Anatomy Exam 2: Shoulder And Axilla

Front 1

Deltoid

Back 1

Action: Flexes, medially rotates abducts extends, laterally rotates arm
Innervation: axillary nerve
Origin: clavicle
Insertion: Deltoid tuberosity

Front 2

Teres Major

Back 2

Action: Adducts and medially rotates arm
Innervation: Lower subscapular nerve
Origin: Inferior angle on the posterior side of scapula
Insertion: Medial side of intertubercular groove

Front 3

Teres Minor

Back 3

Action: laterally rotates arm
Innervation: axillary nerve
Origin: middle part of lateral border of scapula on the posterior side
Insertion: inferior facet of greater tubercle of humerus

Front 4

Triceps Brachii

Back 4

Action: extends arm
Innervation: radial nerve
Origin: upper part of lateral border of scapula (long head)
Insertion: olecranon of ulna

Front 5

Infraspinatus

Back 5

Action: laterally rotates arm
Innervation:suprascapular nerve
Origin: infraspinous fossa of scapula
Insertion: middle facet of greater tubercle of humerus

Front 6

Supraspinatus

Back 6

Action: Initiates abduction of arm
Innervation: suprascapular nerve
Origin: supraspinatus fossa of scapula
Insertion: superior facet of greater tubercle of humerus

Front 7

Latissimus Dorsi

Back 7

Action: extends, adducts, and medially rotates humerus
Innervation: thoracodorsal nerve
Origin: spinous processes of inferior 6 thoracic vertebrae, thoracolumbar fascia, illiac crest, and inferior 3/4 ribs
Insertion: intertubercular groove of humerus

Front 8

Pectoralis Major

Back 8

Action: adducts and medially rotates humerus, flexes clavicular head of humerus, extension of sternocostal head of humerus
Innervation: lateral and medial pectoral nerves
Origin: Anterior surface of medial half of clavicle (clavicular head), anterior surface of sternum, superior 6 or 7 costal cartilages, aponeurosis of external oblique muscle (sternocostal head)
Insertion: lateral lip of intertubercular groove (sulcus) of humerus

Front 9

Pectoralis Minor

Back 9

Action: stabilizes scapula, drawing anteriorly and inferiorly against thoracic wall
Innervation: medial pectoral nerve
Origin: ribs 3-5
Insertion:medial border and superior surface of caracoid process of scapula

Front 10

Serratus Anterior

Back 10

Action: rotates scapula upward, protracts against thoracic wall, stabalizes scapula during abduction of arm
Innervation: long thoracic nerve
Origin: ribs 1-8
Insertion: inferior angle and anterior surface of medial border of scapula

Front 11

Subclavius

Back 11

Action: anchors and depresses clavicle
Innervation: subclavian nerve
Origin: junction of rib 1 and its costal cartilage
Insertion: inferior surface of middle third of clavicle

Front 12

Which joint indicates the approximate midline level of the inferior heart and the superior limit of the liver?

Back 12

xiphisternal joint

Front 13

What is the most frequently fractured bone in the human body and where does the fracture most commonly occur (on bone)?

Back 13

clavicle
occurring at the junction of its middle and lateral thirds

Front 14

fibrosis, or shortening of the suspensory ligaments or invasion of the lactiferous ducts in breast cancer may produce what 2 effects?

Back 14

1. dimpling of the skin
2. retraction of the nipple

Front 15

Puffy edematous skin between pores giving the skin a orange-peel appearance (peau d' orange sign ) is caused by.....

Back 15

obstruction of lymphatic vessels

Front 16

The connection of posterior intercostal veins with the vertebral venous plexuses provides a pathway for __________________ to the vertebrae, spinal cord, and brain.

Back 16

metastasis of breast cancer

Front 17

What symptom in a female patient suggests the possibility of breast cancer and should be investigated?

Back 17

unexplained enlargement of axillary lymph nodes

Front 18

Males account for _____% of breast cancer cases

Back 18

1.5%

Front 19

What nerve provides a pathway for referred pain from the heart to the arm?

