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Shoulder

Fiona Doolan Inglés 68 fichas

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  1. 1innervation of shoulderBP VENTRAL RAMI of spinal nerves C5-T1
  2. 2Muscles of shoulder direct trunk-to-humeruspect maj
    O: clavicular head- clavicle, sternal head- cartilages upper 6 ribs
    I: lateral lip bicipital groove humerus
    A: sternal head- extension of humerus from flexed position
    A: horizontal adduction, medial rotation, adduuction humerus.
    A: clavicular head: flexion hum
    N: medial (sternal, 6 7 C8, T1) and lateral pectoral N (clavicular, C8 T1)
    B: thoracoacromial trunk of Axillary 2
    lats
    O: Thoracolumbar aponeurosis, Lower 6 thoracic spinous processes, Sacrum and iliac crest, Lower 3 to 4 Ribs, INFERIOR ANGLE SCAPULA
    I: Humerus-bicipital (intertubercular) groove
    A: Humerus-medial rotation and adduction, Extension
    N: Thoracodorsal nerve (C6, 7, 8)
    B: thoracodorsal artery
  3. 3extrinsic muscles of shoulderanterior extrinsics: axillary fold M's (pect minor, subclav)
    posterior extrinsics: trapezius, lev scap, rhomboids
    Serratus Anterior (side, not ant or post)
  4. 4pect minor and subclaviuspect minor medial pectoral N only- C8 T1
    subclavius C5 C6
  5. 5lev scap, rhomboids, trapeziustrapezius- spinal accesory nerve not lost in BP damage
    lev scap rhomboids C5 dorsal scapular N
  6. 6Intrinsic shoulder musclesmove free limb relative to shoulder girdle
    SITS
    Teres Maj
    Deltoids
  7. 7Supraspinatus Infraspinatus Teres Minor lesser tubercle: subscapularisbursae?
  8. 8pectoralis major ___ head has better leverage for flexing shoulder/ internal rotation pectoralis major fibres pectoralis major originclavicular
    cross over one another
    inferior to insertion
  9. 9pectoralis major cannot extend the arm. it can take a flexed arm and"extend" it back to neutral
  10. 10extrinsic shoulder pect minordepress scapula, downward rotate it, protract it
  11. 11subclavius good example ofshunt muscle
    contracts to resist dislocating forces occurring at joints, the coracobrachialis, short head of biceps, and long head of triceps all contract to resist downward dislocating forces at the shoulder joint,
    shunt- insertion farther away than origin
  12. 12subclaviusI: subclavian groove clavicle
    STABILIZE STERNOCLAVICULAR JOINT
    thoracoacromial trunk AX II
  13. 13serratus anterior does what ok and what very well? DAMAGE LONG THORACIC N?ok protraction
    very important for ABD/ADD when shoulder joint up high, very good hold scap to thorax
    origin front insertion back
    C5 C6 C7
    found below axilla
  14. 14Supraspinatus essential forinitiate abd of shoulder
    ABD
  15. 15infraspinatus job (same as _______) (opposite to ____)ext rot hum
    teres minor
    subscapularis
  16. 16SITS sit nearCoracoacromial ligament- coracoid process to acromion
    Acromoclavicular ligament- clavicle to acromion
  17. 17teres major note equal to teres minortiny lats.
    why? big origin, inserts also on intertubicular groove so it can
    internally rotate, adduct, extend shoulder
    teres minor- posterior hum attach, ext rotate
  18. 18where does biceps insert? Where do deltoids insert?radial tuberosity (medial Radius)
    deltoid tuberosity (lateral hum)
  19. 19anterior deltoid flex shoulder, internally rotate, horizontal abduction posterior deltoid? Middle?posterior deltoid extend shoulder, externally rotate, horizontally abduct
  20. 20deltoids and teres minorcommon nerve and artery
    axillary N
    posterior circumflex hum A (Axiii)
  21. 21origin of deltoids is likeinsertion of traps
    clavicle, spine of scapula
  22. 22intertubercular groovemedial lip: teres maj
    floor: lats
    lateral lip: pec maj
  23. 23lats & teres majorsame actions at shoulder.
    same blood:
    lats- AXIII, subscap trunk thoracodorsal A
    teres Maj- circumflex scap A from subscap trunk
  24. 24rhomboids and levator scapulaedorsal scapular N and A
  25. 25shoulder attached at what points?SC JOINT!!!! only link to axial skeleton
  26. 26shoulder joints (4)Scapulothoracic (pseudo)
    sternoclavicular
    acromioclavicular
    glenohumeral
  27. 27costoclavicular ligament, coracoclavicular ligament fightstraps
  28. 28scapulothoracic jtelevation- upper traps, lev scap
    depression- lower traps, pec min
    retraction- middle traps, rhomboids
    protraction- serratus anterior
    rotation- trapezius upper, lower. serrat ant.
  29. 29shoulder jt motions ABDuctiondeltoid provide power
    0-90 degrees- normal ROM glenohumeral. supraspinatus essential to initiate
    90-120 degrees- passive external rotation up until this point. close-packed.
    120-180 degrees- NEED scapulo-thoracic rotation to get beyond this point. ADD traps, serrat ant
  30. 30degrees GH movement degrees scapulothoracic rotation10 degrees GH movement 5 degrees scapulothoracic rotation
  31. 31SC jointarticular disk
    fibrous capsule NOT HAC
    3 major ligaments- anterior & posterior SC
    costoclavicular
    interclavicular
  32. 32Anterior and posterior SC ligprevent joint separating in scapular retraction
