Upper limb - Shoulder + back Flashcards

1
Q

What forms the anterior wall of the Axilla?

A

Pectoralis Major + Minor

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2
Q

What forms the posterior wall of the axilla?

A

Latissmus Dorsi + teres Major

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3
Q

What forms the medial wall of the axilla?

A

Thoracic wall

Serratus anterior

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4
Q

What forms the lateral wall of the axilla?

A

Intertubular groove of humerus

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5
Q

What are the contents of the axilla?

A

Axillary artery/nerve
Axillary lymph nodes
Brachial plexus
Biceps Brachi

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6
Q

At what anatomical point does the axillary artery begin?

A

Lateral margin of 1st rib

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7
Q

At what anatomical point does the brachial artery begin?

A

Lower margin of teres major

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8
Q

What nerve roots constitute the Brachial plexus?

A

C5-T1

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9
Q

What nerve roots form the upper trunk of the brachial plexus?

A

C5-6

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10
Q

What nerve roots form the middle trunk of the brachial plexus?

A

C7

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11
Q

What nerve roots form the lower trunk of the brachial plexus?

A

C8-T1

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12
Q

What is Erb’s point?

A

Erb’s point is the convergance of C5+C6 when the form the upper trunk
If damaged this can cause Erb’s palsy

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13
Q

What is Erb’s palsy?

A

Injury to the upper trunk of brachial plexus
Results in “waiters tip” of upper limb
Arm is medially rotated, wrist flexed

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14
Q

What muscles are affected in Erb’s palsy

A

Deltoid
Wrist extensors
Elbow flexors

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15
Q

What can cause Erb’s palsy?

A

Hyperextension of head form shoulder

I.e Fall on shoulder, birth injury or iatrogenic

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16
Q

What is Klumpke’s palsy?

A

Injry to the lower trunk of the brachial plexus

Affects intrinisc muscles of hand and ulnar flexors of wrist and fingers

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17
Q

What causes klumpkes palsy?

A

Hyper abduction of the arm

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18
Q

What are the cords od hw brachial plexus?

A

Lateral
Medial
Posterior

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19
Q

What are the branches of the lateral cord of the brachial plexus?

A

Lateral pectoral nerve
Median nerve (lateral root)
Musculocutaneous nerve

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20
Q

What are the bracnhes of the medial cord of the brachial plecus?

A

Medial pectoral nerve (C8-T1)
Medial cutaneous nerve of arm (T1)
Medial cutaneous nerve of forearm (C8-T1)
Ulnar nerve

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21
Q

What are the branches of the posterior cord of the brachial plexus?

A

Thoracodorsal
Axillary nerve
Radial nerve
Subscapular nerve

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22
Q

What does the lateral pectoral nerve supply?

A

Pectoralis major

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23
Q

What does the medial pectoral nerve supply?

A

Pectoralis muscles

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24
Q

What does the thoracodorsal nerve suply?

A

Latissimus dorsi

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25
Q

What does teh subscapular nerve supply?

A

Teres major

Supsacpularis

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26
Q

What is the sensory value + nerve of the badge area?

A

Axillary nerve - C5/6

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27
Q

What are the different axillary lymph nodes?

A
Pectoral group
Subscapular group
Apical group
Central group
Lateral group
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28
Q

Where does the upper limb + pectoral girdle articulate ?

A

Sternocalvicular joint

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29
Q

What type of bone is the clavicle?

A

A long bone

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30
Q

What muscles attach to the shaft of the clavicle?

A
Deltoid
Trapezius
Subclavius
Pectoralis major
Sternocleidmastoid
Sternohyoid
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31
Q

What is the weakest segment of the clavicle?

A

Medial + lateral 1/3s

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32
Q

What does the scapula articulate with?

A

Humerus
Clavicle
Lesser extent, ribs

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33
Q

What type of joint is the sternoclavicular joint?

A

Shallow saddle (synovial)

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34
Q

What type of joint is the acromioclavicular joint?

A

Synovial plane

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35
Q

What type of joint is the glenohumeral joint?

