Shoulder/upper arm (+muscles)

Question 1

olecranon fossa is at the back of humerus what fossa(s) is at the front

Answer 1

coronoid and radius

Question 2

what articulates with the ulnar and radius on the humerus

Answer 2

ulnar - trochlear

capitulum - radius

Question 3

3 ligaments between clavicle and sternum

Answer 3

anterior sternoclavicular

costoclavicular

interclavicular

Question 4

ligaments between clavicle and scapula

Answer 4

acromioclavicular ligament

coracoclavicular ligament:
-trapezoid ligament
-conoid ligament
(the 2 strongest ligaments providing support and attachment for upper limb)

Question 5

what is glenoid labrum

Answer 5

fibrocartilaginous structure that forms a ring around glenoid fossa to deepen the socket - increasing the stability/congruity of the glenohumeral joint

Question 6

what is subacromial bursa

Answer 6

sack of synovial fluid within subacromial space between supraspinatus muscle and coracoacromial ligament, it prevents friction and ensures smooth movement of supraspinatus muscle

Question 7

transverse humeral ligament

Answer 7

between the greater and lesser tubercles of humerus

creates a intertubucular canal that the long head of biceps brachii goes through (keeps it in place)

Question 8

What movements normally occur at the acromioclavicular and sternoclavicular joints?

Answer 8

Acromioclavicular:
anterior/posterior gliding of acromion during pronation/retraction of scapula

Rotation of clavicle - occurs during abduction and adduction of shoulder

Sternoclavicular:
anterior, posterior & vertical movement of clavicle, limited rotation

Question 9

Which part of the fibrous capsule of glenohumeral joint is most loose?

Answer 9

Inferior part

Increases risk of inferior dislocation

Question 10

What are the roles of the acromion and coracoacromial ligament in maintaining gleno- humeral stability?

Answer 10

Limit superior movement of the humeral head and abduction of arm

Question 11

in which direction is humeral dislocation most common

Answer 11

downward

(Anterior dislocation of the glenohumeral joint is usually caused by excessive extension and lateral rotation of the humerus. It occurs most often in young particularly athletes.)

Question 12

glenohumeral joint is a ball and socket, what kind of joint is the elbow

Answer 12

hinge (synovial)

Question 13

annular ligament

Answer 13

around head of radius

stabilising radio-ulnar joint

Question 14

What movements occur at the humeroradial, humeroulnar, and proximal radioulnar joints?

Answer 14

Humeroradial:
flexion + extension

Humeroulnar:
flexion + extension

Proximal radioulnar:
supination + pronation

Question 15

What is the anatomical relationship between the epicondyles and olecranon process in elbow extension and flexion

Answer 15

extension - between the epicondyles

flexion - olecranon inferior the epicondyles

Question 16

lateral and medial epicondylitis

Answer 16

lateral = tennis elbow

• radial nerve injury risk
• pain posterior forearm
• repetitive forceful flexion/extension of wrist /lateral epicondyle

medial = golfer’s elbow

• ulnar nerve injury risk
• anterior forearm pain
• repetitive gripping/flexing/swinging

Question 17

Subluxation and Dislocation of the Radial Head

Answer 17

sublimation = incomplete dislocation

usually in young children

tear of annular ligament –> radial head move distally out

proximal part of torn ligament may get trapped between radial head and capitulum of humerus

treatment = supination of forearm during elbow flexion

Question 18

brachial plexus

Answer 18

C5-T1

Roots, Trunks(superior, middle, inferior), Divisions(Anterior, posterior), Cords(lateral, posterior, medial), Branches

Question 19

what do the branches of the brachial plexus supply and what are their roots

Answer 19

musculocutenaous (C5,6,7)
-biceps brachii

Axillary (C5,6)

• delotoid
• teres minor

median(C6,7,8,T1)

• forearm flexors
• thenar muscles
• 2 lateral finger flexors

radial(all)

• posterior extensor muscles
• triceps brachii

ulnar (C8, T1)

• forearm extensors
• medial finger flexors

Question 20

winged scapula is a consequence of which nerve damage

Answer 20

long thoracic (C5,6,7)

supplying the serratus anterior

Question 21

consequence of damaging axillary nerve

Answer 21

can’t abduct arm between 15-90 degrees

up to 15 = supraspinatous

Question 22

what causes superior and inferior brachial plexus injuries

Answer 22

superior is more common

• increased angle between neck and shoulder
• eg. accident where neck and shoulder seperate

inferior
-upper limb is suddenly pulled superiorly (eg. grabbing onto something as you fall)

