W12 - SHOULDER & ELBOW

Question 1

Brachial Plexus: associations, span, and main 3 cords

Answer 1

*pectoralis mn closely associated, axillary art.

Span C5-T1

MEDIAL
LATERAL
POSTERIOR
= bifurcate

Question 2

Posterior Cord of Brachial Plexus

Answer 2

Axillary N. = Shoulder and deltoid
(C5,C6)

Radial N. = Posterior forearm and hand
(C5-C8)

Question 3

Medial Cord of Br. Pl.

Answer 3

ULNAR N. = hand and little bit of forearm
(C8, T1)

MEDIAN N.
(C6-C8, T1)

Question 4

Lateral Cord of Br. Pl.

Answer 4

MUSCULOCUT. N. = anterior of arm
(C5-C6)

also MEDIAN N.
(C6-C8, T1)

Question 5

Dorsal Muscles

Answer 5

1. TRAPEZIUS
   (CN XI)

2. LATISSIMUS DORSI
(sixth, seventh, and eighth cervical nerves through the thoracodorsal (long subscapular) nerve
-----deeper
3. LEVATOR SCAPULAE
= elevate scapula

4. RHOMBOIDS: in pair
   = retract and elevate scapula

Question 6

Anterolateral & Ventral Musculature

Answer 6

1. SERRATUS ANTERIOR = protraction
   (long thoracic n.) = winging scapula
2. PERCTORALIS Mj. =
   * 6th costal cartilage

+EObliques
+ Platysma (superior to clavics. coming down from mandible)

Question 7

Deltoid Movements

Answer 7

Abductor @ Shoulder Joint

Anterior = Arm flexion

Posterior = Arm extension

Question 8

Posterior Short Scapular Group

Answer 8

1. SUPRASPINATUS = abduction
2. INFRASPINATUS = external rotation
3. TERES Mn = adduct, internal rot., humeral extension
4. TERES Mj = internal rot
   * doesnt attach to glenohumeral head/joint

*support glenohumeral head

Question 9

Anterior Short Scapular Group

Answer 9

1. Subscapularis = Internal rot.

Question 10

Flexors of the Elbow

Answer 10

1. BICEPS BRACHII
   (musculocut. n)

long head = intertubercular sulcus,
short head = coricoid process of scapula
=> radius

2. BRACHIALIS
   (musculocut. n.)
3. brachioradialis = flexor only in mid-position
   (radial n.)

Question 11

Extensors of the Elbow

Answer 11

1. TRICEPS BRACHII

Question 12

Common consequence of midhumeral #

Answer 12

Radial nerve dmg = triceps affected & joints of the hand

= wrist drop

Question 13

Conditions Affecting Shoulder

Answer 13

FROZEN SHOULDER

IMPINGMENT SYNDROME

ROTATOR CUFF TEARS

OArth

#

DISLOCATIONS

Question 14

Frozen Shoulder

Answer 14

adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move.

Frozen shoulder most commonly affects people between the ages of 40 and 60, and occurs in women more often than men.

*diabetes are at an increased risk for developing frozen shoulder.

> steroid injection (early presentation)
sx (later)

Question 15

Impingement Syndrome

Answer 15

pain, weakness and a loss of movement at the affected shoulder

• dt subacromial space narrowing
• painful arc

1. suprascapular n. compression as it passes notch between supraspinatus and infraspinatus

> steroid injection
physio
arthroscopic subacromial decompression

Question 16

Rotator Cuff Tears

Answer 16

aRotator cuff tears are classified as either acute (lasting <3 months) or chronic (lasting >3 months) tears. They can be either partial thickness or full thickness tears.
* traumatic Vs degenerative

*often supraspinatus tear = humeral head will elevate

> Sx (acute, early)
Sx (chronic tears only symptomatic)

Question 17

OArth affecting shoulder

Answer 17

Glenohumeral osteoarthritis (GH OA) is defined as progressive loss of articular cartilage, resulting in bony erosion, pain, and decreased function.

*
*XR

Question 18

Conditions affecting Elbow

Answer 18

Tennis & Golfer’s Elbow

Olecranon Bursitis

& Dislocations

Question 19

Tennis & Golder’s Elbow

Answer 19

inflamm of tendons

TENNIS = LATERAL EPICONDYLITIS

GOLFER = MEDIAL EPICONDYLE

Question 20

Olecranon Bursitis

Answer 20

olecranon bursa

d/t overuse or sports

> rest
NSAID
Immobilise

Question 21

Elbow # & Dislocation

Answer 21

> conservative mgmt

Question 22

Bones of the Shoulder

Answer 22

ACROMION

CORACAOID PROCESS

GLENOID (articulates w/ articular humeral cart.)

Question 23

What muscles attach to the greater tuberosity

Answer 23

SUPRASPINATUS

INFRASPINATUS

TERES MN.

*rotator cuff = provides stability and protection

Question 24

What attaches to the clavicle

Answer 24

TRAPEZIUS

DELTOID

PECT. Mj

SUBCLAVIUS

SCM

STERNOHYOID

Question 25

Ligaments associated with the acromioclavicular joint

Answer 25

ACROMIOCLAVICULAR LIGAMENT

CORACO-ACROMIO LIGAMENT

CORACO-CLAVICULAR LIGAMENT

Question 26

What is the function of the Labrum?

Answer 26

increases SA and glenoid depth

shock block limiting glenohumeral translation

Question 27

What is associated with surgical neck of humerus?

Answer 27

or sx. dmg = axillary n. injury = deltoid weakn. and sensory loss in badge area

Question 28

Clavicular injury/fracture/dislocation

Answer 28

Associated with acromio-clavicular ligament snapping and displacement of the acromion; can become visible

Question 29

What is the main blood supply to the humeral head?

Answer 29

anterior humeral circumflex artery

Question 30

Common shoulder and elbow problems associated w/ certain age groups

Answer 30

teens/20s = # and instability

30s-40s = rotator cuff & capsulitis

50s-60s = impingment and AC joint

70s+ = degenerative rotator cuff and joint

Question 31

What is a Bankart tear?

Answer 31

labral tear is called a Bankart tear. A Bankart tear typically occurs when an individual sustains a ​shoulder dislocation. As the shoulder pops out of joint, it often tears the labrum, especially in younger patients. The tear is to a part of the labrum called the inferior glenohumeral ligament