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31 Cards in this Set

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  • Back
Osteology of Rotator Cuff
The rotator cuff is made up of the scapula and the clavicle bones
Ligaments of Scapula
Coracoclavicular (CCL, 2) - trapezoid and conoid
Coracoacromial (CAL)
Superior Glenohumeral (SGHL)
Middle Glenohumeral (MGHL)
Inferior Glenohumeral (IGHL)
Coracoclavicular (CCL, 2) - trapezoid and conoid
Coracoacromial (CAL)
Superior Glenohumeral (SGHL)
Middle Glenohumeral (MGHL)
Inferior Glenohumeral (IGHL)
Acromioclavicular Joint
Ligament: acromio clavicular ligament
Function: uses this ligament to attach acromion and clavicle
Ligament: acromio clavicular ligament
Function: uses this ligament to attach acromion and clavicle
Coracoacromial Joint
Uses corocoacromial Ligament to connect the coracoid and acromion processes
Uses corocoacromial Ligament to connect the coracoid and acromion processes
Posterior sternoclavicular Joint
Uses posterior steroclavicular ligament to connect the clavicle to the manubrium.  It also uses the Anterior sternoclavicular Ligament on the front side.
Uses posterior steroclavicular ligament to connect the clavicle to the manubrium. It also uses the Anterior sternoclavicular Ligament on the front side.
Saddle Joint of clavicle to manubrium
Uses the costoclavicular ligament deep to the anteriorsternoclavicular ligament in order to connect some of the clavicle to the cartilaginous areas of the manubrium
Uses the costoclavicular ligament deep to the anteriorsternoclavicular ligament in order to connect some of the clavicle to the cartilaginous areas of the manubrium
Scapulothoracic Articulation/Scapulothoracic Joint
Only has soft tissue:
Joint is surrounded by Subscapularis on Posterior side of joint and surrounded by serratus anterior on the anterior side of joint.
Only has soft tissue:
Joint is surrounded by Subscapularis on Posterior side of joint and surrounded by serratus anterior on the anterior side of joint.
Superficial Hypaxial Muscles of Back Region
Five Muscles:
Layer 1 : trapezius and latissimus dorsi
Layer 2 : levator scapulae, rhomboid minor, rhomboid major
ALL INNERVATED BY BP EXCEPT TRAPEZIUS (innervated by accessory nerve CNXI)
Five Muscles:
Layer 1 : trapezius and latissimus dorsi
Layer 2 : levator scapulae, rhomboid minor, rhomboid major
ALL INNERVATED BY BP EXCEPT TRAPEZIUS (innervated by accessory nerve CNXI)
Hypaxial innervation
All innervated by the ventral rami of spinal nerves
epaxial innervation
All innervated by dorsal rami of spinal nerves
Trapezius Muscle
Diamond Shape muscle, most superior and most superficial muscle of the back

PA:external occipital protuberance, nuchal ligament, spinous processes of C7-T12
DA: Lateral 1/3 of clavicle (anteriorly), acromion, and spine of scapula

Action: el...
Diamond Shape muscle, most superior and most superficial muscle of the back

PA:external occipital protuberance, nuchal ligament, spinous processes of C7-T12
DA: Lateral 1/3 of clavicle (anteriorly), acromion, and spine of scapula

Action: elevates, depresses, retracts the scapula; rotates glenoid fossa superiorly or upwards

BS: Transverse Cervical Artery: (superficial branch of transverse cervical artery: superficial cervical artery)
Motor innervation: Cranial Accessory Nerve XI
Sensory Innervation/proprioception: Spinal Nerves C3 and C4

TCART-trapezius has tranverse cerv art,
Triangle of Auscultation
Posterior side:
Borders: Trapezius medially, Deltoid superiorly, latissimus dorsi inferiorly
Posterior side:
Borders: Trapezius medially, Deltoid superiorly, latissimus dorsi inferiorly
Lumbar Triangle/Inferior Lumbar triangle/Triangle of Petit
Slight weakening in lateral abdominal wall which is prone to herniation. Sits laterally to the portion of the latissimus dorsi which is tendonous
Slight weakening in lateral abdominal wall which is prone to herniation. Sits laterally to the portion of the latissimus dorsi which is tendonous
Latissimus Dorsi Muscle
Huge muscle that sits slightly deep to the trapezius

PA: Spinous Processes of T7-T12 (inferior six SP of T vert), thoracolumbar fascia, illiac crest, and inferior 3 ribs.
DA: Floor of intertubercular groove of humerus

Action: extends, adduc...
muscle that sits slightly deep to the trapezius
PA: Spinous Processes of T7-T12 (inferior six SP of T vert), thoracolumbar fascia, illiac crest, and inferior 3 ribs.
DA: Floor of intertubercular groove of humerus

Action: extends, adducts, and medially rotates humerus; raises torso towards arms during climbing; pulls humerus down when torso is fixed

BS: Thoracodorsal Artery
Innervation: Thoracodorsal nerve C6 C7 C8
LATD: TD artery/TD nerve C6C7C8 Pull ups are great!
Deeper Posterior Axioappendicular Muscles
Levator Scapulae, Rhomboid Major, Rhomboid Minor

