shoulder and arm

Question 1

3 bones of region

Answer 1

scapula, clavicle, humerus

Question 2

sections of scapula

Answer 2

spine on posterior surface separating suprapinous and infraspinous fossa; lateral end is acromion; coracoid process protrudes forward; lateral arch bone widened into glenoid cavity and rim (socket for ball and socket joint); superior, lateral and inferior angles

Question 3

sections of clavicle, including when it becomes calcified

Answer 3

first bone to start becoming calcified during foetal development, and one of the last to finish; S-shaped, flattened at acromial-end; sternal end has flattish sternal facet that articulates with manubrium and first costal cartilage

Question 4

sections of humerus

Answer 4

long bone with relatively straight shaft; proximal and distal ends are widened out; smooth rounded head; radial groove; deltoid tuberosity (irregular) where proximal part of deltoid attaches; epicondyles above sections of condyles (capitulum and trochlea)

Question 5

2 necks of humerus

Answer 5

surgical, anatomical (true)

Question 6

what humerus neck is more commonly damaged

Answer 6

surgical

Question 7

location of proximal attachments in general

Answer 7

closer to trunk

Question 8

5 muscular anatomy compartments of shoulder and arm

Answer 8

anterior pectoral girdle muscles, posterior pectoral girdle muscles, intrinsic shoulder muscles, anterior compartment of [“upper”] arm, posterior compartment of [“upper”] arm

Question 9

4 anterior pectoral girdle muscles

Answer 9

pectoralis major, pectoralis minor, subclavius, serratus anterior

Question 10

orientation serratus anterior runs

Answer 10

posterior to anterior

Question 11

proximal and distal attachments of pectoralis major

Answer 11

proximal attachments to medial 1/3 clavicle (clavicular head), sternum, costal cartilages (sternocostal head); distal attachment to lateral lip of intertubercular sulcus (groove) in anterior part of humerus

Question 12

nerves supplying pectoralis major

Answer 12

medial and lateral pectoral nerves

Question 13

functions of pectoralis major

Answer 13

adducts and medially rotates humerus (lesser actions on scapula)

Question 14

pectoralis minor proximal attachment

Answer 14

coracoid process of scapula

Question 15

pectoralis minor distal attachment

Answer 15

finger-like parts which attach to 2-5th ribs (close to costrochondral joints)

Question 16

pectoralis minor function

Answer 16

pulls scapula forward and possibly down

Question 17

subclavius attachments

Answer 17

proximal to first rib close to costochondral joint; distal to clavicle

Question 18

subclavius function

Answer 18

stabilising clavicle

Question 19

serratus anterior attachments

Answer 19

runs from medial border of scapula, anteriorly over surface of thoracic cage, to anterior attachments on ribs (typically 1-9)

Question 20

serratus anterior nervous supply

Answer 20

long thoracic nerve

Question 21

serratus anterior function

Answer 21

holds scapula to wall

Question 22

4 posterior pectoral girdle muscles

Answer 22

trapezius, latissimus dorsi, levator scapulae, rhomboids

Question 23

trapezius attachments

Answer 23

attachments most superiorly to nuchal line of skull, cervical and thoracic vertebrae; descending (superior fibres), middle fibres come across, ascending (inferior fibres); curls round to front (very large muscle); attach to spine, clavicle and acromion

Question 24

trapezius function

Answer 24

stabilise and move scapula

Question 25

nerve innervation of trapzius

Answer 25

spinal accessory nerve (CN XI)

Question 26

latissimus dorsi movements

Answer 26

extends adducts and rotates humerus e.g. pulls body up to arm during climbing

Question 27

latissimus dorsi supply

Answer 27

thoracodorsal nerve

Question 28

location and attachments of rhomboids

Answer 28

medial border of scapula; form quadrilateral parallelogram of muscle which attaches to spinous process of C7-T5 vertebrae

Question 29

rhomboid nevrous supply

Answer 29

dorsal scapular nerve

Question 30

rhomboid movement of scapula

Answer 30

retracts, rotates and fixes scapula

Question 31

levator scapulae attachements

Answer 31

C1-C4 transverse process and superior angle of scapula

Question 32

levator scapulae nervous supply

Answer 32

dorsal scapula nerve and C3,4

Question 33

levator scapulae movement of scapula

Answer 33

elevates and rotates scapula

Question 34

3 intrinsic shoulder muscles

Answer 34

deltoid, teres major, rotator cuff muscles

Question 35

4 rotator cuff muscles

Answer 35

supraspinatus, infraspinatus, teres minor, subscapularis

Question 36

deltoid nervous supply, attachments and movement

Answer 36

supplied by axillary nerve; attachments to spine of scapula, acromion and anterior to lateral clavicle (clavicular, middle and spinal/posterior part); abducts arm after 15 degrees

