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S&F 1 > Shoulder > Flashcards

Shoulder Flashcards

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1
Q

this is palpable along its entire length of the upper anterior part of the shoulder?

A

Clavicle

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2
Q

On the anterior view of the clavicle, what can you see that differentiates it from the posterior view?

A

The coracoid process.

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3
Q

The spine of the scapula is seen from which view?

A

Posterior view

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4
Q

Glenoid cavity is between which two structures?

A

Humerus and scapula

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5
Q

The coracoid and acromion process are part of which structure.

A

Scapula

Coracoid = seen anteriorly

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6
Q

Which part of the scapula is connected to the clavicle?

A

Acromion process (also considered the point of the shoulder) continuation of the scapular of the spine

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7
Q

Which portion of the clavicle is closer to the vertebra?

A

Medial end

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8
Q

T/F the anatomical head of the humerus is the point that always breaks.

A

False

It is the surgical neck that always breaks

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9
Q

Which tuberosity on the humerus is more lateral?

A

The Greater tuberosity

The lesser tuberosity is more medial

Intertubercular groove in-between the two

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10
Q

A fracture of the humerus surgical neck affects which nerve?

A

Axillary nerve

This is also the most common fracture

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11
Q

What is the sternoclavicular joint?

A

Between the clavicle and the manubrium of the sternum

Initiates all the movement of the shoulder

Indirect movement of the arm

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12
Q

What are the parts of the sternum?

A

Manubrium

Body

Xiphoid process

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13
Q

What is the sternal angle?

A

It is the prominence between the manubrium and the body at the level of the second rib

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14
Q

What are the three joints/ligaments between the scapula and the clavicle?

A

Acromioclavicular joint (not really mobile, just to attach the scapula)

Caracoclavicular ligament (contains two - trapezoid and conoid)

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15
Q

Slide 8

A

?

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16
Q

Slide 9

A

?

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17
Q

What is a grade 1 shoulder separation?

A

Simple sprain of the AC joint capsule

AC and CC space widths are in normal range

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18
Q

Subluxation of the AC joint, what is this?

A

Grade 2 shoulder separation

AC joint capsule significantly damage; AC space width at least 50% greater than normal CC space width in normal range

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19
Q

When the AC and CC space widths both are at least 50% greater than normal this is know as a?

A

Grade III shoulder separation (acromioclavicular dislocation)

Dislocation of the AC joint capsule and CC ligament significantly damaged

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20
Q

Patient comes to you with a bruise over the right acromioclavicular joint? What do you suspect is going on?

A

Grade II Shoulder location

Scapula is inferolaterally displaced from the lateral end of the clavicle and the coracoclavicular space is within normal range

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21
Q

What muscle is between the clavicle and the superior portion of humerus?

A

Superspinatis muscle

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22
Q

What are the cartilages that line the glenoid cavity?

A

Glenoid Labrum (small)

Hyaline Cartilage covering the head of the humerus and the glenoid cavity

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23
Q

Whats is the most mobile bone in the body?

A

Humerus

180 degrees Abduction or elevation retained from primates

This movement is dependent on 4 muscle -> supraspinatus, deltoid, trapezius, and serratus anteriror

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24
Q

Why are sports injuries with the humerus so common?

