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115 Cards in this Set

  • Front
  • Back
What are the parts of the upper limb?
Arm (brachium)- shoulder to elbow
Forearm (antebrachium)-elbow to wrist
What are the bones in the shoulder?
Pectoral girdle (Clavicle, Scapula)
What are the joints in the shoulder?
Sternoclavicular joint
Acromioclavicular joint
Glenohumeral (shoulder) joint
What is the function of the pectoral girdle?
For attachment of the upper limb to the trunk. Provides strength, support, and mobility for the upper limb.
What are the bones of the pectoral girdle?
Clavicle and Scapula
Where does the Clavicle articulate?
Articulates with the axial skeleton (sternum).
Articulates with the scapula (acromion).
Where does the Scapula articulate?
Attached to axial skeleton (ribs) by muscles.
Articulates with the clavicle and with the head of the humerus.
Where does the humerous articulate in the shoulder?
Articulates with the glenoid fossa of the scapula.
Describe fractures of the clavicle.
Fractures of the clavicle are common, and occur between the middle and lateral 1/3 of the clavicle.
Describe Fractures of the Scapula
rare, and usually occur at the acromion.
Describe Fractures of the Humerus
common, and usually occur at the surgical neck or proximal shaft of the humerus.
What can cause a fracture to the clavicle?
Fall onto the shoulder or outstretched hand.
Direct blow to the clavicle.
The most commonly fractured bone in the body.
Break usually occurs at the junction of the middle and outer thirds.
What are the symptoms of a clavicle fracture?
Pain, swelling, bruising.
Deformity or “bump” over the fracture site.
Sagging shoulder (down and forward).
Lateral fragment is depressed by the weight of the limb, and pulled medially and anteriorly by the strong pectoralis major muscle.
Medial fragment is tilted upward by the sternocleidomastoid muscle.
Where does the Rhomboid Minor attach?
Rhomboid minor attaches to the root of the scapular spine at the medial border
What is contained in the suprascapular notch?
the Suprascapular Nerve and Suprascapular Artery travel through the suprascapular notch
Describe the Sternoclavicular Joint type.
Saddle synovial joint
Describe movement in the Sternoclavicular Joint
Anterior-posterior and vertical planes; some rotation.
What are the ligaments of the Sternoclavicular Joint?
Anterior and posterior sternoclavicular ligaments.
Interclavicular ligament
Costoclavicular ligament
What is the articluation of the Sternoclavicular Joint?
Manubrium articulates with clavicle.
Describe the Acromioclavicular Joint type
Plane synovial joint
Describe the Acromioclavicular Joint articulation.
Acromium of scapula articulates with clavicle
Describe the movement of the Acromioclavicular Joint.
Anterior-posterior and vertical planes; some axial rotation.
What are the ligaments of the Acromioclavicular Joint?
Acromioclavicular (AC) ligament
Coracoclavicular ligaments (Trapezoid ligament and Conoid ligament)
Coracoacromial ligament
What is a Grade 1 Acromioclavicular Joint Separation ? (Shoulder Separation)
Acromioclavicular ligament is sprained.
What is a Grade 2 Acromioclavicular Joint Separation ? (Shoulder Separation)
Acromioclavicular ligament is torn; trapezoid ligament is sprained.
What is a Grade 3 Acromioclavicular Joint Separation ? (Shoulder Separation)
Acromioclavicular, trapezoid, and conoid ligaments are torn.
Complete separation.
What muscles are responsible for retraction of the scapula?
Trapezius, Rhomboids
Name the movements of the Scapula
Elevation, Depresion, Protraction, Retraction, Medial Rotation, Lateral Rotation
What defines rotation of the scapula?
Where the inferior angle goes.
What is the Glenohumeral (Shoulder) Joint type?
Ball and Socket
Describe the articulation of the Glenohumeral (Shoulder) Joint
glenoid fossa of scapula with head of humerus; surfaces covered by hyaline (articular) cartilage.
What are the movements of the Glenohumeral (Shoulder) Joint?
Flexion/extension, abduction/adduction, rotation, circumduction
Describe the Articular fibrous capsule of the Glenohumeral (Shoulder) Joint
contains 2 openings for
(1) tendon of long head of biceps brachii muscle
(2) communication between synovial cavity and subscapular bursa
What are the ligaments of the Glenohumeral (Shoulder) Joint?
Glenohumeral ligaments (Superior, middle, inferior)
Coracohumeral ligament
What is the function of the Transverse Humeral Ligament?
holds tendon of long head of the biceps brachii m. in intertubercular groove.
What is the Coracoacromial Arch?
formed by acromion, coracoid process, and AC & coracoacromial ligaments; protects shoulder joint superiorly.
Where are the strengths and weaknesses of the Glenohumeral (Shoulder) Joint?
Weakest inferiorly.
