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Shoulder Flashcards

Shoulder and Upper Limb (43 cards)

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1
Q

Deltopectoral Triangle Boundaries

A

Superior: Clavicle
Lateral: Deltoid
Medial: Clavicular Head of Pectoralis Major

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2
Q

Deltopectoral Triangle Contents:

A

Clavipectoral Fascia
Cephalic Vein
Branches of thoracoacromial trunk (artery)

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3
Q

Biceps Brachii Muscle

A

Origin:
Long Head: Supraglenoid tubercle of scapula
Short Head: Tip of coracoid Process

Insertion: Radial tuberosity plus bicipital aponeurosis

Innervation: musculocutaneous nerve (C5/C6)

Action: Forearm flexion and supination, assists with arm flexion (arm abduction when externally rotated)

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4
Q

Coracobrachialis Muscle

A

Origin: Tip of the coracoid process

Insertion: Medial surface of humerus, Midshaft

Innervation: Musculocutaneous Nerve (C5, C6, C7)

Action: Scapular protration, upward rotation by lower fibers, fixes scapula for other muscles, keeps scapula against chest wall

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5
Q

Subscapularis Muscle

A

Origin: Medial 2/3 of subscapular fossa

Insertion: Lesser tubercle of the humerus

Innervation: Upper and Lower subscapular nerves (C5/ C6)

Action: arm internal rotation (medial rotation) holds the head of the humerus in the glenoid cavity (with all rotator cuff muscles)

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6
Q

Pectoralis Major Muscle

A

Origin:

  • Clavicular Head: Medial 1/2 of clavicle (anterior and superior surfaces)
  • Sternocostal Head: Lateral 1/2 anterior surface of manubrium and body of sternum, costal cartilages of all true ribs, aponeurosis of external oblique muscle

Insertion: Lateral lip of intertubercular groove (crest of greater tubercle of humerus)

Innervation: Lateral (C5-7) and medial (C8-T1) pectoral nerves

Action:

  • Both heads: arm flexion, adduction, internal rotation, horizontal adduction
  • Clavicular head - Flexion of extended arm
  • Sternalcostal head - extension of flexed arm; pulls trunk up with arms stabilized; accessory muscle of respiration (Inspiration) by helping to expand the thoracic cage
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7
Q

Subclavius

A

Origin: first rib at junction with costocartilage

Insertion: Inferior surface of clavicle (subclavian groove)

Innervation: Nerve to subclavius (C5, C6)

Action: depressed the clavicle (lateral end); also stabilizes the clavicle during shoulder joint movements

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8
Q

Pectoralis Minor Muscle

A

Origin: anterior surface and superior margin of ribs 3-5 near costal cartilages, and fascia of intercostal spaces

Insertion: Medial border of coracoid process of scapula

Innervation: Medial pectoral nerve (C8, T1)

Action: Scapular protraction, depresses the tip of the shoulder joint, (depression of the scapula), cups the shoulder forward

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9
Q

Serratus Anterior Muscle

A

Origin: outer surface and superior borders of ribs 1-9 midway between angles and costal cartilages; deep fascia of related intercostal spaces; Low 3 digitations interdigitate with origin of external oblique muscles

Insertion: Anterior surface of entire medial border of scapula (costal surface)

Innervation: Long Thoracic Never (C5, C6, C7)

Action: scapular protration, upward rotation by lower fibers; fixes scapula for other muscles, Keeps scapula against chest wall

(Winged scapula)

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10
Q

Blood Supply of posterior shoulder

A

Suprascapular artery
Posterior circumflex humeral artery
circumflex scapular artery

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11
Q

Suprascapular artery

A

(5 Points)

  • Branch of thyrocervical trunk (artery) in the neck or the third part of the subclavian artery
  • Passes superior to the suprascapular foramen
  • Travels with the suprascapular nerve
  • Supplies supraspinatus and infrapsinatus muscles
  • Helps form an anastomoses around the scapula
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12
Q

Posterior circumflex humeral artery

A

(3 points)

  • branch off of the third part of the axillary artery
  • leaves acilla through the quadrangular space with the axillary nerve
  • supplies related muscles and glenohumeral joint
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13
Q

Circumflex scapular artery

A

(4 points)