A

Synovial ball and socket

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36
Q

What is scapulo-humeral rhythm

A

The 2:1 ration of: 2 degrees occurring at the Shoulder (Glenohumeral) Joint 1 degree occurring at the Scapulo-Thoracic joint

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37
Q

What is the scapulothoracic joint?

A

It is not a true joint, but has movement around a joint axis

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38
Q

What muscles cause elevation of the scapula (shrugging)

A

Levator scapulae
Trapezius (upper fibres)
Serratus anterior

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39
Q

What muscles cause depression of the scapula?

A

Pectoralis minor
Trapezius (inferior fibres)
Latissimus dorsi

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40
Q

What muscles cause protraction of the scapulae (forward movement like punching/pushing)

A

Serratus anterior

Pectoralis minor

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41
Q

What muscles cause retraction (backward movment of the scapulae)?

A

Trapezius (middle fibres)

Rhomboids

42
Q

What muscles cause upward rotation (lateral) of the scapulae? (Note, this elevates the glenoid cavity)

A

Trapezius (Upper + lower fibres)
Serratus anterior (lower 5 digitations)
Deltoid

43
Q

What causes medial (downward) rotation of the scapulae?

A

Levator scapulae
Rhomboids
Pectoralis minor
Gravity

44
Q

What is the glenoid labrum?

A

The rim of cartilage surrounding the socket

45
Q

What is the function of the glenoid labrum?

A

Deepens the socket to reduce the chance of dislocation

46
Q

Which three rotator cuff muscles attach to the greater tubercle?

A

Supraspinatus
Infraspinatous
Teres minor

47
Q

What attach to the lips of the intertubercular sulcus?

A

Tendons of three muscles
Pectoralis major
Teres Major
Latissimus Dorsi

48
Q

What is the clinical significance of the head of the humerus being larger than the glenoid fossa?

A

Inherent joint instability

49
Q

What are teh surfaces of the glenohumeral joint covered in?

A

Hyaline cartilage

50
Q

What are the 4 main ligaments of the glenohumeral joint?

A

Glenohumeral ligament
Coracohumeral ligament
Transverse ligament
Coracoacromial ligament

51
Q

What is the function of the coracohumeral ligament?

A

They strengthen the anterior aspect of the joint capsule

52
Q

What is the function of the coracohumeral ligament?

A

Strengthens the superior aspect of the joint capsule

53
Q

Where is the transverse humeral ligament found?

A

Between the Greater and lesser tubercles of the humerus

54
Q

What is the function of the transverse humeral ligament?

A

Holds the tendon of biceps brachi in place

55
Q

Where does the corcaoacromial ligament run between?

A

The coracoid process of the scapula

The acromium

56
Q

Where does the coracohumeral ligament attach to?

A

The base of the coracoid process

The greater tubercle of the humerus

57
Q

What forms the coracoacromial arch made up of?

A

Coracoid
Acromial process
Coracoacromial ligament

58
Q

What is the function of the coracoacromial arch?

A

To prevent superior displacement of the humeral head

59
Q

Which part of the shoulder is weakest, why?

A

Inferior aspect, as no muscles to protect it from dislocation

60
Q

Which bursae communicates with the shoulder joint cavity?

A

Subscapular

61
Q

What is the role of the subacromial bursa?

A

Allows free motion and reduces friction between muscle/bone

62
Q

Where is the subscapular bursa found?

A

Between the subscapular tendon and the scapula

63
Q

Where is the subacromial (deltoid) bursa found?

A

Inferior to deltoid
Inferior to acromion
Superoir to supraspinatous tendon
Superior to joint capsule

64
Q

What contributes to glenohumeral joint stability?

A

Rotator cuff muscles
Glenoid labrum
Ligaments

65
Q

What are the rotator cuff muscles?

A

Supraspinatous
Infraspinatous
Teres Minor
Subscapularis

66
Q

What movements are generated by the rotator cuff muscles?

A

Abduction
Lateral Rotation
Medial Rotation
Adduction

67
Q

Where does the subscapularis attach to?

