles Sources from subclavian and axillary a. Junction to: transverse cervical a. scapular circumflex a. posterior humeral circumflex a. suprascapular a. small acromial branches from the axillary ```
30
Nerves supplying pectoral/shoulder region
ALL C5 & C6 Axillary n. Suprascapular n. Upper & Lower Scapular N.
31
Axillary nerve
C5 & C6 Arises from brachial plexus Travels with Posterior humeral circumflex Emerges through quadrangular space Sensory to skin over inferior portion of deltoid
32
Suprascapular nerve
C5 & C6 From brachial plexus Passes posteriorly deep to trapezius Passes inferiorly to transverse scapular ligament (with suprascapular vein)
33
Upper and lower scapular nerve
C5 & C6 From brachial plexus Enters subscapularis from ventral surface
34
Shoulder Joint & | Accessory Shoulder Joints
``` Composed of three joints: Sternoclavicular joint Acromioclavicular joint Glenohumeral joint May also include: "Scapulothoracic joint" ```
35
Sternoclavicular Joint Where? What type of joint? Features?
Sole point of connection between the trunk and upper limb Multiaxial synovial joint Joint capsule is thickest anteriorly Articulating fibrous disc within the capsule (divides cavity into TWO synovial cavities) Clavicle lined with fibrocartilage Sternum lined with hyaline cartilage Capsule reinforced by ligaments
36
Acromioclavicular Joint
Plane joint Clavicle rides higher than acromiom process Small articular capsules with fibrocartilage articulating disc Capsule reinforced by ligaments
37
Scapulothoracic Joint
Not a true joint Considered as part of shoulder region Represents how scapula sits over thorax
38
Glenohumeral Joint
``` "Shoulder joint" Ball & Socket Most of stability due to muscle tendons Has Loose articular capsule Reinforced by RC tendons, and ligaments ```
39
What reinforces the acromioclavicular joint?
Acromioclavicular lig. Coracoclavicular lig. Conoid lig. (medial) Trapezoid lig. (lateral)
40
Coracoclavicular ligament
Provides strength to the AC joint because weak articular capsule
41
Conoid ligament
Medial Fibers run posteriomedially from coracoid process Checks forward rotation of clavicle on scapula Prevents posterior displacement
42
Trapezoid ligament
Lateral Fibers run posterolaterally from coracoid process Checks backward rotation of clavicle on scapula Checks slide of acromiom process under clavicle Prevents anterior displacement
43
Movements of Acromioclavicuolar joint?
Gliding of acromiom process on clavicle Rotation of clavicle on scapula Closed pack position = 90* of shoulder abduction
44
Nerve supply of acromioclavicular joint?
Suprascapular and lateral pectoral nerves
45
Nerve supply of acromioclavicular joint?
Suprascapular and lateral pectoral nerves
46
Articular capsule of Glenohumeral joint
LOOSE! Taught superiorly, loose anteroinferiorly Attached to scapula and anatomical neck of humerus to labrum Capsule strengthened by tendons and lig.
47
Rotator cuff tendons
Reinforces loose articular capsule of glenohumeral joint Blend with articular capsule Hold humeral head in place Checks superoposterior displacement of humeral head
48
Glenohumeral ligaments
Reinforces loose articular capsule of glenohumeral joint Are WITHIN the capsule on anterior wall Appear as a "thickening" of capsule They check anterior displacement of humeral head Has THREE parts: Superior glenohumeral lig. small from anterior supraglenoid tubercle to lesser tubercle of humerus horizontal fibers Middle glenohumeral lig. Arises near superior glenohumeral lig. and travels to lesser tubercle Inferior glenohumeral lig. anteroinferior region of glenoid fossa to dorsal surface of anatomical humeral check
49
Coracohumeral ligaments
Reinforces loose articular capsule of glenohumeral joint
50
Tendon of the long head of the biceps brachii
Reinforces loose articular capsule of glenohumeral joint
51
Coracohumeral ligaments
Reinforces loose articular capsule of glenohumeral joint Blends with capsule Attaches to anatomical neck near greater tubercle
52
Tendon of the long head of the biceps brachii
Reinforces loose articular capsule of glenohumeral joint Passes through joint, pierces capsule Attaches to glenoid labrum, continuous with Strengthens capsule anterosuperiorly
53
Openings of articular capsule in glenhohumeral joint
Represent potential weak spaces Near intertubercular groove (for long head of biceps brachii tendon) Near subscapular bursa Subacromial bursa
54
Inferior glenohumeral lig.
Reinforces loose articular capsule of glenohumeral joint Part of glenhohumeral ligaments (three of them) anteroinferior region of glenoid fossa to dorsal surface of anatomical humeral check
55
Inferior glenohumeral lig.
Reinforces loose articular capsule of glenohumeral joint Part of glenhohumeral ligaments (three of them) anteroinferior region of glenoid fossa to dorsal surface of anatomical humeral check
56
Dislocations of GH joint
Tend to be inferior and anterior Least protected region of capsule Triceps muscle prevents inferior/posterior dislocations
57
Bursae of GH Joint
Subacromial/Subdeltoid - outside of capsule | Subscapular - communicates with capsule
58
Bursae of GH Joint
Subacromial/Subdeltoid - outside of capsule | Subscapular - communicates with capsule
59
Coracoacromial ligament
Forms a roof over GH joint | Helps prevent superior displacement of humeral head
60
Triceps brachii muscle tendons
Strengthens capsule posteriorly
61
Blood supply of GH joint
``` Anastomosis among: Subscapular a. Anterior humeral circumflex a. Posterior humeral circumflex a. Scapular circumflex a. ```
62
Nerve supply of GH joint
Tends to send "twigs" to joint capsule Suprascapular Axillary Subscapuar n.
63
Movements of GH Joint
``` Shoulder Flexion Shoulder Extension Abduction Adduction Lateral Rotation Medial Rotation ```