These are all still hypaxial muscles
Levator Scapulae, Rhomboid Major, Rhomboid Minor

These are all still hypaxial muscles
Rhomboid Major Muscle
Sits on the most inferior portion of scapula under minor and levator

PA:Spinous Process of T2-T5
DA: Medial Border of scapula from Spine to Inferior Angle

Action: Retract, elevate, rotate scapula downward and fix scapula to the thoracic wal...
Sits on the most inferior portion of scapula under minor and levator

PA:Spinous Process of T2-T5
DA: Medial Border of scapula from Spine to Inferior Angle

Action: Retract, elevate, rotate scapula downward and fix scapula to the thoracic wall

BS: Dorsal Scapular Artery
Innervation: Dorsal Scapular Nerve C4 and C5
Rhomboid Minor Muscle
Sits superior to the Rhomboid major Muscle

PA: Nuchal Ligament, Spinous processes of C7 and T1
DA: Medial end of spine of scapula

Action: Retract, Elevate, Rotate scapula downwards and and scapula to thoracic wall

BS:Dorsal Scapular Arte...
Sits superior to the Rhomboid major Muscle

PA: Nuchal Ligament, Spinous processes of C7 and T1
DA: Medial end of spine of scapula

Action: Retract, Elevate, Rotate scapula downwards and and scapula to thoracic wall

BS:Dorsal Scapular Artery
Innervation: Dorsal Scapular Nerve C4 and C5
Levator Scapulae
Superior to the Rhomboid Muscles
PA: posterior tubercles of transverse processes of C1-C4
DA: Medial border of scapula at the superior portion of the scapular spine 

Action: elevates scapula, tilts glenoid cavity inferiorly

BS: Dorsal Scap...
Superior to the Rhomboid Muscles
PA: posterior tubercles of transverse processes of C1-C4
DA: Medial border of scapula at the superior portion of the scapular spine

Action: elevates scapula, tilts glenoid cavity inferiorly

BS: Dorsal Scapular Artery
Innervation: Dorsal Scapular Nerve C5 and Cervical Spinal Nerves C3 and C4 DSN 5
Raise your scapula to the sky
Circulation of Back, Shoulder, and Pectoral Regions
There are two major arteries that accomplish this: 
Subclavian Artery and Axillary Artery
There are two major arteries that accomplish this:
Subclavian Artery and Axillary Artery
Subclavian Artery Origin on Left and Right
Asymmetric Artery:
Origin on right side is brachiocephalic trunk and origin on left side is the aortic arch. Arises posterior to sternoclavicular joint and right lateral to manubrium.
Divided into three divisions: Part one is anteior to scalene muscle, part two is posterior to scalene muscle, and part three is lateral to scalene muscle.

After it passes the clavicle, it becomes the axillary artery
Subclavian Artery Divsions of Medial portion of Subclavian Artery
Internal thoracic (mammary)-goes inwards and anteriorly

Vertebral Artery- goes up through the transverse foramina of C spine and is important for brain blood carriage

Thyrocervical trunk-runs into thoracic cavity and lies at the posterior as...
Internal thoracic (mammary)-goes inwards and anteriorly

Vertebral Artery- goes up through the transverse foramina of C spine and is important for brain blood carriage

Thyrocervical trunk-runs into thoracic cavity and lies at the posterior aspect of the thoracic wall, lateral to sternum. Is important for recirculation or anastomosis during coronary bypasses.
Transverse Cervical Artery of the Thyrocervical Arterial Trunk
Arises from Medial Branch of subclavian artery

Splits into superficial branch and deep branch: superficial cervical artery and dorsal scapular artery
Arises from Medial Branch of subclavian artery

Splits into superficial branch and deep branch: superficial cervical artery and dorsal scapular artery
Thryocervical Arterial Trunk
Splits into: 
transverse cervical artery
suprascapular artery
Splits into:
transverse cervical artery
suprascapular artery
Suprascapular Artery
Goes to the suprascapular fossa and the suprascapular region.
Goes to the suprascapular fossa and the suprascapular region.
Subclavian Artery Division at the Posterior aspect of the subclavian artery
Becomes the Costocervical Arterial Trunk:
composed of Supreme Intercostal Artery and Deep Cervical Artery
Becomes the Costocervical Arterial Trunk:
composed of Supreme Intercostal Artery and Deep Cervical Artery
Deep cervical artery
will go deep into the neck structure
supreme intercostal artery
Follows under the clavicle and first rib
Lateral Part of Subclavian Artery
Has NO branches.

At times, the dorsal scapular artery may arise independent from this part of the subclavian artery

The lateral border of first rib is where this part of the subclavian artery becomes the AXILLARY artery
Subscapular artery
Arises from Axillary artery from subclavian artery
Thoracodoral artery
Arises from the subscapular artery from axillary artery
WHAT HAPPENS WHEN AXILLARY ARTERY IS BLOCKED?
Blood flow still remains because the circumflex scapular branch of subscapular artery becomes reversed to allow blood to flow to the distal portion of the axillary artery and also via deep brachial artery
Blood flow still remains because the circumflex scapular branch of subscapular artery becomes reversed to allow blood to flow to the distal portion of the axillary artery and also via deep brachial artery