Shoulder Girdle and Arm Flashcards

1
Q

shoulder girdle consists of the

A

clavicle and scapula

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2
Q

clavicle and scapula articulate with one another at this joint

A

acromioclavicular

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3
Q

long, slender bone that lies horizontally across the root of the neck just beneath the skin

A

clavicle

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4
Q

clavicle articulates with this/these structures medially

A

sternum and 1st costal cartilage

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5
Q

the clavicle articulates with this structure laterally

A

acromion process of the scapula

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6
Q

the clavicle acts as a ____

A

strut that holds the arm away from the trunk

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7
Q

clavicle transmits forces from the upper limb to the

A

axial skeleton

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8
Q

medial two thirds of the clavicle is

a. convex forward
b. concave forward

A

a. convex forward

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9
Q

flat triangular bone

A

scapula

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10
Q

scapula location

A

posterior chest wall

between 2nd and 7th ribs

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11
Q

on the posterior surface of the scapula, this projects backward

A

spine of the scapula

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12
Q

lateral end of the spine of scapula is free and forms the

A

acromion

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13
Q

this angle of the scapula forms the glenoid cavity or fossa

A

superolateral angle of the scapula

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14
Q

shape of glenoid cavity

A

pear-shaped

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15
Q

glenoid cavity artiulates with

A

head of the humerus at shoulder joint

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16
Q

projects upward and forward above the glenoid cavity

provides attachment for muscles and ligaments

A

coracoid process

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17
Q

medial to the base of the coracoid process is the

A

suprascapular notch

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18
Q

anterior surface of the scapula is

a. concave
b. convex

A

a. concave

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19
Q

spine of the scapula

position

A

posterior surface

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20
Q

acromion position

A

lateral

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21
Q

glenoid cavity

position

A

lateral

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22
Q

coracoid process location

A

lateral

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23
Q

subscapular surface

postion

A

anterior

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24
Q

concave anterior surface of the scapula forms the shallow

A

subscapular fossa

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25
Q

this surface of the scapula is divided by the spine

A

posterior surface

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26
Q

posterior surface of the scapula is divided by the spine into

A

supraspinous fossa

infraspinous fossa

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27
Q

this part of scapula can be palpated easily in a living subject

A

inferior angle of scapula

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28
Q

inferior angle, marks this level

A

7th rib

spine of 7th thoracic vertebra

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29
Q

most commonly fractured bone in the body.

A

clavicle

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30
Q

clavicular fracture usually occurs as a result of

A

fall on the shoulder

fall on an outstretched hand

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31
Q

weakest point of the clavicle

A

middle and outer thirds

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32
Q

this fragment of the clavicle will get depressed by weight of the arm, if it is fractured

A

lateral fragment

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33
Q

what will pull the lateral fragment of the clavicle, after fracture, medially and forward

A

strong adductor muscles of the shoulder joint

esp. pectoralis major

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34
Q

position of clavicle after fracture

A

lateral fragment depressed, pulled medially and forwards

medial end, tilted upward

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35
Q

what pulls the medial end of clavicle upward after fracture

A

sternocleidomastoid muscle

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36
Q

this nerves cause persistent pain over the side of the neck after clavicular fracture

A

supraclavicular nerves

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37
Q

group of disorders that occur when blood vessels or nerves in the space between your collarbone and first rib are compressed

