VIVA EXAM UPPER LIMB Acromioclavicular joint ⢠Where the clavicle ...
VIVA EXAM
UPPER LIMB Acromioclavicular joint • •
Where the clavicle drops off laterally, prominent bump 1. It is a plane synovial joint, 2. Acromioclavicular ligament and both superior and inferior ligament attach and stabilise it, 3. Part of the shoulder complex (1 of 4 joints), 4. Pectoralis major attaches, 5. Deltoid attaches, 6. Trapezius attaches, 7. Sternocleidomastoid attaches. Acromion process: the entire structure, not just a part of it • •
Just after the AC joint, about an inch wide and two inches long (anterior to posterior) 1. Origin for deltoid fibres, 2. Deltoids then go to insert on deltoid process of humerus, 3. Attachment for a portion of trapezius, 4. Acromion is an end/extension of the scapula spine, 5. Scapula spine forms supraspinatus fossa, 6. which is an origin for supraspinatus muscle Coracoid process • •
About an inch inferior to lateral end of clavicle. Between pec major and deltoids 1 Attachment for coracoclavicular fascia, 2 attachment for coracoacromial ligament, 3 pectoralis minor inserts on to coracoid, 4 biceps brachii short head originates here, 5 coracobrachialis originate here as well. Inferior angle of scapula • •
Inferior point of scapula, the bottom end. A union of lateral and medial border, its posterior surface is an attachment to the teres major and latissimus dorsi muscle. Medial border of scapula •
Medial border, from inferior angle upwards. About 2 inches either side of spinous process of the vertebra • 1 Trapezius, 2 serratus anterior, 3 levator scapulae, 4 rhomboid minor, 5 rhomboid major muscle attach to the medial border. Spine of scapula: the entire structure, not just a part of it •
From the acromion process/AC joint, all the way to medial border of scapula. Rough 3 inches long, on the upper posterior portion of the scapula • 1 Separates the supraspinatus fossa from the infraspinatus, 2 origin to supraspinatus, 3 Origin to infraspinatus, 4 Forms a extensions from the acromion process Pectoralis major as it borders the axilla • •
Just before the armpit, pinching the anterior chest and armpit will make it obvious 1 lies superficial to pectoralis minor, 2 innervated by anterior thoracic nerve, 3 claical head (origin medial clavicle) sternal head (origin first 6 ribs), 4 inserts on intertubercular groove and greater tubercle of humerus
Latissimus dorsi as it borders the axilla •
Same as Pec Major but on the posterior side. Follow same steps
•
1 Inserts on intertubercular groove of humerus, 2 Thoracodorsal nerve, has 5 origins (inferior border of scapular, spinous processes T1-L5, iliac crest, lower 3-4 ribs), 5 adducts arm
Outline of deltoid with its three sections: be exact about the origins and insertion point of each section •
Small anterior portion on the front of shoulder, originates from the clavicle. Lateral section quite large, on top of shoulder, originates from the acromion process. Posterior portion is slightly posterior and originates from the spine of scapula. Use origins to figure out each section and outline them. All insert onto deltoid process of humerus. • 1 Inserts on deltoid process of humerus, 2 originates from the clavicle, 3 acromion process and 4 spine of scapula, axillary nerve, 5 abducts the arm Greater tubercle of humerus •
Just below acromion process, can feel it when arm/hands are by sides and you rotate your arm medially and laterally. • Attachment (insertion) for 1 supraspinatus, 2 infraspinatus and 3 teres minor, 4 pectoralis major, 5 is the larger, lateral head of humerus Lateral and medial epicondyles of humerus •
Run hands down triceps squeezing either side until you reach the first bony prominences, these are the epicondyles. Remember to do it in the anatomical position • Lateral gives attachment to 1 the supinator, extensor carpi radialis brevis, extensor digitorum, extensor digiti, and extensor carpi ulnaris. Medial gives attachment to the Pronator teres, and to a common tendon of origin (the common flexor tendon), 4 Ulna nerve runs in a groove behind medial epicondyle. Cubital tunnel • •
Between the medial epicondyle of humerus and the olecranon. 1 where the ulna nerve runs, bordered by 2 Medial condyle and 3 olecranon. Often becomes compressed causing cubital tunnel syndrome. Cubital Fossa • •
On the inside of the elbow joint, it is a triangle on the top end of forearm. Contents: 1 Lateral border = brachioradialis, 2 Medial border = Pronator Teres, 3 Superior border = the imaginary line between epicondyles of humerus (the fold on the inside of elbow). Contents = Median nerve, Radial nerve, brachial artery, biceps tendon.
