UPPER LIMB FINAL FLASHCARDS (to page 13)

What are the origins of Pectoralis major?

Medial ½ of clavicle, sternum

What are the origins of Pectoralis minor?

3rd, 4th, and 5th ribs

What is the origin of Subclavius?

First rib

What is the insertion of Pectoralis major?

Lateral lip of bicipital groove

What is the insertion of Pectoralis minor?

Coracoid process

What is the insertion of Subclavius?

Clavicle

What is the nerve supply of Pectoralis major?

Medial and lateral pectoral nerves

What is the nerve supply of Pectoralis minor?

Medial pectoral nerve

What is the nerve supply of Subclavius?

Nerve to subclavius

What is the action of Pectoralis major?

Flexion, adduction, and medial rotation of arm

What is the action of Pectoralis minor?

Protraction of scapula

What is the action of Subclavius?

Stabilization of clavicle

What does the clavipectoral fascia enclose?

Subclavius muscle and pectoralis minor, continues as suspensory ligament of axilla and end as ( axillary facia )

What structures pierce the clavipectoral fascia?

• Thoraco-acromial artery

• Cephalic vein

• Lateral pectoral nerve

• Lymphatic vessels

mention the muscles of the back

superficial layer: trapezius m. & latismus dorsi

deep layer: levator scapula , Rhomoideus minor and major

What is the origin of Trapezius?

Superior nuchal line

nuchal ligament

spine of 7th cervical and all thoracic vertebrae

What is the insertion of Trapezius?

Lateral 1/3 of clavicle

acromion, upper border of spine of scapula

What is the nerve supply of Trapezius?

Motor: Spinal accessory nerve

Sensory: C3, C4

What is the action of upper fibers of Trapezius?

Elevation of shoulder and upward rotation of scapula (glenoid cavity upwards)

What is the action of middle fibers of Trapezius?

Retraction of scapula

What is the action of lower fibers of Trapezius?

Depression of shoulder

What is the origin of Latissimus dorsi?

iliac crest

Spines of T7-T12

lower 3 or 4 ribs

inferior angle of scapula

What is the insertion of Latissimus dorsi?

Floor of bicipital groove of humerus

What is the nerve supply of Latissimus dorsi?

Thoracodorsal nerve

What is the action of Latissimus dorsi?

Extension, adduction, medial rotation of arm

What is the origin of Levator scapula?

C1-C4 vertebrae

What is the insertion of Levator scapula?

Medial border of scapula above spine

What is the nerve supply of Levator scapula?

Dorsal scapular nerve (C5)

What is the action of Levator scapula?

Elevation of scapula

What is the origin of Rhomboideus minor?

C7 to T1 vertebrae

What is the insertion of Rhomboideus minor?

Medial border of scapula at spine

What is the nerve supply of Rhomboideus minor?

Dorsal scapular nerve (C5)

What is the action of Rhomboideus minor?

Retraction and downward rotation of scapula

What is the origin of Rhomboideus major?

T2 to T5 vertebrae

What is the insertion of Rhomboideus major?

Medial border of scapula below spine

What is the nerve supply of Rhomboideus major?

Dorsal scapular nerve (C5)

What is the action of Rhomboideus major?

Retraction and downward rotation of scapula

What is the origin of Supraspinatus?

Supraspinous fossa of scapula

What is the insertion of Supraspinatus?

Greater tuberosity of humerus

What is the nerve supply of Supraspinatus?

Suprascapular nerve

What is the action of Supraspinatus?

Abduction of arm from 0° to 18°

What is the origin of Infraspinatus?

Infraspinous fossa of scapula

What is the insertion of Infraspinatus?

Greater tuberosity of humerus

What is the nerve supply of Infraspinatus?

Suprascapular nerve

What is the action of Infraspinatus?

Lateral rotation of arm

What is the origin of Teres minor?

Lateral border of scapula

What is the insertion of Teres minor?

Greater tuberosity of humerus

What is the nerve supply of Teres minor?

Axillary nerve

What is the action of Teres minor?

Lateral rotation and adduction of arm

What is the origin of Teres major?

Lateral border of scapula

What is the insertion of Teres major?

Medial lip of bicipital groove of humerus

What is the nerve supply of Teres major?