A

thoracic outlet syndrome

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38
Q

clinical manifestations expected from thoracic outlet syndrome

A

pain in shoulders and neck

numbness in fingers

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39
Q

fractures of the scapula are due to

a. severe trauma
b. mild trauma

A

a. severe trauma
such as run-over accident victims
automobile accidents

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40
Q

most fractures of the scapula require little treatment because

A

muscles on the anterior and posterior surfaces adequately splint the fragments

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41
Q

what maintains the position of the scapule on the posterior wall

A

tone and balance of muscles attached to it

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42
Q

paralysis of the trapezius results in

A

dropped shoulder

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43
Q

paralysis of the serratus anterior

A

winged scapula

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44
Q

humerus articulates with

A

scapula at shoulder joint

radius and ulna at elbow joint

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45
Q

upper end of the humerus has a

A

head

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46
Q

the head of the humerus forms this shape

A

1/3 of a sphere

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47
Q

humerus articulates with

A

glenoid cavity of the scapula

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48
Q

below the head of the humerus is the

A

anatomic neck

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49
Q

below the neck of the humerus is

A

greater and lesser tuberosities

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50
Q

what separates the greater and lesser tuberosities

A

bicipital groove

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51
Q

where the upper end of the humerus joints the shaft is a

A

narrow surgical neck

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52
Q

halfway down the lateral aspect of the shaft is a roughened elevation called

A

deltoid tuberosity

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53
Q

this landmark accomodates the radial nerve

A

spiral groove

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54
Q

behind and below the deltoid tuberosity

A

spiral groove

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55
Q

lower end of the humerus possesses

A
medial and lateral epicondyles
capitulum
trochlea
radial fossa
coronoid fossa
olecranon fossa
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56
Q

this landmark of humerus is for articulation with the head of the radius

A

capitulum

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57
Q

this landmark of humerus is for articulation with the trochlear notch of the ulna

A

trochlea

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58
Q

shape of the trochlea

A

pulley-shaped

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59
Q

above the capitulum is

A

radial fossa

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60
Q

above the trochlea anteriorly

A

coronoid fossa

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61
Q

receives the head of the radius whent he elbow is flexed

A

radial fossa

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62
Q

receives the coronoid process of ulna

A

coronoid fossa

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63
Q

above the trochlea posteriorly

A

olecranon fossa

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64
Q

receives the olecranon process of ulna

landmark on humerus

A

olecranon fossa

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65
Q

elbow is flexed

which fossa receives

a. olecranon fossa
b. radial fossa

A

b. radial fossa

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66
Q

elbow is extended

which fossa receives

a. olecranon fossa
b. radial fossa

A

a. olecranon fossa

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67
Q

fractures of the proximal end of the humerus

A

humeral head fractures
greater tuberosity fractures
lesser tuberosity fractures
surgical neck fractures

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68
Q

fractures of the humerl head can occur during

A

process of anterior and posterior dislocations of the shouldeer joint

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69
Q

what happens when the glenoid labrum of the scapula produces the fracture, and the labrum becomes jammed in the defect

A

makes reduction of the shoulder joint difficult

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70
Q

greater tuberosity of the humerus can be fractured by

A

direct trauma
displaced by glenoid labrum during dislocation of the shoulder joint
avulsed by violent contractions of the supraspinatus muscle

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71
Q

bone fragment of a greater tuberosity fracture will have attachments of

A

supraspinatus, teres minor, infraspinatus muscles (part of rotator cuff muscles)

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72
Q

When associated with a shoulder dislocation, severe tearing of the cuff with the fracture can result in the greater tuberosity remaining ___________ after the shoulder joint has been reduced

A

displaced posteriorly

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73
Q

When associated with a shoulder dislocation, severe tearing of the cuff with the fracture can result in the greater tuberosity remaining displaced posteriorly after the shoulder joint has been reduced.

tx

A

open reduction of the fracture is necessary to attach the rotator cuff back into place.

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74
Q

lesser tuberosity fracture accompanies _____ dislocation of the shoulder joint

a. posterior
b. anterior

A

a. posterior

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75
Q

Lesser Tuberosity Fractures

bone fragment receives the insertion of

A

subscapularis tendon

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76
Q

surgical neck of the humerus

can be fractured by

A

direct blow on the lateral aspect of the shoulder

indirect manner by falling on the outstretched hand.

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77
Q

Fractures of the humeral shaft

displacement of the fragments depends on the relation of the site of fracture to the insertion of the

A

deltoid muscle

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78
Q

When the fracture line is proximal to the deltoid insertion, the proximal fragment is

A

adducted by the

pectoralis major, latissimus dorsi, and teres major muscles

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79
Q

Fractures of the Shaft of the Humerus (proximal to deltoid insertion)

distal fragment is

A

pulled proximally by deltoid, biceps, and triceps

80
Q

When the fracture is distal to the deltoid insertion, the proximal fragment and distal fragment is