Strengthened anterior, posterior, and superior by ligaments and rotator cuff muscles:
Describe Shoulder Dislocation
Humerus dislocates inferiorly. However, shoulder dislocations are designated as ‘anterior’ or ‘posterior’ depending on the location of the dislocated humeral head relative to the glenoid fossa.
How are shoulder dislocations designated?
designated as anterior or posterior depending on location of humeral head relative to glenoid labrum after dislocation
What does a shoulder dislocation put at risk?
Axillary Nerve
What is a Bursa?
Sac-like structure containing a film of synovial fluid, located between tendons and bone, ligaments, or other tendons, or where skin moves over a bony prominence.
What are the Bursae of the Shoulder?
Subscapular Bursa
Subacromial (Subdeltoid) Bursa
What is the location of the Subscapular Bursa?
between subscapularis muscle and neck of scapula; extension of joint cavity through articular capsule.
What is the location of the Subacromial (subdeltoid) Bursa?
between deltoid muscle and supraspinatus tendon & joint capsule.
Describe Subacromial Bursitis
Irritation and inflammation of the subacromial bursa due to bone spurs on the inferior surface of acromion process or by calcification of the supraspinatus tendon.
What are the movements of the shoulder?
Flexion/Extension, Abduction/Adduction, Medial/Lateral Rotation, Circumduction
Name the Scapulohumeral Muscles
Deltoid m.
Supraspinatus m
Infraspinatus m.
Teres minor m.
Teres major m.
Subscapularis m
Where does the trapezius attach to the scapula?
The trapezius is inserted into the upper border of the crest of the spine and into the medial border of the acromion.
Where does the deltoid attach to the scapula?
The deltoid arises from the lower border of the crest of the spine and from the lateral border of the acromion.
Where does the supraspinatus attach to the scapula?
The supraspinatus arises from the medial two thirds of the supraspinous fossa (including the upper surface of the spine).
Where does the infraspinatus attach to the scapula?
The infraspinatus arises from the medial two thirds of the infraspinous fossa
Where does the teres minor attach to the scapula?
The teres minor arises from the upper two thirds of the rough strip on the dorsal surface along the lateral border.
Where does the Teres Major attach to the Scapula?
The teres major arises from the lower one third of the rough strip on the lateral aspect of the lateral border.
Where does the subscapularis attach to the scapula?
The subscapularis arises from the medial two thirds of the subscapular fossa.
What is the innervation of the Deltoid?
Axillary Nerve
What are the actions of the Deltoid?
Abducts, flexes, extends, medially and laterally rotates the humerus at the shoulder
Name the attachments of the Deltoid
Lateral third of clavicle; acromion and spine of scapula
Deltoid tuberosity of humerus
Innervation of the Supraspinatus
Suprascapular Nerve
Actions of the Supraspinatus
Stabilizes shoulder joint; initiates abduction of the humerus.
Supraspinatus is responsible for first 30 degrees of abduction
Innervation of the Infraspinatus
Suprascapular nerve
Name the actions of the Infraspinatus
Stabilizes shoulder joint; laterally rotates humerus.
Innervation of the Teres Minor
Axillary Nerve
Name the actions of the teres minor
Stabilizes shoulder jt; laterally rotates humerus
Innervation of the Teres Major
Lower subscapular Nerve
Name the actions of the teres major
Adducts, extends, and medially rotates humerus.
Innervation of the Subscapularis
Upper and Lower Subscapular Nerves
Name the actions of the subscapularis
Stabilizes shoulder joint; medially rotates the humerus
What is the only thing that attaches to the lesser tubercle of the humerus?
Subscapularis muscle
Name the Rotator Cuff Muscles
Supraspinatus m.
Infraspinatus m.
Teres minor m.
Subscapularis m.

-NOT teres major
Describe the actions of the rotator cuff muscles
Blend with articular capsule; stabilize shoulder joint.
Name two types of rotator cuff tears
1. Full thickness tear of supraspinatus tendon
2. Torn subscapularis tendon
Describe the nerves of the scapular region
Branches from the upper trunk and posterior cord of the brachial plexus (C5-8,T1).
Describe the arteries of the scapular region
Branches from the subclavian and axillary arteries.
What are Scapular Region Spaces?
Spaces between muscles that allow transmission of vessels and nerves from the axilla to the scapular region.
Describe the Quadrangular Space
Boundaries: Teres minor, teres major, long head of triceps brachii, and humerus
Contents: Axillary nerve; posterior circumflex humeral artery and vein.
Name the Scapular Region Spaces
Quadrangular Space
Triangular Space
Triangular Interval
Describe the Triangular Space
Boundaries: Teres minor, teres major, and long head of triceps brachii
Contents: Circumflex scapular a/v.
Describe the Triangular Interval
Boundaries: Teres major, long and lateral heads of triceps brachii
Contents: Radial nerve; deep brachial artery
Triangular interval more like a window, Nerve and artery don’t come through
What are Scapular Anastomoses?
A network of arteries around the scapula form a collateral circulation for the shoulder and upper limb.