Back 19

intercostalbrachial nerve
(lateral cutaneous branch of the 2nd intercostal nerve)

Front 20

In carcinoma, cancer cells may invade the retromammary bursa and the underlying pectoral fascia, fixing the breast to the pectoralis major muscle, what changes does this cause in the appearance of the breast?

Back 20

The breast may elevate when the muscle contracts, and breast contour changes revealing dimpling

Front 21

What clinical examination is standard for breast cancer?

Back 21

having the patient flex pectoralis muscles with hand on her hips to see if breast elevates

Front 22

Anesthetic is sometimes injected into the _________________ to block the brachial plexus for upper extremity surgery

Back 22

axillary sheath

(contains axillary artery and vein in addition to parts of brachial plexus)

Front 23

The scapular circumflex joins the dorsal scapular and the suprascapular arteries in forming ______________________

Back 23

arterial anastomoses around the scapula

Front 24

Arterial anastomoses around the scapula may allow surgical ligation of the _______________ proximal to the subscapular branch.

Back 24

axillary artery

Front 25

What nerve and artery that pass through the quadrangular space are in danger from a fracture at the surgical neck of the humerus?
What other injury can cause damage to this nerve?

Back 25

axillary nerve and posterior humeral circumflex artery

dislocation of the glenohumeral joint

Front 26

injuries of the upper brachial plexus involve the anterior rami of _____ and _____ and usually result from a forcible increase in angle between the ______ and ____________.

Back 26

C5 and C6

shoulder and neck

Front 27

When a rider is thrown from a motorcycle onto on side of the neck and shoulder or when a baby's head is pulled during delivery, it may result in what?

Back 27

Erb-Duchenne's Palsy (Erb's palsy)

Front 28

Erb's palsy results in ________________________

Back 28

"waiter's posture"
arm adducted and medially rotated
forearm extended and pronated
palm facing backwards

Front 29

Klumpke's paralysis is caused by ___________

Back 29

lesions to the lower brachial plexus

Front 30

Injuries to ___ and ___ result when the upper limb is jerked superiorly, such as when a person falls from from a roof and grabs a branch to catch himself or when a babies arm is pulled strongly upward during difficult delivery

Back 30

C8 and T1

Front 31

Klumpke's paralysis results in paralysis of what?
This leads to what characteristic deformity also seen with ulnar nerve lesion?

Back 31

two forearm muscles and most intrinsic hand muscles are paralyzed

leads to "claw hand" deformity

Front 32

The rotator cuff muscles are the dynamic stabilizers of what joint?

The rupture of the ______________ due to trauma and degeneration produces a painful and debilitating injury.

Back 32

glenohumeral joint

rotator cuff tendon

Front 33

What nerves superficial position makes it vulnerable to trauma and axillary surgery such as a radical masectomy for breast cancer?

Back 33

long thoracic nerve

Front 34

"winging of the scapula" the inferior and medial border of the scapula pulling away from the posterior thoracic wall during are movements, is caused by injury to what nerve?

Back 34

long thoracic nerve

Front 35

a patient with an injury to the long thoracic nerve is typically unable to raise the arm above the horizontal plane due to loss of upward rotation of the _____________

(trapezius alone isnt strong enough)

Back 35

glenoid cavity of the scapula

Front 36

_______________ firmly attaches the mammary glands to the dermis of the overlying skin

Back 36

suspensory ligaments (of Cooper)

Front 37

Suspensory ligaments are well developed in the superior part of the breast and help support ______________

Back 37

support the mammary gland lobules

Front 38

The arterial supply of the breast is developed from branches of what 4 arteries?

Back 38

internal thoracic artery
lateral thoracic artery
thoracoacromial artery
posterior intercostal artery

Front 39

The female breast is roughly circular in shape with a small _________ extending into the axillary fossa

Back 39

axillary tail

Front 40

75% of the lymphatic drainage (of lateral quadrants) of the breast flows through the axillary tail into the _________________

Back 40

axillary lymph nodes

Front 41

Lymph from the medial breast quadrants drains into the _____________ along the internal thoracic artery or to the opposite breast.

