Shoulder Breast Pec Flashcards

1
Q

Where is the clavicopectoral fascia?

A

Deep to pec major (encloses subclavius m. and pectoralis minor m.

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2
Q

What dermatome covers the level of the clavicles?

A

C5

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3
Q

What dermatome covers the level of the nipples?

A

T4

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4
Q

What dermatome covers the level of the umbilicus?

A

T10

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5
Q

What are the mm. of the rotator cuff? What does it do?

A

SITS: Supraspinatus; Intraspinatus; Teres minor; Subscapularis
-Fixes humeral head in glenoid cavity during arm flexion and abduction

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6
Q

Pectoralis major: innervation and actions?

A
  • medial and lateral pectoral nerves

- flexes arm, adducts arm, rotates arm medially

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7
Q

Pectoralis minor: innervation and actions?

A
  • medial pectoral nerve

- lowers lateral angle of scapula, protracts scapula. elevates ribs if scapula fixed.

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8
Q

Serratus anterior: innervation and actions?

A
  • long thoracic nerve
  • protracts and rotates scapula, holds it against T-wall (stabilization)
  • Boxer’s muscle
  • Supplied by lateral thoracic artery
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9
Q

Deltoid: innervation and actions?

A
  • axillary nerve
  • clavicular part: flexes and medially rotates arm
  • acromial part: abducts arm beyond initial 10-15 degrees up to 100 degrees (supraspinatus before, trapezius after)
  • spinal part: extends and laterally rotates arm
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10
Q

Supraspinatus: innervation and actions?

A
  • suprascapular nerve

- initiates arm abduction (up to 10-15 degrees), acts w/rotator cuff mm. (doesn’t rotate the humerus)

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11
Q

Infraspinatus: innervation and actions?

A
  • suprascapular nerve

- lateral arm rotation (w/teres minor)

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12
Q

Teres minor: innervation and actions?

A
  • axillary nerve

- laterally rotates arm

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13
Q

Subscapularis: innervation and actions?

A
  • upper and lower subscapular nerves

- medially rotates arm, adducts arm, holds humeral head in glenoid cavity

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14
Q

Which m. is most commonly torn in rotator cuff injuries?

A

Supraspinatus m.

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15
Q

Teres major: innervation and actions?

A
  • lower subscapular nerve

- adducts arm, medially rotates arm

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16
Q

Latissimus dorsi: innervation and actions?

A
  • thoracodorsal nerve
  • extends, adducts, and medially rotates humerus at shoulder
  • supplied by thoracodorsal artery
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17
Q

Levator scapulae: innervation and actions?

A
  • ventral rami of C3-C4, dorsal scapular nerve

- elevates scapula medially, inferiorly rotates glenoid cavity

18
Q

Rhomboid major: innervation and actions?

A
  • dorsal scapular nerve

- fixes scapula to T-wall, retract and rotate scapula to depress glenoid cavity (drops shoulder)

19
Q

Rhomboid minor: innervation and actions?

A
  • dorsal scapular nerve

- fixes scapula to T-wall, retracts and rotates scapula to depress glenoid cavity (drops shoulder)

20
Q

Arteriole anastomoses about the shoulder: subclavian –> axillary route

A

Subclavian a. –> suprascapular a. –> circumflex scapular a. –> subscapular a. –> axillary a.

  • (suprascapular a. is in thyrocervical trunk of subclavian branch)
  • (circumflex scapular a. is branch of subscapular a. from axillary branch)
21
Q

What is important about the suprascapular notch?

A

Suprascapular artery and nerve: army over, navy under (the ligament)

22
Q

Quadrandular space: what makes up its borders? What lies w/in it?

A
  • teres minor, teres major, long head of triceps, humerus

- axillary n. + posterior humeral circumflex a.

23
Q

Triangular space: what makes up its borders? What lies w/in it?

A
  • teres minor, teres major, long head of triceps

- circumflex scapular a.

24
Q

Triangular interval: what makes up its borders? What lies w/in it?

A
  • teres major, long head of triceps, humerus

- deep (profunda) brachial a. and radial n.

25
Q

What nerve innervates all extensor mm. in the arm?

A

Radial nerve

26
Q

What defines the apex of the axilla?

A

1st rib, clavicle, superior edge of the scapular

27
Q

What defines the base of the axilla?

A

Concave skin, sub-Q tissue, axillary fascia (armpit)

28
Q

What defines the anterior wall of the axilla?

A

Pec major and minor mm., pectoral and clavipectoral fascia

29
Q

What defines the posterior wall of the axilla?

A

Scapula and subscapularis m.

30
Q

What defines the medial wall of the axilla?

A

T-wall, 1st-4th ribs (serratus anterior m. covers the ribs)

31
Q

What defines the lateral wall of the axilla?

A

Intertubercular groove of the humerus (plus coricobrachialis m.)

32
Q

Branches of the axillary artery:

A

Screw The Lawyer, Save A Patient

  1. Superior thoracic a.
  2. Thoracoacromial trunk
  3. Lateral thoracic arteries
  4. Subscapular a.
  5. Anterior circumflex humeral a.
  6. Posterior circumflex humeral a.
33
Q

What are the suspensory ligaments (of Cooper)?

A

Breast: attach lobes to skin & divide glandular tissue into lobes

34
Q

How many glands form a breast lobe?
How many lactiferous ducts and sinuses are per gland?
80% of tumors originate where?

A
  • 15-20
  • 1
  • Ducts
35
Q

What 3 arteries supply the breast?

A

Lateral thoracic a., thoracoacromial (pectoral) a., internal thoracic a.

36
Q

What are the 5 major lymph nodes of the breast?

A

CLASP

-central, lateral, apical, subscapular, and pectoral nodes

37
Q

What breast quadrant has by far the highest rate of cancer?

A

Superior lateral quadrant

38
Q

What does the pectoral fascia cover?

A

Covers pectoralis major

39
Q

What does axillary fascia cover?

A

It’s a continuation of pectoral fascia laterally into the axilla

40
Q

What are the branches of the thoracoacromial trunk (“The” lawyer of the axillary a. branch)

A

ACDP

Acromial, Clavicular, Deltoid, Pectoral

41
Q

What are the branches of the subscapular artery (“Save” a patient of the axillary a. branch)

A

Circumflex scapular a. and thoracodorsal a.

42
Q

In the arteriole supply to the shoulder, what’s a pathway where blood can bypass the axillary a.?

A

Subclavian a. –> suprascapular a. –> circumflex scapular a. –> subscapular a. –> axillary a.

  • (suprascapular a. is in thyrocervical trunk of subclavian branch)
  • (circumflex scapular a. is branch of subscapular a. from axillary branch)