Question | Answer |
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 | |
thoracodorsal->inn | |