UPPER LIMB Acromioclavicular joint • •
Where the clavicle drops off laterally, prominent bump 1. It is a plane synovial joint, 2. Acromioclavicular ligament and both superior and inferior ligament attach and stabilise it, 3. Part of the shoulder complex (1 of 4 joints), 4. Pectoralis major attaches, 5. Deltoid attaches, 6. Trapezius attaches, 7. Sternocleidomastoid attaches. Acromion process: the entire structure, not just a part of it • •
Just after the AC joint, about an inch wide and two inches long (anterior to posterior) 1. Origin for deltoid fibres, 2. Deltoids then go to insert on deltoid process of humerus, 3. Attachment for a portion of trapezius, 4. Acromion is an end/extension of the scapula spine, 5. Scapula spine forms supraspinatus fossa, 6. which is an origin for supraspinatus muscle Coracoid process • •
About an inch inferior to lateral end of clavicle. Between pec major and deltoids 1 Attachment for coracoclavicular fascia, 2 attachment for coracoacromial ligament, 3 pectoralis minor inserts on to coracoid, 4 biceps brachii short head originates here, 5 coracobrachialis originate here as well. Inferior angle of scapula • •
Inferior point of scapula, the bottom end. A union of lateral and medial border, its posterior surface is an attachment to the teres major and latissimus dorsi muscle. Medial border of scapula •
Medial border, from inferior angle upwards. About 2 inches either side of spinous process of the vertebra • 1 Trapezius, 2 serratus anterior, 3 levator scapulae, 4 rhomboid minor, 5 rhomboid major muscle attach to the medial border. Spine of scapula: the entire structure, not just a part of it •
From the acromion process/AC joint, all the way to medial border of scapula. Rough 3 inches long, on the upper posterior portion of the scapula • 1 Separates the supraspinatus fossa from the infraspinatus, 2 origin to supraspinatus, 3 Origin to infraspinatus, 4 Forms a extensions from the acromion process Pectoralis major as it borders the axilla • •
Just before the armpit, pinching the anterior chest and armpit will make it obvious 1 lies superficial to pectoralis minor, 2 innervated by anterior thoracic nerve, 3 claical head (origin medial clavicle) sternal head (origin first 6 ribs), 4 inserts on intertubercular groove and greater tubercle of humerus
Latissimus dorsi as it borders the axilla •
Same as Pec Major but on the posterior side. Follow same steps
•
1 Inserts on intertubercular groove of humerus, 2 Thoracodorsal nerve, has 5 origins (inferior border of scapular, spinous processes T1-L5, iliac crest, lower 3-4 ribs), 5 adducts arm
Outline of deltoid with its three sections: be exact about the origins and insertion point of each section •
Small anterior portion on the front of shoulder, originates from the clavicle. Lateral section quite large, on top of shoulder, originates from the acromion process. Posterior portion is slightly posterior and originates from the spine of scapula. Use origins to figure out each section and outline them. All insert onto deltoid process of humerus. • 1 Inserts on deltoid process of humerus, 2 originates from the clavicle, 3 acromion process and 4 spine of scapula, axillary nerve, 5 abducts the arm Greater tubercle of humerus •
Just below acromion process, can feel it when arm/hands are by sides and you rotate your arm medially and laterally. • Attachment (insertion) for 1 supraspinatus, 2 infraspinatus and 3 teres minor, 4 pectoralis major, 5 is the larger, lateral head of humerus Lateral and medial epicondyles of humerus •
Run hands down triceps squeezing either side until you reach the first bony prominences, these are the epicondyles. Remember to do it in the anatomical position • Lateral gives attachment to 1 the supinator, extensor carpi radialis brevis, extensor digitorum, extensor digiti, and extensor carpi ulnaris. Medial gives attachment to the Pronator teres, and to a common tendon of origin (the common flexor tendon), 4 Ulna nerve runs in a groove behind medial epicondyle. Cubital tunnel • •
Between the medial epicondyle of humerus and the olecranon. 1 where the ulna nerve runs, bordered by 2 Medial condyle and 3 olecranon. Often becomes compressed causing cubital tunnel syndrome. Cubital Fossa • •
On the inside of the elbow joint, it is a triangle on the top end of forearm. Contents: 1 Lateral border = brachioradialis, 2 Medial border = Pronator Teres, 3 Superior border = the imaginary line between epicondyles of humerus (the fold on the inside of elbow). Contents = Median nerve, Radial nerve, brachial artery, biceps tendon.
