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Humerus inserts where? Glenoid cavity of scapula
Coracoid what is? forward process from scapula
Acromion what is? backward process that comes off spine of scapula
clavicle to scapula art via? Acromion
Pectoralis Minor O? I? A? O-2,3,4 ribs I-coracoid process A-depresses shoulder
Subclavius O? I? A? O-1st rib I-under clavicle A-steadies clavicles while shoulder moves
Pectoralis Major O? I? A? O-1)front medial 1/2 clavicle 2)upper costal cartilages 3)External oblique aponeurosis 4)sternum front I-Greater tubercle of Humerus A-1)adducts arm 2)med rotates arm
Scapular notch? upper boder, neurovasc bundle -> back of scapula
Subscapular bursa between? joint capsule & muscle
Subscapularis I? A? I=Lesser tubercle of H A= 1) adduct 2) med rotator 3)secures head of humerus in glenoid
Teres major O I A O=post,lat surface scapula I=below subscapularis L tubercle of humerus A=A= 1) adduct 2) med rotator 3)secures head of humerus in glenoid
Latissimus Dorsi O I A O= T and L spinous process, lig, thoracolumbar fascia, illiac crest I=flat tendon -> intertrabecular groove of H A= 1) adduct 2) med rotator 3)great climbing muscle pulls trunk up
Serratus anterior O I A O=1-8 ribs I= medial border of scapula A= protracts scpula forwards secures scpula to chest wall if paralysed-> winged scapula
Deltoid O I A O=U shaped, lat border clavicle -> acromion -> scapular spine I=deltoid tuberosity of H A= ant fibres - flex post fibres extend med main abductor
Muscles of back of scapula (3) 1 Supraspinatus 2 Infraspinatus 3 Teres Minor
Supraspinatus O I Rel Clnical (2) N Art A O= spupraspinous fossa -> under acromion I=G. tubercle H Rel=capsule below, subacromial bursa above Clinical=1 tendon rupture injur 2 caification N=suprascapular n Art=subclavian A=initiation + maintain abduct + stability
Infraspinatus O I N A O=infraspinous fossa I=G. tubercle of H N=suprascapuar n via glenospinous notch ->infra A=lat rotator stability
Teres minor O I A N O=infraspinous fossa I=G.tubercle of H A=lat rotator stability N=axillary n post cord brachial plexus between subscapularis/teres major
Levator scapulae and Rhomboids O I N A O=vertebral column I=med edge scapula N=dorsal scapular n A=rotate scpula so that genoid faces down
Trapezious O I A N o=along vert column, back of skull -> C/T vertebrae spines I=lat 1/3 clavicle, spine scapula ->acromion A=rotates scapular so glenoid faces up N=CN XI accessory n
Cavicular joints (2) sternoclavicular, acromioclavicular, coracoclavicular ligament
Sternoclavicular joint Type Between Other T=synovial with articular disk inbetween B=1st rib-manubrium (1 cart immobile) -> med head clavicle O= see-saw movement opp to shoulder pivot = lig c->1st rib
Coracoclavicular lig use supports weight of upper limbs
Acromioclavicular joint T A T=synovial A=only small gliding move
labrum glenoidale rim of fibrous tissue around glenoid to increase art surface deepens
bursas = def protrudations of synovial membrane decreases friction bet muscle -joint
Ligaments of shoulder joint 1)coracohumeral -> G tubercle prev excessive external rotation 2)coracoacromial prevents excessive upward displacement
Synovial membrane NB lines all intracapsular structures except articular cartilage
subacromial bursa NB not cont with shoulder joint synovia sep joint from coracoacromial arch/deltoid
Rotator cuff tendons of muscles that surround joint Above=Supraspinatus Behind=Infraspinatus + T minnor In front=Subscapularis below=nothing, fold of Sub+Infra dislocation!
Movement-Adduction pec major +lat dorsi
Movement-Abduction intiated by supraspinatus, maintained by deltoid, if s paralysed swing passively then deltoid >90 = scapular rotates increase art surface
Movement-flexion deltoid-ant fibres pec major
Movement-extension deltoid post fibres + lat dorsi
Rotation of humerus subscapularis, infraspinatus, teres major
all ab, add, flex, extend =? circumduction =/ rotation
shoulder dislocation=>? test for axillary nerve damage skin over deltoid tuberosity, + deltoid strength
cervical rib brachial plexus injury
Axilla boundaries front= clavicle back=upper border scapula med=1st rib outer border
Brachial plexus nerve contributions? C5-T1
Brachial plexus break down and areas Roots->Trunks->Divisions->Cords behind scalenous anterior->post triangle->under clavicle->axilla
Long thoracic -> inn serratus ant
Dorsal scapular inn levator scapulae, rhomboids
subscapular n.s inn subscapularis t major
Branches of the axillary artery (7) -superior thoracic A -Thoracoacromial A -Lateral thoracic -Brachial artery -2 circumflex humeral art -subscapular -> circumflex scapular->back scapular muscles thoracodorsal
Axillary nodes drainig pattern Anterior/Pectoral -breast Posterior/subscapular-muscles Lateral group-upper limb all-> central nodes -> apical infraclavicular also -> apical
Position of breast side sternum->edge pec major rib 2-6 nipple 4th intercostal space
blood supply -> breast internal thoracic thoracic brahces of axillary A
Lymph drain of breast internal thoracic nodes axillary infraclavicular
Spread matastises of breast cancer other breast - thoracic cavity abdominal cavity - abdo wall
Suprascapular inn