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73 Cards in this Set
- Front
- Back
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What is the conoid tubercle?
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attachment for conoid ligament, medial part of coracoclavicular ligament
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What is the trapezoid line?
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Attachment for the trapezoid ligament, lateral part of coracoclavicular ligament
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What is the deltoid tubercle?
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Prominence in lateral third of clavicle; attachment for anterior part of deltoid
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What causes the clavicle to fracture? Where does it fracture?
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Violent impact to hand or shoulder
Weak = junction of medial and lateral thirds |
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What are consequences of clavicular fracture?
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Sternocleidomastoid m. elevates medial fragment of bone - prominent and readily palpable/apparent
2. Shoulder dops. 3. Lateral fragment may be pulled medially by adductor mm of arm 4. Overriding of bone fragments = shortening of clavicle |
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What ribs does the scapular overlie?
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ribs 2 - 7
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What is the curvature of the posterior surface of the scapula? Anterior?
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Posterior - convex
Anterior - concave |
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What closes off the suprascapular notch?
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Transverse scapular ligament
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What is the great scapular notch?
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Lateral-most attachment of spine to posterior scapular surface
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Where does the tendon of the long head of biceps brachii m. pass through?
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Intertubercular groove
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What forms the rounder curve of the shoulder?
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Humerus in glenoid cavity of scapula & deltoid m
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What does the head of the humerus articulate with?
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glenoid cavity of the scapula
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What does the anatomical neck separate?
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Head of humerus from the greater and lesser tubercles
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Where is the epiphyseal plate located?
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Anatomical neck of the humerus
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Where do fractures occur most commonly in the humerus? what type of fracture?
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Anatomical neck, impacted, from minor fall on hand
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Where does the deltoid m. attach?
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Deltoid tuberosity on the shaft of the humerus
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What lies in the radial groove?
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The radial n & profunda brachii a.
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What is a humeral avulsion fraction, how does it happen in middle aged and elderly, in younger people, and what causes medial rotation?
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1. Fracture of the greater tubercle
2. Fall on acromion 3. fall on hand when arm is abducted 4. subscapularis pulls limb to medial rotation |
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What is the articular disc of the sternoclavicular joint (a, b)
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A. flat, circular fibrocartilage between sternal & clavicular surfaces
B. Serves as shock absorber of forces transmitted along clavicle |
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What is the articulation between the upper limb (arm) & axial skeleton?
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sternal end of clavicle articulates with manubrium & 1st costal cartilage
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What are the ligaments of the sternoclavicular joint? 3 and their function
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CIA:
Costoclavicular ligaments - anchors sternal end of clavicle to 1st rib, limits elevation of pectoral girdle Interclavicular ligament - strengthens capsule superiorly; extends between sternal ends of clavicle Anterior and Posterior SC ligaments - reinforce joint capsule anteriorly & superiorly |
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What movements does the sternoclavicular joint allow?
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Protraction and retraction of scapula on thoracic wall
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Does the sternoclavicular joint get dislocated?
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Rarely, the clavicle usually fractures first
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What strengthens the acromioclavicular joint?
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Trapezius superiorly
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What are the two ligaments of the acromioclavicular joint? 3, location/function
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Acromioclavicular ligament - acromion to clavicle; strengthens joint superiorly
Coracoacromial ligament - extends from coracoid process to acromion Coracoclavicular ligament - anchors clavicle to coracoid process of scapula |
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What two ligaments make up the coracoclavicular ligament? attachments?
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i. Vertical conoid ligament - medial, inverted triangular ligament; between corocoid process & conoid tubercle on inferior surface of clavicle
ii. Horizontal trapezoid ligament - attached to superior surface of coracoid process & to lateral surface of trapezoid line on inferior surface of clavicle |
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What movement does the acromioclavicular joint allow?
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rotation of scapula
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What can cause a shoulder separation? a severe separation?