Back 41

parasternal lymph nodes

Front 42

Lymph from the inferior breast quadrants may pass deep to the _______________.

Back 42

abdominal lymph nodes

Front 43

What are the 5 main groups of axillary lymph nodes and where do they receive lymph from?

Back 43

1. apical- lymph from all other axillary groups
2. pectoral- lymph from ant. thoracic wall, breast
3. subscapular- lymph from post. thoracic wall & scapular region
4. humeral- receives most of lymph from upper limb
5. central- receives lymph from the pectoral, subscapular, and humeral nodes

Front 44

The efferent vessels of which axillary lymph group form the subclavian lymph trunk?

Back 44

apical group

Front 45

Which axillary lymph group drains to the apical group?

Back 45

central group

Front 46

A mastectomy refers to the surgical removal of what?
In a radical mastectomy what else may also be removed?

Back 46

breast tissue

pectoralis major muscle

Front 47

What 3 muscles attach to the coracoid process of the scapula?

Back 47

pectoralis minor
coracobrachialis
short head of biceps brachii

Front 48

pectoral fascia surrounds what muscle and becomes what laterally?

Back 48

surrounds pectoralis major

becomes axillary fascia laterally

Front 49

What fascia surround the subclavius and pectoralis minor and is continuous inferiorly with the axillary fascia?
What membrane forms between the subclavius and pectoralis minor?

Back 49

clavipectoral fascia

costocoracoid membrane

Front 50

axillary fascia forms what?

Back 50

the floor of the axilla

Front 51

What two things emerge medial to the pectoralis minor muscle to enter and supply the pectoralis major?

Back 51

the lateral pectoral nerve
and
the thoracoacromial artery

Front 52

What nerve supplies and pierces the pectoralis minor to also supply the pectoralis major?

Back 52

medial pectoral nerve

Front 53

What artery serves as the blood supply for the serratus anterior?

Back 53

lateral thoracic artery

Front 54

What is the only major structure that passes directly through the medical axillary wall?

Back 54

intercostobrachial nerve

Front 55

What provides a gateway for the passage of major blood vessels and nerves between the neck and arm?

Back 55

axilla

Front 56

What are the major contents of the axilla?

Back 56

axillary artery and vein
brachial plexus
lymphatic vessels
axillary lymph nodes
axillary fat
proximal parts of 2 muscles

Front 57

What forms the apex of the axilla?

Back 57

formed by convergence of clavicle, superior border of scapula, and first rib
entrance to axilla

Front 58

What forms the base of the axilla?

Back 58

formed by the skin, subcutaneous tissue, and axillary fascia
forms the axillary fossa (armpit)

Front 59

what forms the medial wall of the axilla?

Back 59

formed by the thoracic wall and overlying serratus anterior muscle

Front 60

what forms the lateral wall of the axilla?

Back 60

narrow bony wall formed by the intertubercular groove of the humerus

Front 61

what forms the anterior wall of the axilla?

Back 61

formed by the pectoralis major and minor, pectoral and clavipectoral fascia

anterior axillary fold is the inferiormost part

Front 62

what forms the posterior wall of the axilla?

Back 62

formed by the scapula, subscapularis, teres major, and latissmus dorsi

posterior axillary fold is inferiormost part

Front 63

axillary artery begins at the lateral border of the first rib as a continuation of what artery and ends at the inferior border of the teres major as it becomes what artery?

Back 63

continuation of subclavian artery at first rib

becomes brachial artery at teres major

Front 64

compression of the subclavian artery against the first rib controls bleeding from what 2 arteries and their branches?

Back 64

axillary and brachial artery

Front 65

The axillary artery is divided into three parts in relation to the pectoralis minor muscle, how are the three portions divided?