What vessels contribute to Scapular Anastomoses?
Subclavian artery (Dorsal scapular a.
and Suprascapular a.)

Axillary artery (Circumflex scapular artery from subscapular artery)

Intercostal arteries may contribute thru anastomoses with dorsal scapular and thoracodorsal arteries
What are the anatomical lines of the pectoral region?
Anterior median (midsternal) line (AML)
Midclavicular line (MCL)
Midaxillary line (MAL)
Name the Fascias of the Pectoral Region
Pectoral Fascia
Clavipectoral Fascia
Serratus Fascia
Describe the Pectoral Fascia
deep fascia that invests the pectoralis major muscle
Describe the Clavipectoral Fascia
deep to pectoral fascia; invests subclavius and pectoralis minor muscles
Describe the Serratus Fascia
deep fascia invests the serratus anterior muscle
Describe the Surface Anatomy of the Female Breast
In subcutaneous tissue overlying pectoralis muscles.
Nipple is surrounded by the circular pigmented areola.
Axillary tail (of Spence) extends toward axillary fossa.
Intermammary cleft between breasts.
Describe Retromammary Space
space between breast tissue and pectoral fascia
Describe fascia of the Breast
Rests on bed of pectoral fasica (2/3) and serratus fascia (1/3)
Describe the Structure of the Female Breast
Composed of glandular and supporting fibrous tissue within a fatty matrix
Name structural features of the female breast
Mammary glands are modified sweat glands.
Suspensory ligaments (of Cooper) attached to dermis of skin.
Lactiferous ducts drain mammary lobules.
Lactiferous sinus is a dilation of the lactiferous duct deep to the areola.
Name the arteries of the Breast
Internal Thoracic Artery (Medial mammary branches)
Axillary Artery (Lateral mammary branches)
Posterior Intercostal arteries (Lateral mammary branches)
Name the Nerves of the Breast
Supraclavicular Nerves (C3,C4)
Intercostal Nerves (T4-T6) (Lateral and medial mammary branches)
Fibers convey sensory and sympathetic innervation.
Describe the route of Lymph in the Breast
Lymph first drains to subareolar lymphatic plexus. Most lymph then drains to axillary lymph nodes.
Remaining lymph drains to parasternal nodes, to opposite breast, or to inferior phrenic nodes.
Describe the route through the axillary lymph nodes of the breast
Anterior (pectoral)
Posterior (subscapular)
Lateral (humeral)
Apical – receives lymph from all the others (subclavian lymphatic trunk and right lymphatic duct or (left) thoracic duct)
What is breast cancer?
Malignant tumors of the lactiferous ducts or lobules
Describe metastasis in breast cancer.
Lymph vessels carry cancer cells from the breast to lymph nodes.
Axillary lymph nodes are the most common site of metastasis.
Name the Thoracoappendicular Muscles of the Pectoral Region
Pectoralis Major
Pectoralis Minor
Serratus Anterior
Innervation of the Pectoralis Major Muscle
Medial and Lateral Pectoral Nerves
Actions of the Pectoralis Major Muscle
Flexes, adducts, and medially rotates the humerus at the shoulder.
Name the two heads of the Pectoralis Major Muscle
Clavicular Head and Sternocostal Head
Innervation of the Subclavius
Nerve to subclavius
Actions of the Subclavius Muscle
Stabilizes sternoclavicular joint
Innervation of the Pectoralis Minor Muscle
Medial and Lateral Pectoral Nerves
Actions of the Pectoralis Minor Muscle
Protracts the scapula and depresses shoulder.
What three muscles attach to the Coracoid Process?
Short head of the biceps
Pectoralis Minor
Innervation of the Serratus Anterior Muscle
Long Thoracic Nerve
Actions of the Serratus Anterior Muscle
Protracts and laterally rotates inferior angle of the scapula.
Holds scapula close to the body
Describe Symptoms of Winged Scapula
Medial border of the scapula protrudes outward (winging) due to paralysis of the serratus anterior muscle.
Name the Causes of Winged Scapula
Injury to the long thoracic nerve which innervates the serratus anterior muscle
Damage to long thoracic nerve can happen during a masectomy
Name the Functional Deficits of Winged Scapula.
Unable to abduct above horizontal plane due to inability of serratus anterior m. to rotate glenoid fossa superiorly.
External Oblique Attachments
Attached to ribs 5-12
Rectus Abdominis Attachments
Attached to xiphoid process and costal cartilages 5-7
Describe the path of Nerves and Arteries of the Pectoral Region
Nerves and arteries pierce the clavipectoral fascia.
Describe the Nerves of the Pectoral Region
Nerves from brachial plexus:
Lateral Pectoral Nerve
Medial Pectoral Nerve (comes through the pectoralis minor)
Describe the arteries of the Pectoral Region
Arteries from axillary artery:
Thoracoacromial trunk
Lateral Thoracic Artery