    clavicular notch- covered by ant/post SC lig
    covers the joint, the fibrocartilagenous disk
    the fibrous capsule is attached to both joint surfaces and the perimeter of disc- creating two spaces for fluid....
  33. 33costoclavicular LigMOST IMPORTANT
    reinforce joint capsule. resists any muscle trying to lift clavicle up
  34. 34SC joint issaddle joint
  35. 35interclavicular ligamenthelps in protraction and depression of distal ends of clavicles
  36. 36SC joint is evaluated asplane jt
  37. 37blood SC jointclavicular branch thoracoacromial trunk, internal thoracic, inferior thyroid branch thyrocervical trunk
  38. 38acromio-clavicular joint ligamentsligaments- acromioclavicular, coracoclavicular
    coraco most important
    ties clavicle to coracoid process.
  39. 39coracoacromial joint bloodacromial rete
  40. 40acromial retedeltoid and acromial branches of thoracoacromial trunk of AXIII
  41. 41innervation AC jointsuprascapular, axillary and pectoral nerves
  42. 42glenohumeral jointglenoid labrum. glenoid fossa very small, loose not like hip. unmatched curvatures
    top- long head biceps
    bottom- long head triceps
  43. 43cephalic vein runs onradius side
  44. 44triaxial jointball and socket
    plane
  45. 45coracohumeral glenohumeral transversethe ligaments of the glenohumeral joint
    dislocations happen anterior and inferior at ext rot 50 abe 90
    the transverse hold long head biceps tendon
    bicipital groove!! which has
  46. 46fracture ABOVE pronator teres-BICEPS continues supinating radius and PT continues pronating it- needs splint!
  47. 47coracohumeral ligamentreinforces glenohumeral joint anteriorly and superiorly
  48. 48core stability comes from bony structures in the glenohumeral jointfalse. "dynamic stability" from MUSCLES
    ligaments are an ok contributor, but BONY STRUCTURES ARE NOT. the articulating surfaces are not the same shape.
  49. 49coracoacromial ligament shoulderprevent superior dislocation. Bony structures in back of GH joint, so dislocation is anterior and inferior
  50. 50friction potential GH jointsupraspinatus on coracoacromial ligament
    (in anatomical position)
  51. 51subacromial-subdeltoid subscapularisthe 2 bursae of GH joint.
    subacromial-subdeltoid--- supraspinatus and coracoacromial arch
    subscapularis---- between subscapularis and neck scapula.
  52. 52GH supplied by axillary and suprascapular Narteries must be suprascapular, and the circumflex humeral A's
  53. 53how to abduct beyond 90 degreesabduction started by supraspinatus and delt
    90-120 add in passive external rotation of the humerus, beyond 120 contribute scapular rotation (traps and serrat ant)
  54. 54internal rotators of shoulderteres major
    anterior delt
    supscapularis
    lats
    pec major
  55. 55external rotators of shoulderteres minor
    infraspinatus
    posterior deltoid
  56. 56circumductioncombo flex, ext, add, ab in circle
    circumduction of the shoulder joint are the pectoralis major, deltoid, supraspinatus, long head of triceps, biceps brachii, subscapularis, infraspinatus, coracobrachialis, teres major and minor and the latissimus dorsi
  57. 57quadrangular spacePHCA and axillary nerve visible. lateral border neck of humerus, superior Teres Minor, inferior Teres Major, medial long head of triceps from infraglenoid of scapula
    MEDIAL to it is triangular space.
    Teres Major on bottom, Teres Minor on top, long head of triceps lateral.
    triangular space has circumflex scapular A
    subscapularis
  58. 58circumflex scapular Asubscapularis, an internal rotator of shoulder inserting on lesser tubercle
    teres Major, another internal rotator that can also contribute to extension of shoulder and adduction of shoulder, inserting on medial lip of bicipital groove
  59. 59circumflex scapular Aanastamoses with suprascap, dorsal scap
  60. 60quadrangular space housesPCHA and Axillary N
  61. 61lesion at suprascapular notchsuprascapular N
    lose supraspinatus
    A: abduction of shoulder
    stabilize GH joint
    lose infraspinatus
    A: external rotation of shoulder
    stabilize GH joint
  62. 62lesion at where suprascap nerve emerges from under clavicleonly lose infraspinatus
    an external rotator
    stabilizes GH joint
  63. 63lesion of long thoracic Nwinged scapula, serratus anterior.
    lose last 60 degrees abduction serrat ant contributes along with traps by scapular rotation!!!
    serrat ant compresses scapula against rib cage
  64. 64lesion of axillary N can be frombreak arm right at surgical neck
    abduction power of deltoids lost
    lost teres minor
    still have infraspinatus-- ext rotation compromised but not lost.
    (posterior deltoid does ext rot)
  65. 65blood supply deltoidPCHA
  66. 66blood supply Teres MinorPCHA
  67. 67blood supply supra and infraspinatussuprascapular A
    (comes off thyrocervical trunk)
  68. 68blood supply tricepsbrachial profunda A

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Fichas sobre Shoulder, creado por Fiona Doolan el 02/03/2016.
Creado por
Fiona Doolan
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