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anatomy of the shoulder, Ligaments and tendon, Inflammatory response, AC distrup

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Question
Answer
What is the appendicular skeleteon?   refers to bones of the upper and lower limbs, and the pectoral and pelvic girdles  
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What does the upper limb consist of?   the arm, the forearm and hand all connected to the axial skeleton by pectoral girdle  
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Pectoral girdle?   is formed by the clavicle and scapula, which lie anteriorly and posteriorly to the ribcage  
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Scapula   A large, flat triangular bone that lies obliquely on the back and side of the thorax  
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What articulations does the scapula form?   Acromio-clavicular joint with the acromial end of the clavicle Glenohumeral joint with the head of the humerus  
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Acromion   The expanded lateral end of the spine of the scapula. It has an oval facet for articulation with the clavicle  
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Coronoid process   A large, finger-like bony spur that projects upwards from the upper-aspect of the neck of scpaula.  
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What does the coronoid process give attatchment to?   Coracobrachials, short head of bicepts, pectoralis minor, coraco-clavicular ligaments.  
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Glenoid fossa   A shallow socket that articulates witht he head of the humerus. Is pear-shaped; its depth is increased by the glenoid labrum, which is attatched to the periphery. Lined with hyaline cartilage for articulation.  
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Inferior angle   The medial and lateral borders of the scapula meet at the inferior angle which overlies the seventh rib; with abduction of the arm it moves around the chest wall.  
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Infraspinosous fossa   A large depression if the dorsal aspect of the scapula, below the spine. It gives attatchment to infraspinatus, one of the four rotator cuff muscles.  
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Lateral border   Thick, runs from the infraglenoid tubercle to the inferior angle.  
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Medial Border   Thin, it runs between the superior and inferior angles.  
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Neck of the glenoid   A constriction between the glenoid and the body of the scapula  
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Spine   Triangular ridge of the bone that crosses the back of the scapula from the acromion to the medial border  
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Superior angle   The junction between the superior and medial borders  
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Superior borders   Thin and sharp, it is separated from the coracoid process by the supraglenoid notch.  
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Subscapular fossa   Slightly ridged fossa on the inner surface of the scapula  
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Supraspinosous fossa   A deep fossa located on the back of the scapula, above the spine.  
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Subscapular notch   A dip in the superior border, just medial to the coracoid process  
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What two articulations does the scapula form?   Acromio-clavicular joint with the acromion of the scapula Sterno clavicular joint with the manubrium of the sternum  
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Sternal end of scapula   The medial end of the clavicle that articulates with the sternum  
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Acromial end   The lateral end of the clavicle that articulates acromion of the scapula  
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Coroid tubercle   Small projection from the posterior edge; gives attatchment to the coroid part of the coraco clavicular  
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What three articulations does the humerus form?   Glenohumeral joint, humeroulnar joint, humeroradial joint  
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What type of joint is the shoulder?   Ball and socket joint  
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Superior angle   The junction between the superior and medial borders  
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Superior borders   Thin and sharp, it is separated from the coracoid process by the supraglenoid notch.  
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Subscapular fossa   Slightly ridged fossa on the inner surface of the scapula  
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Supraspinosous fossa   A deep fossa located on the back of the scapula, above the spine.  
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Subscapular notch   A dip in the superior border, just medial to the coracoid process  
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What two articulations does the scapula form?   Acromio-clavicular joint with the acromion of the scapula Sterno clavicular joint with the manubrium of the sternum  
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Sternal end of scapula   The medial end of the clavicle that articulates with the sternum  
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Acromial end   The lateral end of the clavicle that articulates acromion of the scapula  
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Coroid tubercle   Small projection from the posterior edge; gives attatchment to the coroid part of the coraco clavicular  
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What three articulations does the humerus form?   Glenohumeral joint, humeroulnar joint, humeroradial joint  
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What type of joint is the shoulder?   Ball and socket joint  
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What are the anatomical components of the shoulder?   Articular capsule, Coracohumeral ligament, glenohumeral ligament, glenohumeral ligament, transverse humeral ligament, glenoid labrum, Four bursae: Subscapular, subdeltoid, subacromial, subcoracoid  
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Muscles that move the pectoral girdle can be classified into two groups based on their location in the thorax. What are these two groups?   Anterior and posterior thoracic muscles  
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What are the anterior thoracic muscles that move the pectoral girdle   Subclavius, Pectoralis minor, serratus anterior  
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Subclavius   Small cyclinderical muscle under the clavicle that extends from the clavicle to the first rib. Depresses and moves clavicle anteriorly and stabilises  
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Pectorallis minor   Insertion- Coracoid process of scapula. Abducts scapula and rotates it downwards; elevates third through fifth ribs during forced inhalation  
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Serratus anterior   Large, flat fan shaped muscle between the ribs and scapula. Abducts scapula and rotates it upwards; elevates ribs when scapula stabilised  
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What are the posterior thoracic muscles?   Trapezius, levatator scapulae, rhomboid major, rhomboid minor  
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Trapezius   Flat, largem triangular sheet of muscle extending from the skull to vertebral collumn to pectoral girdle laterally. Elevates scapula, help extend head.  