Question 23

when does subclavian become axillary and then brachial artery

Answer 23

becomes axillary at 1st rib

brachial after lower margin of teres major

Question 24

what muscle divides the axillary into 3 parts

Answer 24

pectoralis minor
1st- above
2nd - behind
3rd - below

Question 25

branches of axillary artery

Answer 25

Screw The Lawyers, Save A Patient - superior thoracic - thoracoacromial - lateral thoracic - subscapular - anterior humeral circumflex - posterior humeral circumflex

Question 26

muscles that make up rotator cuff

Answer 26

SITS origin - supraspinatous (supraspinous fossa) - infraspinatous (infraspinous fossa) - teres MINOR (posterior lateral border of scapula) - subscapularis (subscapula fossa) all supplied by sub scapular nerve (C5,6) except teres minor (axillary nerve C4-6) all insert to greater tubercle of humerus except subscapularis (lesser) supraspinatus tendon is the most commonly torn part of the rotator cuff, likely because it is relatively avascular.

Question 27

testing for supraspinatous and infraspinatous muscle problems

Answer 27

both are responsible for abducting arm test for resisting abduction of 20degrees = supraspinatous(/infra) infraspinatous = externally rotates humerus problem with externally rotating humerus = infraspinatous

Question 28

what muscles form the borders of axillary fold | +their origin/insertion

Answer 28

anterior = pectoralis major -medial clavicle, sternum, first 6 costal cartilages, aponeurosis of external abdominal obliques -inserts in greater tubercle crest of humerus posterior = latissimus dorsi -spinous process of T7-12, iliac crest, 9-12th ribs -intertubucular crest of humerus teres major -posterior inferior angle of scapula to lesser humeral tubercle crest

Question 29

muscles for arm abduction

Answer 29

deltoid (15-90) supraspinatous (up to 15) trapezius

Question 30

muscles for arm adduction

Answer 30

pectoralis major pectoralis minor latissimus dorsi teres major

Question 31

muscles for arm flexion

Answer 31

 Pectoralis Major Coracobrachialis Biceps Brachii Deltoid (Anterior fibres)

Question 32

muscles for arm extension

Answer 32

 Latissimus Dorsi Teres Major Long head of triceps Posterior fibres of deltoid

Question 33

muscles for internal arm rotation

Answer 33

```  Subscapularis Latissimus Dorsi Teres Major Pectoralise Major Deltoid (Anterior Fibres) ```

Question 34

muscles for lateral arm rotation

Answer 34

Infraspinatus Teres Minor Deltoid

Question 35

deltoid

Answer 35

origin - lateral 1/3rd clavicle - acromion - spine of scapula insertion -deltoid tuberosity of humerus axillary nerve (C5,6)

Question 36

pectoralis minor

Answer 36

origin -anterior ribs 3-5 insert -coracoid process of scapula action - protraction - downward rotation of pectoral

Question 37

insertion/action difference of trees major and minor

Answer 37

major - lower crest of lesser tubercle (adduction/internal rotation/extension) minor - greater tubercle (lateral rotation)

Question 38

biceps brachii

Answer 38

musculocuteanous nerve (C5,6) flexion and supination long head -supraglenoid tubercle of scapula short head -coracoid process of scapula both heads converge to biceps brachii tendon ---inserts--> radial tuberosity

Question 39

triceps brachii

Answer 39

lateral head -posterior humerus superior to radial groove medial head -infraglenoid tubercle of scapula converge to triceps brachii tendon -----inserts---> olecranon of ulna radial nerve

Question 40

coracobrachialis

Answer 40

origin: coracoid process insertion: middle of medial humerus action: (adduction/) flexion musculocuteanous nerve (C5-7)

Question 41

trapezius

Answer 41

origin - occipital bone - spinous process C7-T12 insertion - posterior, lateral 3rd clavicle - acromion - spine of scapula action - elevates - depresses - retracts - upwardly rotates pectoral - extends and laterally flexes head/neck acessory nerve

Question 42

serratus anterior

Answer 42

origin -external surfaces of first 9 ribs insertion -medial border of scapula (inside/anterior side) action -protracts and upwardly rotates pectoral girdle long thoracic

Question 43

SCM

Answer 43

origin - sternal head (Manubrium) - medial third of clavicle insertion -mastoid process action - flexing head laterally (ipsilateral) - rotating head (contralateral side) accessory nerve (CN XI)

Question 44

rhomboids

Answer 44

minor -spinous process C7-T1 major -spinous process T2-T5 both inserts into medial border of scapula (minor adjacent and major inferior to the scapula spine level) action - retraction - downwardly rotate pectoral girdle dorsal scapular nerve C4-5

Question 45

levator scapulae

Answer 45

origin -transverse process C1-4 insertion - superior angle of scapula - medial border of scapula superior to spine of scapula level action - elevate and downwardly rotate pectoral girdle - extend and laterally flex neck at cervical vertebral joints