  • Branch of the subscapular artery (which branches off of the 3rd part of the axillary artery)
  • Leaves the axilla through the triangular space
  • Passes through the origin of the Teres Minor muscle
  • Helps form anastomoses around the shoulder
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14
Q

Gateways from axilla to posterior scapula

A

Function of the spaces and intervals is for blood vessels and nerves to pass from the axilla to the posterior scapula

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15
Q

Quadrangular Spaces Contents (passes through)

A

Anterior and posterior humeral circumflex artery

Axillary nerve

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16
Q

Triangular Space Contents (passes through)

A

Circumflex Scapular artery

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17
Q

Triangular Interval Contents (passes through)

A

Profunda (deep radial artery/vein)

Radial nerve

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18
Q

Triangular Interval borders

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A

Superior: teres major muscle
Medial: long head of the triceps brachii
Lateral: Shaft of the humerus bone

19
Q

Quadrangular Space Borders

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A

Superior: Teres Minor Muscle
Inferior: Teres major muscle
Lateral: Surgical neck of the humerus
Medial: Long head of the triceps brachii

20
Q

Triangular Space Borders:

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A

Superior: Teres Minor Muscle
Inferior: Teres Major Muscle
Lateral: Long head of the triceps brachii

21
Q

Triangle of Auscultation Borders:

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A

Superior: Trapezius Muscle
Inferior : Latissimus dorsi muscle
Lateral: vertebral border of scapula

22
Q

Triangle of Auscultation Significance

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A

muscle later is thinner; easier to listen for breath sounds, is the site of the 6th intercostal space

23
Q

Lumbar Triangle of Petit Borders

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A

Medial: Latissimus Dorsi Muscle
Lateral border: External oblique muscle
Inferior: Iliac crest

24
Q

Lumbar Triangle of Petit significance

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A

Muscular wall is thinner; potential site for herniation.