Question 37

rotator cuff muscles, nervous supply, attachments and movement

Answer 37

cover scapula; supraspinatus in supraspinous fossa and infraspinatus in infraspinous fossa (supplied by siprascapular nerve); teres minor is straight and supplied by axillary nerve; broad subscapularis muscle is in deep surface (anterior surface of scapula); all run towards head of humerus, cross over shoulder joint to attach; main activity is to fix head of humerus in glenoid fossa, but with supraspinatus important in initiating abduction of arm for first 15 degrees

Question 38

teres major nerve supply, attachments and function

Answer 38

innervated by lowest subscapular nerve; proximal attachment to inferior angle and distal to medial lip of interrubercular sulcus of humerus (latissimus dorsi attaches here too); adducts and medially rotates arm

Question 39

3 muscles of anterior compartment of arm

Answer 39

biceps brachii, brachialis, coraco-brachialis

Question 40

nerve supplying muscles in anterior compartment of arm

Answer 40

musculocutaneous nerve (C5,6,7), lying close to subscapularis tendon anterior to shoulder

Question 41

biceps brachii proximal and distal attachments

Answer 41

short head more lateral (coracoid process), and long head more medially (goes through intertubercular groove held in place by ligament); crosses over shoulder joint and attaches to rim of glenoid fossa; both merge distally and form distal attachments at elbow, forming tendon attaching to radius (radial tuberosity) and bicepital aponeurosis

Question 42

coracobrachialis proximal and distal attachments and function

Answer 42

corachoid process; spindle-shaped that broadens distally and attaches to humerus, acting across shoulder joint; adducts arm

Question 43

brachialis location, function and proximal and distal attachments

Answer 43

underneath biceps; flexion of elbow joint; attaches to middle shaft of humerus proximally; distally has broad attachment at lower parts of shaft and attaches to coronoid process of ulna

Question 44

2 muscles of posterior compartments of arm

Answer 44

triceps brachii, anconeus

Question 45

nerve supply of posterior compartment of arm

Answer 45

radial nerve (C5,6,7,8 T1); lies on humerus in radial groove

Question 46

triceps brachii proximal and distal attachments

Answer 46

proximally the lateral and medial head attach to posterior shaft of humerus, and long head attaches to infraglenoid tubercle of scapula; distally forms triceps tendon which crosses elbow and attaches to olecranon process of ulna

Question 47

anconeus proximal and distal attachments

Answer 47

small muscle attaching to humerus proximally at lateral epicondyle, then broadens out and attaches distally to posterior ulna at olecranon process

Question 48

4 joints of pectoral girdle

Answer 48

sterno-clavicular joint, acromio-clavicular joint, gleno-humeral joint (shoulder joint), scapulo-thoracic "joint"

Question 49

other joint of arm

Answer 49

elbow joint

Question 50

sterno-clavicular joint type

Answer 50

synovial joint composed of 2 portions separated by fibrocartilage articular disc

Question 51

what gives sterno-clavicular joint strength

Answer 51

very strong sterno-clavicular ligaments (injury causes subluxation and dislocation)

Question 52

what does sternal end of clavicle articulate with

Answer 52

sternum at manubrium, first costal cartilage

Question 53

how many planes does the sterno-clavicular joint allow movement of the clavicle and girdle

Answer 53

3

Question 54

acromio-clavicular joint type and where is it between

Answer 54

synovial joint, between acromial end of clavicle and acromion process of scapula

Question 55

3 ligaments involved in connecting and stabilising acromio-clavicular joint

Answer 55

acromio-clavicular ligament, coraco-clavicular ligament, coraco-acromial ligament

Question 56

where does the coraco-clavicular ligament run

Answer 56

from coracoid process of scapula to clavicle

Question 57

2 main sections of coraco-clavicular ligament

Answer 57

conoid, trapezoid

Question 58

what can the coraco-acromial ligament often cause

Answer 58

impingement of gleno-humeral joint

Question 59

what ligament of the acromio-clavicular joint is torn in minor dislocations

Answer 59

acromio-clavicular ligament

Question 60

what 2 ligaments of the acromio-clavicular joint are torn in severe dislocations

Answer 60

acromio-clavicular ligament, coraco-clavicular ligament

Question 61

what does the scapulo-thoracic "joint" represent

Answer 61

"articulation" between scapula and chest wall

Question 62

4 movements of scapula at scapulo-thoracic "joint"

Answer 62

elevation and depression of scapula, protraction of scapula (forward and lateral against chest wall), retraction of scapula (backward and medial against chest wall), rotation of scapula