Unit 1: Lecture 10

Question 1

Bony components of the shoulder

Answer 1

• Clavicle

- Scapula

Question 2

Proximal humerus joins shoulder girdle at…

Answer 2

glenoid fossa

Question 3

Joints of the shoulder complex (4)

Answer 3

• Glenohumeral joint
• Sternoclavicular joint
• Acromioclavicular joint
• Scapulothoracic joint

Question 4

Glenohumeral joint ligaments (6)

Answer 4

• Superior/Middle/Inferior glenohumeral ligaments
• Coracohumeral ligament
• Glenoid labrum (SLAP lesion)
• Articular capsule

Question 5

Sternoclavicular joint ligaments/protection (6)

Answer 5

• Anterior/Posterior sternoclavicular ligament
• Anterior/Posterior interclavicular ligaments
• Articular capsule
• Articular disk

Question 6

Acromioclavicular joint ligament (3)

Answer 6

• Acromioclavicular ligament (thickening of articular capsule)
• Coracoacromial ligament (forms supraspinatus tunnel)
• Coracoclavicular ligament

Question 7

Acromioclavicular separation is more commonly referred to as a…

Answer 7

shoulder separation

Question 8

Scapulohumeral rhythm

Answer 8

2/3::1/3 abduction movement for glenohumeral joint movement compared to scapulothoracic joint movement

Question 9

“Winged scapula?”

Answer 9

Potential damage to long thoracic nerve, which innervates the serratus anterior, which helps in affixing the scapula to the thoracic wall

Question 10

Rotator cuff muscles and attachments (4)

Answer 10

• Subscapularis - lesser tubercle
• Supraspinatus - greater tubercle (superior facet)
• Infraspinatus - greater tubercle (middle facet)
• Teres Minor - greater tubercle (inferior facet)

Question 11

Motions muscles of rotator cuff help with:

Answer 11

Medial rotation: subscapularis
Lateral rotation: infraspinatus and teres minor
Initiates abduction: supraspinatus

Question 12

Pectoralis major is a large muscle which covers the upper chest _________ and contributes to the anterior ____________

Answer 12

Anteriorly; axillary fold

Question 13

Pectoralis Major arises from…

Answer 13

side of sternum, shaft of clavicle, and cartilages of first 7 ribs, with fibers attaching to LATERAL lip of intertubercular groove of humerus

Question 14

Pectoralis major actions

Answer 14

G/H medial rotator and adductor

Question 15

Pectoralis minor arises from…

Answer 15

3rd, 4th, and 5th ribs to coracoid process of scapula.

Question 16

Primary function of pectorals minor (and clinical aspect)

Answer 16

stabilization of shoulder girdle, but also assists lower trapezius

crutch walkers may use the pec minor as they lift the trunk against a stationary shoulder girdle base during ambulation

Question 17

Subclavius connects…

Answer 17

first rib and clavicle

Question 18

Subclavius primary function

Answer 18

stabilization of clavicle, but also depresses and protracts clavicle

Question 19

Bursae

Answer 19

sac-like structures containing fluid

found at points of friction (where a tendon inserts into bone)

Question 20

Example of bursa? (and 5 facts about it)

Answer 20

Subacromial bursa/subdeltoid bursa

• size of half dollar
• located deep to deltoid
• overlying tendon of supraspinatus and joint capsule
• has an extension which courses beneath the acromion and coracoacromial ligament

The subacromial/subdeltoid bursa facilitates movement of the deltoid over the joint capsule and supraspinatus tendon

Question 21

Supraspinatus tendinitis

Answer 21

Subacromial/subdeltoid bursa may become irritated and ultimately fuse to supraspinatus tendon and joint capsule.

Also would lead to “bursitis,” or “shoulder pain”

Question 22

Axilla superior markings (3)

Answer 22

• 1st rib
• scapula
• clavicle

Question 23

Axilla boundaries (base, anterior, posterior, medial, lateral, and apex)

Answer 23

Base - armpit (formed and supported by axillary fascia)
Anterior - anterior axillary fold (pec major)
Posterior - poster axillary fold (lat. dorsi and teres major)
Medial - serratus anterior
Lateral - floor of intertubercular groove of humerus
Apex - triangle formed by 1st rib, scapula, and clavicle

Question 24

Axillary fascia

Answer 24

from latissimus dorsi to the pectorals major and makes hollow of armpit

Question 25

Clavipectoral fascia

Answer 25

investing layer of the subclavius and pectorals minor and covers the anterior aspect of the axilla

Question 26

Structures that pierce the clavipectoral fascia (3)

Answer 26

- cephalic vein: drains upper limb and terminating in the axillary vein - thoracoacromial vessels: supplies vascular branches to the anterior chest wall - lateral pectoral nerve: supplies pectoralis major

Question 27

Axillary sheath

Answer 27

adherent to the clavipectoral fascia behind the pec mini, and encloses vessels and nerves of axilla (except the axillary vein which is OUTSIDE sheath) The axillary sheath is a fascial extension of the pre-vertebral layer of cervical fascia covering the scalene muscles