A

proximal fragment - abducted by the deltoid

distal fragment - pulled proximally by the biceps and triceps

81
Q

what nerve lies in the spiral groove

A

radial nerve

82
Q

on what surface of the humerus is the spiral groove

A

posterior

83
Q

radial nerve lying on the spiral groove is under the cover of what muscle

A

triceps muscle

84
Q

supracondylar fractures are common in this population

A

children

85
Q

Supracondylar fractures

occur when the

A

child falls on the outstretched hand with the elbow partially flexed

86
Q

supracondylar fractures

nerve injury

A

median, radial, and ulnar nerves

87
Q

does function usually quickly returns after reduction of the Supracondylar fractures

A

yes

88
Q

this artery can be damaged or pressure can be applied in Supracondylar fractures

A

brachial artery

89
Q

Damage to or pressure on the brachial artery can occur at the time of the fracture or from swelling of the surrounding tissues; the circulation to the forearm may be interfered with, leading to

A

Volkmann’s ischemic contracture

90
Q

can be avulsed by the medial collateral ligament of the elbow joint if the forearm is forcibly abducted

A

medial epicondyle

91
Q

can be injured at the time of the fracture (medial epicondyle avulsion)

A

ulnar nerve

92
Q

role of ulnar nerve in a medial epicondyle fracture

A

repair p cess of the fracture (in the callus)

irritation on the irregular bony surface after the bone fragments are reunited

93
Q

Anterior wall of the axilla

A

pectoralis major
subclavius
pectoralis minor

94
Q

shape of the axilla or armpit

A

pyramid-shaped space

95
Q

upper end of the axilla

A

apex

96
Q

apex

bound anteriorly by

A

clavicle

97
Q

apex

bound posteriorly by

A

upper border of the scapula

98
Q

apex

bound medially by

A

outer border of the first rib

99
Q

lower end of axilla

A

base

100
Q

lower end, or base of axilla, is bounded in front by

A

anterior axillary fold

101
Q

anterior axillary fold formed by the lower border of this muscle

A

pectoralis major muscle

102
Q

lower end, or base of axilla, is bounded in behind by

A

posterior axillary fold

103
Q

posterior axillary fold is formed by

A

tendon of latissimus dorsi a

teres major muscle

104
Q

the base of the axilla is bound medially by the

A

chest wall

105
Q

posterior wall

axilla

A

subscapularis
latissimus dorsi
teres major muscles

106
Q

medial wall

axilla

A

upper four or five ribs and the intercostal spaces

serratus anterior

107
Q

lateral wall

axilla

A

coracobrachialis

biceps muscles in the bicipital groove of the humerus

108
Q

triangular muscle that lie pectoralis major

A

Pectoralis Minor

109
Q

Pectoralis Minor

arises from

A

3rd, 4th, and 5th ribs

110
Q

insertion

pectoralis minor

A

coracoid process (scapula)

111
Q

It is used when describing the axillary artery to divide it into three parts

A

pectoralis minor

112
Q

nerves and arteries crossed by the pectoralis minor

A

axillary artery

brachial plexus

113
Q

strong sheet of connective tissue that is attached above to the clavicle

A

clavipectoral fascia

114
Q

clavipectoral fascia

it splits to enclose the pectoralis minor muscle and then continues downward as the

A

suspensory ligament of the axilla

115
Q

this important nerve plexus is in the axilla

A

brachial plexus

116
Q

important artery in the axilla

A

axillary artery and its branches

117
Q

supplies blood to the upper limb

A

axillary artery

118
Q

drain blood from upper limb

A

axillary vein

119
Q

the structures in the axilla are embedded in

A

fat

120
Q

axillary artery begins at

A

begins at the lateral border of the 1st rib

121
Q

axillary artery is a continuation of the

A

subclavian

122
Q

The axillary artery ends at the

A

lower border of the teres major muscle

123
Q

at the lower border of the teres major muscle

the axillary artery continues as the

A

brachial artery

124
Q

Throughout its course, the axillary artery is closely related to the cords of the

A

brachial plexus and their branches

125
Q

axillary artery and cords of the brachial plexus and their branches
is enclosed in a connective tissue sheath called the