A

Because the humerus is hyper-mobile

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25
How do you identify a shoulder dislocation?
when the More lateral point is the acromion Head of the humerus goes anterior and medially (no longer the most lateral portion). Also more elevated Glenoid cavity & becomes more lateral
26
What is an anterior shoulder dislocation?
The head of the humerus has come to rest in a subarachnoid position (humeral head lies inferior to the coracoid process)
27
Which nerve is more exposed with a shoulder dislocation?
Axillary nerve (it goes more medial)
28
What is the shoulder joint also called?
Glenoid joint
29
What is cleidocranial dysostosis?
A hereditary condition characterized by defective ossification of cranial bones and clavicle ## Footnote **"Person has no clavicle"**
30
T/F Clavicle has nothing to do with the shoulder really, it has more to do with the head?
True
31
T/F all mammals have clavicles
False
32
80% of all clavicular fractures occur where?
In the middle third of the clavicle. Does not typically cause major vascular or nerve injury
33
Which vessels/nerves does the clavicle overlie?
Subclavian artery Subclavian vein Part of brachial plexus
34
What are the three parts of the clavicle. ?
Proximal third Middle third Distal third
35
The shoulder movements are characterized by?
Movements of the **point of the shoulder** ( Acromion)
36
how do the shoulder muscles raise or shrug the shoulder?
By pulling the clavicle and scapula upward at the sternoclavicular joint "Elevation"
37
How do the muscles lower the shoulder
by pulling the clavicle and scapula downward at the sternoclavicular joint "Depression"
38
What are the six movements of the shoulder?
1. Raise the shoulder (elevate) 2. Lower the shoulder (depression) 3. Protraction (going anteriorly) 4. Retraction (going posteriorly) 5. Abduction (away from midline) - lateral rotation 6. Adduction (towards midline) - medial rotation
39
What is articulating the 6 movements of the shoulder?
Sternoclavicular joint
40
By pulling the clavicle and scapula forward at the sternoclavicular joint the shoulder muscles are able to do what?
Protaction
41
How do the muscles retract the shoulder?
By pulling the clavicle and scapula backwoods at the sternoclavicular joint
42
For every two degrees of abduction what is happening?
The shoulder moves one degree and the sternoclavicular joint moves one degree
43
During abduction what is happening to the scapular?
It is rotating. Point of reference is the inferior angle (moving laterally)
44
What are the movements of the arm at the shoulder joint?
Flexion Extension Internal rotation external rotation **Humerus is moving not the scapula.**
45
What is happening to the arm when the scapula is rotating medially?
Adduction of the arm
46
Do you only move the shoulder joint in the six movements of the shoulder/arm?
No. During adduction and abduction you move the sternoclavicular joint
47
**Trapezius** Invervation Orign Insertion Function
innervation: Accessory nerve (Cranial nerve 11) - motor innervation and contains 3 parts C3 and C4 - sensory innervation Orgin: Skull (extrnal ocipital protuberance) and vertebra (lower part) middle part of the trapezius comes from the nuchal ligament Insertion: upper part goes to the acromion, middle and lower part to the spine of the scapula (this is the part that really moves when the muscle contracts) Function: raise/lower the shoulder "Cranial muscle" not a true back muscle. prime movers for lateral rotation of the scapula and the prime mover for retraction of the shoulder.
48
T/F The trapezius contains three parts and they all have to contract together
False! You can contract one part alone
49
What is the purpose of the nuchal ligament?
Prevents head from bending down to far
50
**Levator Scapulae** Innervation Origin Insertion Function
Innervation: dorsal scapular nerve (C5) and C3 and C4 nerve fibers, and branch of brachial plexus Origin: tranvserse process of C1 and C2 Insert: Superior angle and medial border of scapula Funciton: Raise and medially rotate the scapula
51
**Rhomboid Major & Minor** Inervation Insertion Origin Funtion
Innervation: dorsal scapular nerve (C5) Origin: Vertebra Insertion: Medial border of scapula Function: retract the shoulder (i.e aduction, completely moving the scapula) and medially rotate the scapula
52
The upper part of the trapezius does what to the scapula?
Elevating and lateral rotation the scapula
53
indirect abduction to the humerus is done by what?
Trapezius
54
If the trapezius moves the scapula 20 degrees, how many degrees is the humerus abducting the arm?
40 degrees
55
The middle part of the trapezius does what to the scapula?
retraction of the scapula
56
If you contract the trapezius as a whole, all three heads at the same time, what is happening to the scapula?
retraction and lateral rotation of the scapula ## Footnote **Upper and lower part functions will cancel out leaving the function of the middle part.**
