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MSI Module II > Shoulder > Flashcards

Flashcards in Shoulder Deck (36):
1

Movements of the scapula

Elevation, depression, abduction, adduction, lateral rotation, medial rotation

2

Sternoclavicular joint

  • Articular disc divides into two synovial cavities—allows flat joint to act like a ball-and-socket joint

3

Acromioclavicular joint

  • Allows for axial rotation and anteroposterior movement

4

Glenohumoral joint

  • Highly mobile, shallow ball-and-socket joint

  • Flexion/extension, abduction/adduction, medial+lateral rotation, circumduction

5

Scapulothroacic “joint”

  • Allows for elevation/depression, protraction/retraction, rotation

6

Subclavius muscle

  • Innervated by nerve to subclavius
  • Depression

7

Pectoralis minor

  • Innervated by medial pectoral nerve
  • Depresses scapula, elevates rib

8

Serratus anterior

  • Innervated by long thoracic nerve
  • Abducts scapula, elevates ribs

9

Trapezius

  • Innervated by accesory nerve (CN XI)
  • Superior: elevates scapula, upward rotation of scapula

  • Middle: retracts scapula

  • Inferior: depresses scapula, upward rotation of scapula

10

Rhomboid major and minor

  • Innervated by dorsal scapular nerve
  • Adducts scapula, downward rotation of scapula, fix scapula to thoracic wall

11

Levator scapulae

  • Innervated by dorsal scapular nerve and cervical (C3, C4) nerves
  • Elevates scapula, rotates glenoid cavity inferiorly by rotating scapula

12

Ligaments stabalizing glenohumoral joint

Superior, middle, and inferior glenohumeral ligaments

13

Rotator cuff muscles that stabalize glenohumoral joint

Supraspinatus, infraspinatus, teres minor, and subscapularis

 

Supraspinatus holds head of humerous in the glenoid cavity

14

Danger of glenohumoral dislocation

Disruption of quadrangular space and risk of injuring the axillary nerve and posterior circumflex humeral vessels

15

Test for spinal accesory nerve lesion

Weakness in turning the head to the opposite side against resistance

Ipsilateral weakness when shoulders are shrugged against resistance

16

Test for long thoracic nerve lesoin

Observation: winged scapula when arm is raised

Abduction of the arm against resistance

17

Test for axillary nerve lesion

Observation: deltoid atrophy

Abduction of the arm against resistance

Test sensation over the lateral aspect of the proximal arm

18

Rotator cuff muscles and their innervation

Supraspinatus - abducts the arm, innervated by the suprascapular nerve

Infraspinatus - externally rotates the arm,  innervated by the suprascapular nerve

Teres minor - externally rotates and weakly adducts the arm, innervated by the axillary nerve

Subscapularis - the only rotator cuff muscle that arises from the anterior aspect of the scapula, innervated by the subscapular nerves

19

Location and function of subacromial bursa

Between the supraspinatus tendon and the coracoacromial ligament

Functions to allow the deltoid muscle to move smoothly over the fibrous capsule of the shoulder joint

20

Symptoms and likely cause of rotator cuff injury

Rupture or tear of the supraspinatus tendon is the most common injury

Symptoms:

  • Dull ache deep in shoulder
  • Disturbed sleep if lying on affected shoulder
  • Arm weakness

21

"Frozen Shoulder"

Adhesive fibrosis and scarring of the joint capsule, rotator cuff muscles, subacromial bursa, and deltoid muscle

22

"Shoulder separation"

Dislocation of the acromioclavicular joint (two joint surfaces lose all contact)

In severe dislocation, there is tearing of the acromioclavicular (AC) ligament and coracoclavicular ligament

23

Clavicular fracture (site, presentation, at-risk structures)

The most common clavicular fracture is a midclavicular fracture

Clavicle fractures are fairly common (5% of all adult fractures) and fairly "easy" to do (only 8 lbs of pressure required to break)

Clavicle fractures most often occur following a direct blow to the shoulder.

Symptoms:

  • Sagging of the shoulder downward and forward
  • Inability to lift the arm because of pain
  • A grinding sensation when you try to raise the arm
  • A deformity or "bump" over the break
  • Bruising, swelling, and/or tenderness over the collarbone

 

At-risk areas

  • The subclavius muscle protects underlying neurovascular structures
  • Major neurovascular structures at risk in clavicular fracture include:
  • Lateral cord of brachial plexus
  • Lateral pectoral nerve
  • Axillary artery
  • Axillary vein

24

C3 dermatome

25

C4 dermatome

26

C5 dermatome

Test upper lateral arm

27

C6 dermatome

Test pad of thumb

28

C7 dermatome

Test pad of index or middle finger

29

C8 dermatome

Test pad of little finger

30

T1 dermatome

Test medial aspect of elbow

31

T2 dermatome

32

Cutaneous innervation of axillary nerve

33

Cutaneous innervation of radial nerve

34

Cutaneous innervation of musculo-cutaneous nerve

35

Cutaneous innervation of ulnar nerve

36

Cutanious innervation of median nerve