A

axillary sheath

126
Q

axillary sheath
upward
is continuous with the

A

prevertebral fascia

127
Q

this muscle crosses in front of the a lary artery and divides it into three parts

A

pectoralis minor muscle

128
Q

First Part of the Axillary Artery This extends from the

A

lateral border of the 1st rib to the upper border of the pectoralis minor

129
Q

Second Part of the Axillary Artery

A

lies behind the pectoralis minor muscle

130
Q

Third Part of the Axillary Artery

A

extends from the lower border of the pectoralis minor to the lower border of the teres major

131
Q

anterior

First Part of the Axillary Artery

A

pectoralis major

cephalic vein

132
Q

First Part of the Axillary Artery

posterior

A

long thoracic nerve

133
Q

First Part of the Axillary Artery

lateral

A

three cords of the brachial plexus

134
Q

First Part of the Axillary Artery

medially

A

axillary vein

135
Q

Second Part of the Axillary Artery

anterior

A

pectoralis minor

pectoralis major

136
Q

Second Part of the Axillary Artery

Posteriorly

A

posterior cord of the brachial plexus
subscapularis muscle
shoulder joint

137
Q

Second Part of the Axillary Artery

medially

A

medial cord of the brachial plexus

axillary vein

138
Q

is the most commonly missing part of an Absent Pectoralis Major

A

sternocostal origin

139
Q

Second Part of the Axillary Artery

Laterally

A

lateral cord of brachial plexus

140
Q

absent sternocostal origin of pectoralis major may cause

A

weakness in adduction and medial rotation of the shoulder joint.

141
Q

Third Part of the Axillary Artery

anterior

A

pectoralis major

medial root of the median nerve

142
Q

Posteriorly

Third Part of the Axillary

A

subscapularis
latissimus dorsi
teres major

axillary
radial nerves

143
Q

Third Part of the Axillary Artery

Laterally

A

coracobrachialis
biceps
humerus

lateral root of the median and musculocutaneous nerves

144
Q

Medially

Third Part of the Axillary Artery

A

ulnar nerve
axillary vein
medial cutaneous nerve

145
Q

first branch of Axillary Artery, is small and runs runs along the upper border of the pectoralis minor.

A

highest thoracic artery

146
Q

second part of the branches of the axillary artery, which immediately divides into terminal branches

A

thoracoacromial artery

147
Q

this branch of the axillary artery runs along the lower border of the pectoralis minor

A

lateral thoracic artery

148
Q

second part of the axillary artery after highest thoracic artery

A

thoracoacromial artery

lateral thoracic artery

149
Q

third part of the branches of the axillary artery, runs along the lower border of the subscapularis muscle.

A

subscapular arter

150
Q

third part of axillary artery, wind around the front and the back of the surgical neck of the humerus, respectively

A

anterior and posterior circumflex humeral arteries

151
Q

The axillary vein (Fig. 9.12) is formed at the lower border of the

A

teres major muscle

152
Q

axillary vein is formed by the

A

venae comitantes of the brachial artery

basilic vein

153
Q

location of the axillary vein

A

lower border of thhe teres major muscle
runs upward on the medial side of the axillary artery
ends at the lateral border of the 1st rib

154
Q

at the lateral border of the 1st rib, the axillary vein becomes

A

subclavian vein.

155
Q

the axillary vein receives tributaries, which correspond to the branches of the

A

axillary artery, and the cephalic vein

156
Q

Spontaneous thrombosis of the axillary vein occasionally occurs after

A

excessive and unaccustomed movements of the arm at the shoulder joint

157
Q

axillary sheath encloses

A

axillary vessels and brachial plexus

158
Q

how is a brachial plexus nerve block achieved

A

distal part of the sheath is closed with finger pressure, and a syringe needle is inserted into the proximal part of the sheath. The anesthetic solution is then injected into the sheath, and the solution is massaged along the sheath to produce the nerve block.