57
The third part of the trapezius does what to the scapula?
depresses the scapula
58
These three muscles are all innervated by the dorsal scapular nerve Which is medial to the scapula)?
Rhomboid major Rhomboid minor Levator scapular nerve All medial (intermediate layer of back) muscles
59
Suprascapular nerve is located where?
Above the scapula
60
The subscapular nerves are located where?
below the scapula
61
What are the nerves that go from medial to the posterior scapula?
Dorsal scapular (medial to scapula) Suprascapula nerve Subscapular nerve Axillary nerve (lateral to scapula)
62
What is the common function of the levator scapula muscle, rhomboid minor muscle , and the rhomboid major muscle?
medially rotate the scapula
63
**Supraspinatus & Infraspinatus** Innervation Origin Insertion Function
Innservation: Suprascapular nerve function: Lateral rotation of the humerus (both) Origin: Scapula (Spine of scapula separates them) Insertion: Head of humerus
64
A muscle being parallel to the bone is good for what?
flexion and extension
65
If a muscle wants to abduct or adduct in what position should it be relative to the bone?
oblique/parallel
66
If a muscle wants to rotate a bone what position should it be in?
perpendicular to bone
67
What is the special function of the supraspinatus?
Abduction Only in primates and humans because of movement of 190 degrees good for the first 27 degrees and then deltoid comes in to assist?
68
What is need for first 27 degrees of abduction?
The supraspinatus muscle after that the deltoid can help compensate
69
The deltoid (touches clavicle, scapula and humerus) and the teres minor are innervated by what nerve?
Axillary nerve
70
What it the importances of the deltoid muscle?
Abduction after 27 degrees
71
The subscapular nerve innervates which muscle?
contains 3 parts **Teres major** (lower subscapular n.) **Latissimus dorsi** (middle subscapular/thoracodorsal nerve) **Subscapularis** (upper and lower subscapular n.)
72
**Subscapularis** Innervation Insertion Origin Function
Innervation: Upper and lower subscapular nerve Origin - scapula insertion - anterior part of humerus Funciton: medial rotation of the arm. Perpendicular to the bone
73
**Teres Major** Innervation Origin Insertion Function
Innervation: Lower subscapular nerve (C5 & C6) insertion - anterior part of the humerus origin - inferior angle of scapula Funciton: (internally) Medial Rotation and adduction. This muscle is oblique to the bone
74
**Latissimus Dorsi** Innervation Origin Insertion Function
insertion - anterior part of the humerus origin - thoracic vertebra Function: (internally) medial rotation and extension, adduct innervation: Thoracodorsal nerve
75
This muscle is the most powerful protractor of the shoulder and one of the two prime movers for lateral rotation of the scapula
Serratus anterior
76
Loss of serratus Anterior actions weakens the ability to do what?
Raise the arm above the shoulder
77
**Serratus anterior** Innervation Origin Insertion
Innervation: Long Thoracic Nerve Funciton: Protraction of the shoulder and lateral rotation of the scapula (puling scapula anteriorlly). Abduction of the arm indirectily Origin: Ribs Insertion: Lateral border of scapula
78
What happens when someone has isolated seraatus anterior palsy?
Pronounced flaring of the inferior angle of the scapula When outstretched arm is thrust forward this pronounced flaring is frequently referred to as winging of the scapula
79
**Pectoralis Minor** Innervation Function Origin Insertion
Function: Lower and protract the shoulder Innervation: medial pectoral nerve Origin: ribs Insertion: Coracoid process of the scapula
80
**Subclavius** Innervation Origin Insertion Function
Innervation: Subclavius nerve Function: Lower the shoulder Insertion: Clavicle Orgin: 1st rib
81
What are the muscles of the rotator cuff?
Subscapularis Supraspinatus Infraspinatus Teres minor All innervated by C6 nerve fibers only
82
Teres Minor Innervation Origin Insertion
Innervation: Axillary Nerve (C5 & C6) Function: Lateral rotation of the arm (part of rotator cuff)
83
Which 3 muscles make up the posterior portion of the scapula?
Supraspinatus Infraspinatus Teres Minor
84
Which two muscles are the most powerful external rotators of the arm at hte shoulder joint?
Infraspinatus and Teres minor
85
Deltoid Innervation Origin Insertion Function
Innervation: Axillary nerve (C5 & C8) Function: Prime mover for abduction of the arm at the shoulder joint; Flexes, internally rotates, extend, and externally rotate arm
86
**Pectoralis Major** Innervation Insertion Origin Function
Innervation: Medial and lateral pectoral nerve Function: Adduct, flex. and internally (medial) rotate the arm Origin: clavicle, sternum, ribs Insertion: anterior part of the posterior humerus **"Opposite to Latissimus Dorsi in many way"**
87
Cephalic vein runs where?
In the delto-pectoral triangle

S&F 1 (25 decks)

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