Session 2 Lecture Notes

Question 1

What is the shoulder girdle?

What is it’s function?

Answer 1

The clavicle and scapula

Connects the arm to the skeleton

Question 2

Name the 4 joints within the shoulder girdle

Answer 2

1. Sternoclavicular
2. Acromioclavicular
3. Scapulothoracic
4. Glenohumeral

Question 3

Which bone is FIRST to start ossifying but LAST to complete?

Answer 3

The clavicle

Question 4

What part of the humerus used to be the growth plate?

Answer 4

The anatomical neck

Question 5

Where to the rotator cuff muscles attach to?

Answer 5

The greater and lesser tubercles

Question 6

What tubercle of the humerus appears more laterally?

Answer 6

The greater tubercle

the lesser tubercle is more medial

Question 7

What is the most commonly dislocated joint?

Answer 7

The glenohumeral joint

Question 8

What is the glenoid labrum?

Answer 8

A ring of fibrocartilage that deepens the glenoid cavity and allows the humeral head a more secure fit

Question 9

What are the 3 glenohumeral ligaments?

Answer 9

1. Superior
2. Middle
3. Inferior

Question 10

What are the 3 extracapsular ligaments?

Where do they all attach to?

Answer 10

1. Coracoacromial
2. Coracoclavicular
3. Coracohumeral

All attach to the coracoid process

Question 11

Name the 4 rotator cuff muscles

Where do they all insert?

Answer 11

SITS:
1. Supraspinatus
2. Infraspinatus
3. Teres minor
4. Subscapularis 
All insert at the proximal humerus

Question 12

What innervates infraspinatus and supraspinatus?

Answer 12

The suprascapular nerve

Question 13

What innervates teres minor?

Answer 13

The axillary nerve

Question 14

What innervates subscapularis?

Answer 14

The upper and lower subscapularis nerves

Question 15

At the shoulder joint - what does subscapularis do?

Answer 15

Medially rotates the shoulder

Question 16

At the shoulder joint - what do supraspinatus do?

Answer 16

Abduction of shoulder (0-15 degrees)

Question 17

At the shoulder joint what does infraspinatus and teres minor do?

Answer 17

Laterally rotates the shoulder

Question 18

The space between the acromion and head of humerus is 1-1.5 cm. What is within this space?

Answer 18

1. Subacromial bursa
2. Rotator cuff tendons
3. Capsule
4. Long head of biceps

Question 19

Abduction is an action that requires 2 joints - what are they?

Answer 19

1. Glenohumeral - 0-90 degrees

2. Scapulo-thoracic - over 90 degrees

Question 20

What muscles abduct the arm above 90 degrees at the scapula-thoracic joint?

Answer 20

1. Trapezius

2. Serratus anterior

Question 21

What innervates the deltoid?

Answer 21

Axillary nerve

Question 22

What innervates pectoralis major?

Answer 22

The medial and lateral pectoral nerves

Question 23

What innervates latissimus dorsi?

Answer 23

Thoracodorsal nerve

Question 24

What innervates teres major?

Answer 24

Thoracodorsal nerve

Question 25

What innervates coracobrachialis?

Answer 25

Musculocutaneous nerve

Question 26

What innervates biceps brachii?

Answer 26

Musculocutaneous nerve

Question 27

The brachiocephalic trunk passes into the subclavian artery on which side?

Answer 27

Only the left side | The right side starts with the right subclavian artery

Question 28

What 2 arteries branch from the axillary artery into the proximal humerus?

Answer 28

1. Anterior circumflex artery | 2. Posterior circumflex artery

Question 29

When might the anterior and posterior circumflex arteries be damaged?

Answer 29

Following a dislocated shoulder

Question 30

Although rare, breaks to clavicle could damage brachial plexus - why?

Answer 30

The roots and trunks of brachial plexus are behind the clavicle

Question 31

Which 2 nerves come from the posterior cord of the brachial plexus? Which one wraps around the humerus?

Answer 31

``` Radial nerve Axillary nerve (which wraps around humerus) ```

Question 32

Which nerve of the brachial plexus is most at risk following a shoulder fracture or dislocation? Where would you lose sensation?

Answer 32

The axillary nerve | The regimental badge area

Question 33

Where does the radial groove insert? | Give an example of when this could be damaged

Answer 33

The radial groove | In a mid shaft fracture - the radial nerve could be damaged

Question 34

In an anterior dislocation of shoulder, what will be sticking out?

Answer 34

The acromion process

Question 35

In a posterior dislocation of shoulder - how will the patient be holding their shoulder? How does this dislocation occur?

Answer 35

Holding in internal rotation | Can happen following electric shock or seizure when the muscles move so forcibly it moves the shoulder too

Question 36

What is calcification tendinitis?

Answer 36

Deposit of calcium hydroxyapatite in the subacromial space

Question 37

What is acute calcific tendinitis?

Answer 37

When the build up of calcium hydroxyapatite deposit in the subacromial space bursts

Question 38

With a popeye muscle appearance - what tendon has ruptured and what is the treatment?

Answer 38

The long head of biceps brachii has ruptured | As short head is functioning no treatment

Question 39

What is impingement? | Give 2 ways in which this may be caused

Answer 39

When the subacromial space is reduced either because: 1. Disease in tendon and tendon has become swollen 2. Inflammation in bursa

Question 40

What are full thickness large rotator cuff tears? | Can treat with allograft - what is this?

Answer 40

Tears that involve the rotator cuff muscles eg tear across the head of the humerus The rotator cuff muscles can become shrunken and need allograft repair This is using tissue from another person

Question 41

When does rotator cuff arthropathy typically occur? | What happens?

Answer 41

In the elderly | The humeral head rubs against bone and wears away the acromion