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direct blow/hard fall on shoulder or outstretched upper limb as seen with contact sports, torn acromioclavicular and coracoclavicular ligaments
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What does a torn coracoclavicular ligament present as?
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Shoulder separation from clavicle & falls due to weight of upper limb
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What holds the humeral head in place?
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rotator cuff mm.
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What are the three ligaments of the glenohumeral joint?
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Glenohumeral ligaments, Transverse humeral ligament, coracohumeral ligament
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What does the glenohumeral ligament do and what does it look like?
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3 fibrous bands that strengthen anterior aspect of joint capsule
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What does the coracohumeral ligament look like and what does it do and where is it?
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strong band that reinforces capsule superiorly; from base of coracoid process to anterior aspect of greater tubercle of humerus
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Where does the transverse humeral ligament run, and what does it do?
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A broad fibrous band running obliquely from greater to lesser tubercle of humerus; bridges over intertubercular groove to hold tendon of long head of biceps brachii m. in place during movements of joint
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What is the coraco-acromial arch? What is it spanned by? What does it prevent?
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protective structure formed by smooth inferior aspect of acromion and coracoid process of scapula
Spanned by coracoacromial ligament Prevents superior displacement of humeral head from glenoid cavity |
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What will fracture before the coraco-acromial arch will fracture?
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Clavicle or the humeral shaft
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Which nerve is most likely to be damaged during a shoulder separation?
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Axillary
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What movements does the glenohumeral joint allow?
a-d |
a. flexion - extension
b. Abduction - adduction c. Rotation (medial and lateral - increase range of abduction) of humerus d. Circumduction |
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What does stiffening or fixation of joints of pectoral girdle (ankylosis) cause?
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more restricted range of movement, even if GH joint is normal
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What is a bursae?
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sac-like cavity containing films of synovial fluid secreted by synovial membrane
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Where are bursae located?
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Where tendons rub against bones, ligaments, or other tendons and where skin moves over bony prominence
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Where is the subscapular bursa located and what does it communicate with?
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Between subscapularis tendon & neck of scapula. Communicates with GH joint
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Where is the subacromial bursa? and what does it not communicate with?
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Between acromion, coracoacromial ligament, & deltoid superiorly and supraspinatus tendon and joint capsule of GH joint inferiorly. Does not communicate with GH joint cavity
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What doe most dislocations of the GH joint involve, and what might be injured in the dislocation?
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Inferior displacement of the humeral head (anterior inferior dislocation). Axillary n. may be injured
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What causes adhesive capsulitis? and what are consequences (2) of it?
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Adhesive fibrosis and scarring between inflamed joint capsule of GH joint, rotator cuff, subacromial bursa, and deltoid
Consequence: 1. difficulty abducting the arm- can obtain abduction up to 45 degrees by elevating and rotating scapula 2. Lack of GH joint movement - pain during elevation of shoulder |
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What is torn for a shoulder separation?
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Acromioclavicular ligament
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What is wrong in a shoulder dislocation?
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The glenohumeral joint, humeral head displaced from glenoid cavity affecting axillary n and may be the musculocutaneous n.
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What ligament holds the clavicle to the acromion and when broken reveals a widening lateral articulation?
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Acromioclavicular
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What are the three parts of the deltoid, and what does each part do?
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Clavicular - flexion & medial rotation of the arm
Acromial part - Abduction of the arm Spinal part - extension and lateral rotation of the arm |
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What nerve and artery supplies the deltoid?
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Axillary n. and the posterior circumflex humeral a.
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What type of injection is the deltoid a common site for?
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intramuscular
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When is axillary nerve injury common? 3
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Fracture of surgical neck of the humerus, dislocation of the GH joint, compression due to incorrect use of crutches
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What does axillary injury lead to?
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Atrophy of deltoid mm -> flattening of rounded contour of shoulder
Loss of sensation over lateral side of proximal arm |
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What is the action of the teres major, and what is its n & a?