159
Q

The position of the axillary sheath can be verified by

A

feeling the pulsations of the third part of the axillary artery

160
Q

third part of the axillary artery

A

subscapular artery

anterior and posterior circumflex humeral arteries

161
Q

important functions of nerves in the brachial plexus

A

sensory innervation to the skin and deep structures (the joints)

motor innervation to the muscles

diameters of the blood vessels by the sympathetic vasomotor nerves

sympathetic secretomotor supply to the sweat glands

162
Q

At the root of the neck, the nerves form a complicated plexus called the

A

brachial plexus

163
Q

location of the brachial plexus

A

posterior triangle of the neck

164
Q

bbrachial plexus is formed by what nerves

A

union of the anterior rami of the 5th, 6th, 7th, and 8th cervical and the 1st thoracic spinal nerves

165
Q

brachial plexus can be divided into

A

roots
trunks
divisions
cords

166
Q

upper trunk

A

roots of C5 and 6

167
Q

middle trunk

A

root of C7

168
Q

lower trunk.

A

C8 and T1

169
Q

anterior divisions of the upper and middle trunks unite to form the

A

lateral cord

170
Q

anterior division of the lower trunk continues as the

A

medial cord

171
Q

posterior divisions of all three trunks join to form the

A

posterior cord

172
Q

The roots, trunks, and divisions of the brachial plexus reside in the

A

lower part of the posterior triangle of the neck

173
Q

The cords become arranged around this structure

A

axillary artery

174
Q

position of the cords of the brachial plexus to the first part of the axillary artery

A

above and lateral

175
Q

this cord of the brachial plxus crosses behind the axillary artery to reach the medial side of the second part of the artery

A

medial cord

176
Q

this cord lies behind the second part of the artery

A

posterior cord

177
Q

this cord lies on the lateral side of the second part of the artery

A

lateral cord

178
Q

the cords of the plexus have the relationship to the ______________ that is indicated by their names

A

second part of the axillary artery

179
Q

The rotator cuff consists of the tendons of the

A

subscapularis, supraspinatus, infraspinatus, and teres minor muscles
(fused to the underlying capsule of the shoulder joint)

180
Q

role of the Rotator Cuff

A

stabilizing the shoulder joint by pressing the humeral head into the glenoid cavity

181
Q

Failure of the rotator cuff is due to either

A

wear ( Degenerative changes in the bursa are followed by degenerative changes in the underlying supraspinatus tendon, and these may extend into the other tendons of the rotator cuff)
and tear

182
Q

During abduction of the shoulder joint, this tendon is exposed to friction against the acromion

A

supraspinatus tendon

183
Q

Under nomal conditions, the amount of friction (between supraspinatus tendon and acromion) is reduced to a minimum by

A

the large subacromial bursa, which extends laterally beneath the deltoid

184
Q

Rotator Cuff Tendinitis (when the subacromial bursa degenerates which results in degeneration of supraspinatus tendon)
Clinically, the condition is known as

A

subacromial bursitis, s spinatus tendinitis, or pericapsulitis

185
Q

It is characterized by the presence of a spasm of pain in the middle range of abduction, when the diseased area impinges on the acromion.

A

Rotator Cuff Tendinitis

186
Q

Rotator Cuff Tendinitis

Extensive acute traumatic tears are best repaired

A

surgically as soon as possible

187
Q

Small chronic cuff injuries are best managed

A

without surgery using nonsteroidal anti-inflammatory drugs and muscle exercises

188
Q

In advanced cases of rotator cuff tendinitis, the necrotic supraspinatus tendon can become

A

calcified or rupture

189
Q

Rupture of the supraspinatus tendon seriously interferes with the

A

normal abduction movement of the shoulder joint

190
Q

main function of the supraspinatus muscle

A

hold the head of the humerus in the glenoid fossa at the commencement of abduction

191
Q

The patient with a ruptured supraspinatus tendon is unable to

A

initiate abduction of the arm

192
Q

The patient with a ruptured supraspinatus tendon is unable to initiate abduction of the arm. However, if the arm is passively assisted for the first _______ of abduction, the ______ can then take over and complete the movement to a right angle.

A

15°

deltoid

193
Q

The accessory nerve can be injured as the result of

A

stab wounds to the neck

194
Q

The axillary nerve can be injured in

A

dislocations of the s der joint

195
Q

how to preserve the upper limb when it is necessary to ligate axillary artery

A

existence of the anastomosis (anastomosing circle by circumflex arteries) around the shoulder joint