Shoulder

Question 1

What is the sternoclavicular joint?

Answer 1

Plane synovial joint formed by medial end of clavicle and manubrium of sternum and 1st costal cartilage. Contains articular disc.

Question 2

What stabilises the sternoclavicular joint?

Answer 2

Costoclavicular ligaments that attach to clavicle and 1st rib

Question 3

What is the acromioclavicular joint?

Answer 3

Plane synovial joint located between lateral end of clavicle and the acromion of scapula.

Question 4

What is the acromioclavicular joint stabilised by?

Answer 4

Weak fibrous capsule is strengthened superiorly by acromioclavicular ligaments and trapezius and deltoid fibres. Mainly by coraco-clavicular joint (suspends weight of upper limb from the clavicle)

Question 5

What is the scapulothoracic joint?

Answer 5

Bone-muscle-bone between costal surface of scapula, subscapularis ,uscle, serratus anterior and thoracic wall.

Question 6

What movements are possible at the scapulothoracic joint?

Answer 6

protraction, retraction, elevation, depression and rotation

Question 7

What produces protraction and lateral rotation of the scapula?

Answer 7

Serratus anterior

Question 8

What rotates inferiorly, retracts, elevates and depresses scapula?

Answer 8

Trapezius

Question 9

What retracts and inferiorly rotates scapula?

Answer 9

Rhomboid major and minor

Question 10

How is the glenohumeral joint commonly dislocated? Why?

Answer 10

Anteriorly. The coracoacromial ligament stabilises the joint superiorly

Question 11

What does the fibrocartilagenous glenoid labrum do?

Answer 11

Deepens the glenoid fossa

Question 12

What stabilises the glenohumeral joint?

Answer 12

Capsule and glenohumerla, coracohumeral and coracoacromial ligaments. Also rotator cuff muscles.

Question 13

Name the rotator cuff muscles

Answer 13

Teres minor, infraspinatus, supraspinatus, subscaularis

Question 14

Where are the glenohumeral ligaments?

Answer 14

On the internal surface of the fibrous capsule

Question 15

Where does the coracohumeral ligament attach?

Answer 15

Coracoid process, anatomical neck of humerus and transverse humeral ligament

Question 16

Where are the most important cushions in the shoulder?

Answer 16

The subacromial/subdeltoid bursa separate coracoacromial arch and deltoid from supraspinatus tendon and glenohumeral joint

Question 17

What may pain in the shoulder region be caused by?

Answer 17

Inflammation or tendons or bursa, muscle injury, osteophytes or microtrauma. Could be referred pain from diaphragm or peritoneum (phrenic innervation also C3-5)

Question 18

Where does the serratus anterior attach?

Answer 18

1-8 ribs to anterior surface of scapula

Question 19

Where does the pectoralis major attach?

Answer 19

Medial clavicle, maubrium and body of sternum and 1-6 costal cartilages to bicipital groove.

Question 20

Where does the latisimus dorsi attach?

Answer 20

Spinous processes of lower T, L and S vertebrae to iliac crest. Tendon attaches to bicipital groove.

Question 21

What innervates the lat dorsi?

Answer 21

Thoracodorsal nerve (C6, 7 &8)

Question 22

Where does the deltoid attach?

Answer 22

Clavicle, scapula and deltoid tuberosity.

Question 23

Where does the trapezius attach?

Answer 23

Occipital bone and C7-T12 to the scapula spine and clavicle.

Question 24

Where does the pectoralis minor attach?

Answer 24

Deep to the pectoralis major, 3-5 ribs and coracoid process.

Question 25

Where does the teres major attach?

Answer 25

Between lateral border of scapula and bicipital groove (next to pec maj and lar dorsi)

Question 26

Where does the subscapularis attach and what does it do?

Answer 26

Costal scapula-> lesser tuberosity | Medial rotation

Question 27

Describe the supra and infra spinatus

Answer 27

Dorsal surface of scapula, superior/inferior to spine of scapula, attach to greater tuberosity Abduction and lateral rotation

Question 28

Describe teres minor

Answer 28

Dorsal surface of scapulas on lateral border to greater tuberosity Lateral rotation

Question 29

What muscles are involved in abduction of the arm?

Answer 29

Suprspinatus, deltoid at shoulder joint. Trapezius and serratus anterior to get scapula to rotate to bring arm up further

Question 30

What muscles laterally rotates the humerus?

Answer 30

Supra and infra spinatus and teres minor

Question 31

What muscles medially rotate the humerus?

Answer 31

Subscapularis

Question 32

What does the deltoid do?

Answer 32

Abduction, flexion and extension

Question 33

What is found in the axilla?

Answer 33

Brachial plexus (C5-T1), axillary artery, axillary vein (from basilic), lymph nodes, axillary sheath

Question 34

Why is the axillary sheath clinically important?

Answer 34

Need to inject local anaesthetic into it for upper limb nerve block

Question 35

Name the lymphatic groups found in the axilla

Answer 35

Pectoral, lateral, subscapular, central and apical

Question 36

What is the brachial plexus?

Answer 36

Ventral rami of C5-T1 spinal nerves that merge together

Question 37

How may roots are there? What do they split up into?

Answer 37

5 roots, 3 trunks (superior, middle, inferior), 6 divisions (each trunk into anterior and posterior), 3 cords (lateral, medial and posterior) and 5 branches

Question 38

Name the 5 branches of the brachial plexus

Answer 38

Musculocutaneous, axillary, radial, median, ulnar

Question 39

What does the musculocutaneous nerve innervate?

Answer 39

Coracobrachialis, biceps brachi and brachialis

Question 40

What does the axillary nerve innervate?

Answer 40

Deltoid, teres minor

Question 41

What does the radial nerve innervate?

Answer 41

Triceps brachi and forearm extensors

Question 42

What does the median nerve innervate?

Answer 42

Forearm flexors, pronator teres, palmaris longus and pronator quadratus

Question 43

What does the ulnar nerve innervate?

Answer 43

Flexor d g profundus, f c ulnaris

Question 44

Where does the ulnar nerve come from?

Answer 44

C8, T1, inferior trunk, anterior division, medial cord

Question 45

Where does the median nerve come from?

Answer 45

C5-T1, anterior divisions of all trunks, media and lateral cords

Question 46

Where do the radial and axillary nerves come from?

Answer 46

C5-T1, all posterior divisions of trunks, and posterior cord

Question 47

Where does the musculocutaenous nerve come from?

Answer 47

C5-C7, anterior branches of middle and superior trunks, lateral cord