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It adducts and medially rotates the arm. It is the lower subscapular n and the posterior circumflex humeral a.
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What does the rotator cuff mm do and what are they (4)?
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Hold humeral head in glenoid cavity of scapula
SITS Supraspinatus, Infraspinatus, Teres minor, subscapularis |
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What are the a. and n. of:
1. Supraspinatus 2. Infraspinatus 3. Teres minor 4. Subscapularis |
1. suprascapular a & n
2. suprascapular a & n 3. Axillary n. posterior circumflex a. 4. Upper and lower subscapular n and the subscapular a. |
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What does the following do?
1. supraspinatus 2. Infraspinatus 3. Teres minor 4. subscapularis |
1. initiates & assists deltoid in abduction of the arm to 15 degrees
2. laterally rotates arm 3. laterally rotates arm 4. medially rotates arm |
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What causes rotator cuff injury (2)?
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1. repetitive use of upper limb above horizontal line
2. Recurrent inflammatino of tendon |
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Where do the following originate?
1. suprascapular a. 2. tranverse cervical a 3. subscapular a. |
1. proximal axillary artery
2. Subclavian a. 3. Distal axilary a. |
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Which arteries anastomose in the posteriro aspect of the scapula?
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Deep branch of transverse cervical a., suprascapular a, and scapular circumflex a.
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What is the bloodflow due to ligation/compression of proximal axillary a?
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Suprascapular and transverse cervical a -> scapular circumflex a. -> subscapular a. -> brachial a.
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What is the blood flow if there is a ligation below the subscapular a?
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There is no collateral system
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What are the borders of the quadrangular space?
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i. Superior - capsule of shoulder joint and teres minor m
ii. Inferior - teres major m iii. Lateral - surgical neck of humerus iv. Medial - long head of triceps brachii m. |
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What is contained in the quadrangular space?
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Axillary n. and posterior circumflex humeral a.
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What are the boundaries of the triangular space and what are its contents?
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i. Superior - teres minor m
ii. Inferior - teres major m iii. lateral (base) - long head of triceps brachii m scapular circumflex a |
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What are the boundaries of the triangular interval and contents?
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i. Superior (base) teres major m
ii. Lateral - lateral head of triceps brachii m. iii. Medial - long head of triceps brachii m. Radial n. and profunda brachii a. |
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What is the origin, insertion and nerve of the deltoid?
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Origin: lateral 1/3 of clavicle, acromion, spine of scapular
Insertion: deltoid tuberosity of humerus Nerve: Axillary n C5,6 |
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What are the action of the deltoid?
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Clavicular - flexes and medially rotates the arm
Acromial - abducts the arm Spinal - extends and laterally rotates the arm |
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What is the origin, insertion, action, and nerve of the supraspinatus m?
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Origin: Supraspinous fossa of scapula
Insert: Superior facet of greater tubercle of the humerus Action: Initiates & assists deltoid in abduction of the arm Nerve: Suprascapular n C5,6 |
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What is the Origin, insertion, action and nerve of the infraspinatus m?
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Infraspinous fossa of scapula
Insert: Middle facet of greater tubercle of humerus Action Laterally rotates the arm Nerve: Suprascapular n. C5,6 |
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What is the origin, insertion, action and nerve of the teres minor?
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Origin: middle part of lateral border of scapular
Insert: Inferior facet of greater tubercle of humerus Action: laterally rotates arm Nerve: Axillary n C5,6 |
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What is the origin, insertion, action, and nerve of the teres major?
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Origin: posterior surface of inferior angle of scapula
Insert: Medial lip of intertubercular groove of humerus Action: adducts and medially rotates the arm Nerve: Lower subscapular n C5,6 |
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What is the origin, insertion, action, and nerve of the subscapularis?
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1: Subscapular fossa
2: Lesser tubercle of humerus 3: medially rotates arm 4: Upper and lower subscapular nn C5,6 |