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Levatator scapulae   Elevatos scapula and rotates it downwards  
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Rhomboid major and rhomboid minor   lies deep to the trapezius, Rhomoid major = T2-T5 Rhomboid minor= C7-T1, elevatos and adducts scaupla and rotates it downwards.  
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Which AXIAL muscles move the HUMERUS?   pectorallis minor, latissimus dorsi  
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pectorallis minor   Adducts and medially rotates arm at shoulder joint; clavicular head flexes arm, and sternal costal head extends the flexed arm to the side of trunk  
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latissimus dorsi   Extends adducts, and medially rotates arm at shoulder joint, drwas arm inferiorly and posteriorly  
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What are the SCAPULAR muscles that move the humerus?   Deltoid, Subscapularis, Supraspinatus, infraspinatus, teres minor, teres major, coracobrachials  
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Inflammation can be?   Acute or chronic  
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Acute inflammation   Is a rapid in onset and of short duration, lasting from a few minutes to as long as a few days, and is characteriszed by fluid and plasma proteins.  
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Chronic inflammation   Lasts longer than acute, more insidious, typified by influx of lymphocytes+macrophages, Vascular proliferation, scarring.  
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what are the five characteristic signs of inflammation?   Redness, Heat, pain and swelling, loss of function  
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What type of response is inflammation?   Non-specific immune response  
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what are the three basic stages of the inflammatory response?   1. vasodilation and increased permeability of blood vessels 2. emigration of phagocytes from the blood into interstitual fluid 3. tissue repair  
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Vasodilation and increased permeability of capillaries   Increased permeability means substances normally retained in blood are permitted to pass from the blod vessels. vasodilation= more blood flow to the area  
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What three symptoms of inflammation does vasoldilation and increased permeability give rise to?   Heat, redness, swelling.  
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Emigration of phagocytes   After 1 hour, phagocytes appear. neutrophils stick to inner surface of enothelium. Neutrophils squeeze through to reach injured area. Depends on chemotaxis.  
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Mechanism of acromio-clavicular joint distruption   usually follows trauma, eg due to a direct blow to the acromion with the humerus adducted, as in collision in high-impact contact sports, or after a fall on to the apex of the shoulder. Injury may occur as consequence of throwing sports or weightlifting  
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Type 1 joint distruption   joint sprained without tear of either ligament  
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Type 2 joint distruption   Ac ligaments torn but CC ligaments still intact. lateral end of clavicle not elevated  
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Type 3 joint distruption   AC and CC ligaments torn >5mm elevation of AC joint in X-ray  
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Type 4 joint distruption   lateral clavicle separated and impaled posteriorly into trapezial fascia.  
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Type 5 joint distruption   complete separation of clavicle and scapula with gross upward clavicular displacement.  
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How are type 1 and 2 injuries managed?   with ice, a sling for 1-3 weeks and non-steroidal anti-inflammatory drugs (NSAIDs) followed by physiotherapy to strengthen muscles and ligaments after the acute phase.  
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how are type 3 and 4 injuries managed?   •Type III injuries should be managed conservatively but carefully selected cases may benefit from surgical intervention if conservative therapy fails  
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What is the difference between a tendon and a ligament?   Tendons attach muscle to bone. Ligaments attach bone to bone  
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