25
Triceps Brachii Muscle:
Origin - Long head: Infraglenoid tubercle of scapula - Lateral Head:posterior surface and lateral border of humerus proximal to radial groove - Medial Head: Posterior surface of humerus distal to radial groove, medial intermuscular septum Insertion: Superior and posterior surface of olecranon process of ulna Innervation: Radial nerve (C6, C7, C8) Action: Forearm extension, Arm extension and adduction by long head.
26
Intertubercular groove (sulcus) of humerus
- Three muscles insert near this area - Two of them originate on the posterior back (Teres Major muscle @medial lip // latissimus dorsi @floor of sulcus and wraps around teres major) - Tendon of the long head of the bicep brachii muscle lies lateral to these tendons - Pectoralis major muscle inserts on the lateral lip of the intertubercular sulcus
27
Teres Major Muscle
Origin: Oval area on the posterior surface of the inferior angle of the scapula; lower 1/3 of axillary boarder of the scapula Insertion: Medial lip of the intertubercular groove fo the humerus; Innervation: lower subscapular nerve (C5, C6) Action: Medial rotation, extension, and adduction of arm
28
Latissimus Dorsi Muscle
Origin: - Spinous processes of lower six thoracic vertebrae and related supraspinous ligaments - SPinous proceses of lumbar and sacral vertebrae via thoracolumbar fascia - External lip of iliac crest - Lower 3-4 ribs by fleshy attachments - May attach to the inferior angle of the scapula Insertion: Floor of intertubercular groove of the humerus Innervation: thoracodorsal nerve (C6, C7, C8) Action: - Arm: Extension, adduction, internal (medial) Rotation, forms "power stroke" - If arms are stabilized, pulls trunk up (pull up/chin up) - Exhalation: Splints posterior abdomen
29
Deltoid Muscle | superficial muscle capping the shoulder
Origin: lateral 1/3 anterior border of clavicle; lateral border of acromion process; inferior lip, spine of scapula, to smooth triangular space Insertion: Deltoid tuberosity of humerus Innervation: Axillary nerve (C5, C6) Action: Can act as a whole or in 3 parts: - Middle: major abductor of arm (after 15 degrees done by supraspinatus) - Anterior: arm flexion, internal rotation, horizontal adduction Posterior: arm extension, external rotation, horizontal abduction.
30
Teres Minor Muscle | Rotator Cuff Muscle
Origin: Upper 2/3 of the posterior surface of the axillary border of the scapula Insertion: Inferior facet of the greater tubercle of the humerus Innervation: Axillary nerve (C5/C6) Action external (lateral) rotation, weak adduction of the arm at the glenohumeral joint; hold head of the humerus in the glendoid cavity (as rotator cuff muscle)
31
Infraspinatus Muscle | Rotator Cuff Muscle
Origin: Medial 2/3 of the infraspinous fossa of the scapula and the deep fascia that covers the muscle Insertion: middle facet of the greater tubercle of the humerus Innervation: Suprascapular nerve (C5/C6) Action: External (lateral) rotation of the arm at the glenohumeral joint; hold the head of the humerus in the glenoid cavity (as rotator cuff muscle)
32
Supraspinatus Muscle | Rotator Cuff Muscle
Origin: Medial 2/3 of the supraspinous fossa of the scapula and the deep fascia that covers the muscle Insertion: superior facet of on the greater tubercle of the humerus Innervation: Suprascapular nerve (C5/C6) Action: Initiation of abduction of arm to 15 degrees at glenohumeral joint; holds head of humerus in glenoid cavity (as rotator cuff muscle)
33
Rotator Cuff Muscles (action as a group)
4 actions: - Hold head of humerus in glenoid cavity - Rotate humerus on long axis - protect shoulder joint by common musculotendinous shealth - stabilize shoulder joint by acting as extensile ligament for shoulder motions.
34
Levator scapula Muscle | fixes the scapula
Origin: Transverse processes of C1-C4 vertebra Insertion: medial borderof the scapula from superior angle to top of smooth triangular space at base of spine Innervation: Dorsal scapular nerve (C5), branches from C3 and C4 spinal nerves Action: Elevates, downwardly rotates and assists in retraction of scapula
35
Rhomboid Major Muscle | Fixes the scapula
Origin: Spinous processes of T2-T5 vertebrae and corresponding spinous ligaments Insertion: medial border of scapula from the bottom of the smooth triangular surface to inferior angle Innervation: Dorsal Scapular nerve (C5) Action: Retracts, downwardly rotates and assists with elevation oft he scapula.
36
Rhomboid Minor Muscle | Fixes the scapula
Origin: Spinous processes of C7-T1 vertebrae and Lower portion of ligamentum nuchae Insertion: medial border of scapula at the root of the spine of the scapula Innervation: Dorsal Scapular nerve (C5) Action: Retracts, downwardly rotates and assists with elevation oft he scapula. Synergist for elevation
37
Trapezius Muscle
Origin: medial 1/3 superior Nuchael line of occipital bone; external occipital protuberance (inion process), ligamentum Nuchae, spinous processes C7-T12 and related supraspinous ligaments. Insertion: Posterior border of lateral 1/3 clavicle; Median margin of acromion, Superior lip of the spine of the scapula to the smooth triangular space Innervation: Motor: Spinal nerve of accessory nerve CN XI; Propriroception: Anterior rami of C3 and C4 Action: - Superior fibers: elevate scapula (shrug shoulders) and rotate scapula when arm is abducted above horizontal - Middle fibers: Retract scapula - Inferior fibers: Depress scapula - Superior and inferior: Superior (upward) rotation of scapula - Action on the head: Superior fibers (when acting unilaterally) laterally flex and rotate head to opposite side; (acting bilaterally) extended head
38
Posterior muscles that fix the scapula
3 muscles: - trapezius - Rhomboid major/minor - Levator scapula
39
Anterior muscles that fix the scapula
3 Muscles: - Serratus anterior - Pectorallis minor - Subclavius
40
Posterior Muscles that move the GH joint
5 Muscles - Rotator cuff muscles ( Supraspinatus, Infraspinatus, Teres Minor, Subscapularis) - Deltoid (posterior -> anterior) - Latissimus Dori - Teres Major - Triceps brachii, long head
41
Anterior Muscles that move the GH joint
3 Muscles - Pectoralis Major - Coracobrachialis - Biceps Brachii
42
Movements of the Sternoclavicular Joint
- Some rotation - Elevation/depression - protraction /retraction.
43
Movements of the Scapula
- Elevation/ Depression - Protraction/ retraction - Rotation (Up/down)

Anatomy (18 decks)

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