Lower subscapular nerve

What is the action of Teres major?

Medial rotation, adduction, and extension of arm

What is the origin of Subscapularis?

Subscapular fossa

What is the insertion of Subscapularis?

Lesser tuberosity of humerus

What is the nerve supply of Subscapularis?

Upper and lower subscapular nerves

What is the action of Subscapularis?

Medial rotation and adduction of arm

What are the origins of Deltoid muscle?

Anterior: lateral 1/3 clavicle, Middle: acromion, Posterior: lower spine of scapula

What is the insertion of Deltoid?

Deltoid tuberosity of humerus

What is the nerve supply of Deltoid?

Axillary nerve

What is the action of anterior fibers of Deltoid?

Flexion and medial rotation

What is the action of middle fibers of Deltoid?

Abduction from 18° to 90°

What is the action of posterior fibers of Deltoid?

Extension and lateral rotation

What are the rotator cuff muscles?

Subscapularis, Supraspinatus, Infraspinatus, Teres minor

What joint do rotator cuff muscles stabilize?

Shoulder joint

What are the boundaries of quadrangular space?

Superior: Teres minor

Inferior: Teres major

Medial: Long head of triceps

Lateral: Surgical neck of humerus

What are the contents of quadrangular space?

Axillary nerve, Posterior circumflex humeral artery

What are the boundaries of medial triangular space?

Superiorly: Teres minor

Inferiorly: Teres major

Laterally: Long head of Triceps

contents of medial triangular space?

circumflex scapular vessels

What are the boundaries of lateral triangular space?

Superiorly: Teres major

Medially: Long head of the Triceps

Laterally: Humerus

contents of lateral triangular space?

- Radial nerve

- profunda brachii artery

origin of Serratus anterior muscle?

upper 8 ribs

Insertion of Serratus anterior muscle?

- medial border of scapula

nerve supply of Serratus anterior muscle?

long thoracic nerve

action of Serratus anterior muscle?

(1) Protraction of the scapula

(2) Keeping the scapula in contact with chest wall

(3) raising the arm above the head

what lead to ( winging of the scapula ) ?

injury of the long nerve

paralysis of serratus anterior muscles

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What forms the base of the axilla?

Axillary fascia

What are the boundaries of the apex of the axilla?

Anterior: clavicle

Posterior: scapula

Medial: 1st rib

What forms the anterior wall of the axilla?

Pectoralis major, pectoralis minor, subclavius, clavipectoral fascia

What forms the anterior fold of the axilla?

Pectoralis major only

What forms the posterior wall of the axilla?

Subscapularis, latissimus dorsi, teres major

What forms the posterior fold of the axilla?

Latissimus dorsi and teres major

What forms the medial wall of the axilla?

thoracic wall Upper 4 ribs

serratus anterior

What forms the lateral wall of the axilla?

Shaft of humerus, coracobrachialis, and short head of biceps

Where should axillary incisions be made?

Vertical and near medial wall to avoid vessels and nerves

Where does the axillary artery begin?

Outer border of 1st rib as continuation of subclavian artery

Where does the axillary artery end?

Lower border of teres major, continues as brachial artery

What divides the axillary artery?

Pectoralis minor muscle

how many parts does the pectoralis minor muscle divides the axillary artery to?

3 parts

where is the 1st part of axillary artery located?

from lateral border of 1st rib to upper border of pectoralis minor

where is the 2nd part of axillary artery located?

behind pectoralis minor

where is the 3rd part of axillary artery located?

from lower border of pectoralis minor to lower border of teres major

What are the branches from the 1st part of axillary artery?

Superior thoracic artery

What are the branches from the 2nd part of axillary artery?

1. Thoraco-acromial artery

2. lateral thoracic artery

What are the branches from the 3rd part of axillary artery?

1. Subscapular artery

2. anterior circumflex humeral artery

3. posterior circumflex humeral artery

How to stop bleeding from distal axillary artery?

Compress against outer border of 1st rib ( the beginning of the artery)

What are the groups of axillary lymph nodes?

Anterior (pectoral)

Posterior (subscapular)

Lateral (brachial)

Central

Apical

Which artery is related to anterior axillary lymph nodes?

Lateral thoracic artery

Which artery is related to posterior axillary lymph nodes?

Subscapular artery