A

Subscapular fossa on costal surface of scapula

Lesser rubercle of the humerus

68
Q

What is the innervation of the subscapularis?

A

Upper and lower subscapular nerves

69
Q

What is the function of the subscapularis?

A

Medially rotates the arm

70
Q

Where does the supraspinatous attach?

A

Supraspinatous fossa on scapula

Greater tubercle of humerus

71
Q

What is the innervation of the supraspinatus?

A

The suprascapular nerve

72
Q

What is the function of the supraspinatus?

A

Abducts the arm from 0-15

Assists deltoid after that to 90

73
Q

Where does the infraspinatus attach?

A

Infraspinatous fossa of the scapula

Greater tubercle of the humerus

74
Q

What is the innervation of the infraspinatus?

A

Suprascapular nerve

75
Q

What is the function of the infraspinatus?

A

Laterally rotates the arm

76
Q

Where does the Teres minor attach to?

A

Posterior surface of scapula. adjacent to the lateral border

Greater tubercle of the humerus

77
Q

What is the innervation of the Teres minor

A

Axillary nerve

78
Q

What is the function of the Teres minor?

A

Laterally rotates arm

79
Q

Where does the deltoid attach to?

A

Scapula
Clavicle
Deltoid tuberosity on lateral surface of humerus

80
Q

What is the innervation of the deltoid muscle?

A

Axillary nerve

81
Q

What is the action of the anterior fibres of the deltoid?

A

Flexion

Medial rotation at shoulder joint

82
Q

What is the action of the middle fibres of the deltoid?

A

Abduction at the shoulder joint

83
Q

What is the action of the posterior fibres of the deltoid?

A

Extension

Lateral rotation at shoulder joint

84
Q

What injury can damage the axillary nerve?

A

Dislocation due to hyperextension

85
Q

Where does the Axillary nerve provide sensation to?

A

Lateral upper arm “badge area”

86
Q

What are the attachments of the Teres major?

A

Posterior surface of the inferior angle of the scapula

Intertubercular groove of humerus

87
Q

What is the innervation of the Teres major?

A

Lower subscapular nerve

88
Q

What is the function of the Teres major?

A

Adducts shoulder

Medially rotates arm

89
Q

What are the intrinsic muscles of the shoulder?

A
Subscapularis
Supraspinatus
Infraspinatus
Teres minor
Teres major
Deltoid
90
Q

What vein is found in the deltopectoral triangle?

A

Subclavian

91
Q

What nerve supplies the serratus anterior?

A

The long thoracic nerve (C5-C7)

92
Q

What is the action of the superior fibres of the trapezius on the scapula?

A

Elevate

Lateral rotation

93
Q

What is the action of the middle fibres of the trapezius on the scapula?

A

Retraction

Lateral rotation

94
Q

What is the action of the inferior fibres of the trapezius on the scapula?

A

Depression

95
Q

What are the main actions of the Teres Major on the shoulder joint?

A

Medial rotation

Adduction

96
Q

What are the actions of latissimus dorsi on the shoulder joint?

A

Extension
Adduction
Transverse extension

97
Q

What muscles contribute to shoulder flexion?

A

Anterior deltoid fibres
Upper pectoral major fibres
Serratus anterior
Coracobrachialis

98
Q

What muscles contribute to shoulder extension?

A

Posterior deltoid fibres
Latissimus dorsi
Teres Major

99
Q

What muscles contribute towards shoulder adduction?

A

Lower pectoral major fibres
Teres Major
Latissimus dorsi
Teres Minor

100
Q

What muscles contribute towards shoulder abduction?

A

Middle deltoid fibres

Supraspinatus

101
Q

What muscles contribute towards medial (or internal) rotation of the shoulder?

A
Subscapularis
Lattisimus dorsi
Pectoralis major
Teres Major
Anterior fibres of the deltoid
102
Q

What muscles contribute towards lateral (or external) rotation of the shoulder?

A

Teres minor
Infraspinatus
Posterior deltoid
Lower trapezius fibres