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What is the version of the proximal humerus in relation to the transepicondylar axis?

30 degrees retroverted

1

What is the version of the glenoid? relative to what?

scapular tilt?

scapula position relative to chest wall?

Average 5 degrees. Range 7 retro to 10 anteverted

75% retroverted 7 degrees

25% anteverted 2-10 degrees

relative to the long axis of the scapula - on axial slice, a line connecting midpoint of glenoid with medial apex of scapula

tilted 3-5 degrees upwards

scapula positioned 30 degrees anterior relative to chest wall/coronal plane

2

What is the neck-shaft angle of the humerus?

 

version?  relative to what?

130-150 degrees (130 degrees average)

 

30 degrees retroverted relative to transepicondylar axis of elbow

3

What is the carrying angle in men and women?

Men: 10-15 degrees Women: 15-20 degrees

4

Describe Bauman's angle. What is the normal value?

Angle formed by a longitudinal line down the humeral shaft and another along the open capitellar physis. Normal: 72 degrees

5

suprascapular notch: bound by what ligament?

contains what structure?

What related structure is not within the notch?  relationship to the ligament?

Superior transverse scapular ligament. Suprascapular vessels are over the nerves "Army over Navy" "Army over, Navy under"

 

i.e. the notch contains the suprascapular nerve, with the ligament overlying it and the vessels just above the ligament

6

What are the muscles and nerves affected in medial/lateral scapular winging?

Medial winging: serratus anterior: long thoracic nerve

Lateral winging: Trapezius: CN 11, or accessory nerve

Rhomboids: dorsal scapular n

7

Name 3 anatomic variants of the shoulder labrum aside from the normal:

Buford complex: absence of the anterosuperior labrum with a thickened MGHL

Sublabral foramen - anterosuperior labrum appears detached from glenoid - looks like a tear

sublabral recess - superior labrum appears detached from glenoid - looks like a SLAP tear

 

 

 

8

describe the path of the axillary artery and its branches

once subclavian artery crosses first rib, becomes axillary artery

part I (1 branch): before (medial to) pec minor--gives off supreme thoracic branch

part II (2 branches): deep to pec minor--gives off thoracoacromial artery and lateral thoracic artery

part III (3 branches): lateral to pec minor--gives off subscapular artery, anterior and posterior humeral circumflex arteries

crosses teres major and becomes brachial artery

9

where does the subclavian artery become the axillary artery?

At the lateral edge (after) the 1st rib

10

Where does the brachial plexus become superficial?

At the distal end of clavicle

11

Where do the trunks of the brachial plexus lie?

On the anterior scalene muscles

12

What are the attachments to the greater tuberosity?

Superior facet: supraspinatus (s=s, super = supra) Middle facet: infraspinatus Inferior facet: teres minor

13

What is the attachment to the lesser tuberosity?

Subscapularis

 

sometimes some of supraspinatus according to 2009 JBJS paper 2009;91

14

How much of the trochlea is covered with articular cartilage? (how many degrees of the arc)

300 degree arc

15

Which direction is the distal humeral articulation of the elbow rotated in the axial plane? In the long (sagittal) plane? Varus/valgus (Coronal plane)?

Axial: 5-7deg IR Sagittal: 30deg anterior rotation 6-8deg valgus tilt

16

What is the column theory of the distal humerus?

3 column theory: - Medial, lateral, distal columns (like a spool in your fingers) - Medial column diverges from humeral shaft at 45 deg - Lateral column diverges from humeral shaft at 20 deg

17

What prevents AP displacement of the clavicle?

AC ligament

18

What ligaments are included in the sternoclavicular joint?

Anterior SC ligament

Posterior SC ligament

Interclavicular ligament

Costoclavicular ligament

20

What constitutes the conjoint tendon of the shoulder?

Coracobrachialis & Short head of biceps

21

Suprascapular notch; Compression here affects what?

Suprascapular nerve - Affects both supra and infraspinatus

22

What is a Buford complex?

Normal anatomical variant: Congenital absence of anterosuperior labrum with cord-like middle GH ligament - 2% of population - Normal variant

23

Stermocleidomastoid: OINA?

O: Mastoid I: sternal manubrium, 1/3 sternal end of clavicle N: Accessory nerve A: Head extension, lateral tilt, contralateral rotation

24

Trapezius: OINA

O: External occipital protuberance, superior nuchal line, SP C7-T12 I: Scapular spine, acromial 1/3 of clavicle N: Accessory nerve A: elevates shoulder girlde, rotate scapula

25

Rhomboids: OINA

O: - Major SP T2-5 - Minor SP C7-T1 I: Medial scapula I: Dorsal scapular nerve A: Scapular adduction and rotation

26

Levator Scapulae: OINA

O: TP C1-4 I: Superomedial scapula I: C3, C4 A; Scapular elevation and rotation

27

When does the clavicle ossify?  when does it fuse?

 

ossify at 5 wks GA, fuse at 25yrs

 

clavicle is the first bone to ossify and last to fuse

28

4 extrinsic ligamentous attachments to the scapula?

2 intrinsic ligaments of the scapula?

extrinsic: CA, CH, conoid, trapezoid

intrinsic: superior and inferior transverse scapular ligaments

29

17 muscular attachments to the scapula?

Supraspinatus

infraspinatus

teres minor

subscapularis

teres major

rhomboid major

rhomboid minor

trapezius

levator scapulae

pec minor

deltoid

latissimus dorsi

serratus anterior

biceps

coracobrachialis

omohyoid (inferior belly)

triceps long head

 

 

30

spinoglenoid notch: bound by what ligament?

what structure passes through here? What muscle does it supply? distal to this point?

inferior transverse scapular ligament.

contains suprascapular nerve

supplies infraspinatus distal to the notch