Back 65

first part- btwn lateral margin of 1st rib & medial border of pec minor
second part- posterior to pectoralis minor
third part- btwn lateral border of pec minor and inferior border of teres major

Front 66

axillary vein begins at _______________________________
and is the continuation of the _______________

Back 66

begins at the inferior margin of the teres major

continuation of the basilic vein

Front 67

axillary vein ends at _____________________
and become the ____________________

Back 67

ends at the lateral border of the first rib

becomes the subclavian vein

Front 68

the axillary vein receives the ______________, which drains the lateral and posterior parts of the hand, forearm, and arm

Back 68

cephalic vein

Front 69

The cephalic vein traverses the __________________ between the deltoid muscle and clavicular head of the pectoralis major muscle to drain into the axillary vein.

Back 69

deltopectoral groove (triange)

Front 70

What is the only articulation between the axial skeleton and the bones of the whole upper extremity?

Back 70

sternoclavicular joint

Front 71

What two bones make up the shoulder girdle?

Back 71

clavicle and scapula

Front 72

What bone acts as a strut holding the upper extremities in place?

Back 72

clavicle

Front 73

What type of joint is the acromioclavicular joint and what is it between?

Back 73

plane synovial joint (bone-space-bone)

btwn acromion and clavicle

Front 74

What type of joint is the coracoclavicular joint-ligament?

Back 74

syndesmosis (two bones seperated by cap, sealed by ligaments

btwn conoid ligament-tubercule and trapezoid ligament-line

Front 75

What makes contact with the lateral angle of the scapula?

Back 75

glenoid cavity,
long head of biceps to supraglenoid tubercle
long head of triceps to infraglenoid tubercle
glenoid labrum

Front 76

what makes contact with the inferior angle of the scapula?

Back 76

rhomboid major
teres major
serratus anterior

Front 77

What makes contact with the superior angle of the scapula?

Back 77

levator scapula

Front 78

what is along the superior border of the scapula?

Back 78

superior angle
suprascapular notch
coracoid process
supraglenoid tubercle

Front 79

What makes contact with the suprascapular notch of the scapula?

Back 79

suprascapular ligament
blood vessels and nerve
omohyoid muscle

Front 80

What makes contact with the coracoid process of the scapula?

Back 80

trapezoid ligament
conoid ligament
coracoacromial ligament
coracohumeral ligament
short head of biceps
coracobrachialis
pectoralis minor

Front 81

What is along the medial border of the scapula?

Back 81

levator scapulae
rhomboid major
rhomboid minor

Front 82

what is along the medial border of the scapula?

Back 82

from inferior angle to infraglenoid tubercle
teres major
teres minor
long head of triceps

Front 83

what is along the costal surface of the scapula?

Back 83

seratus anterior muscle
subscapularis fossa
subscapularis muscle

Front 84

what is along the dorsal surface of the scapula?

Back 84

scapular spine (spinoglenoid notch, acromion)
supraspinous fossa (supraspinatus muscle)
infraspinous fossa (infraspinatus muscle)

Front 85

What attaches to the anatomical neck of the humerus?

Why is this necessary?

Back 85

fibrous capsule

lies between humerus and glenoid cavity where a "bony mismatch" would be present without cushioning

Front 86

what attaches directly to the lesser tubercle of the humerus?

what attaches to the crest of the lesser tubercle?

Back 86

subscapularis

teres major and latissimus dorsi

Front 87

what attaches directly to the greater tubercle of the humerus?

what attaches to the crest of the greater tubercle?

Back 87

supraspinatus, infraspinatus, teres minor

pectoralis major

Front 88

what attaches to the bicipital groove of the humerus?

Back 88

tendon of the long head of bicep

Front 89

What muscles make up the shoulder joint?

Back 89

rotator cuff (supra/infra-spinatus, teres minor)
subscapularis
teres major
deltoid
long head biceps

Front 90

(anterior/posterior/inferior) dislocations make up 90% of should joint disorders

Back 90

anterior dislocation
(all types possible)

Front 91

Which muscle of the rotator cuff is most commonly injured?

Back 91

supraspinatus

Front 92

What are the borders of the deltopectoral triangle?
what passes through the space?

Back 92

bound by clavicular head of pectoralis major, deltoid muscle, and middle third of clavicle

cephalic vein