PTA 120 Shoulder and Arm

What actions do the rhomboid major and minor perform?

-adduct of the scapula (scapulothoracic joint -elevate the scapula (S/T joint) -downwardly rotate the scapula (S/T joint)

How many heads does the biceps brachii have?

2 (long and short)

What is the nerve innervation of the lower fibers of the pectoralis major?

C6, 7, 8, T1

What is the nerve innervation of the rhomboids major and minor?

Dorsal scapular C4, 5

What is the nerve innervation of the upper fibers of the pectoralis major?

Lateral pectoral C5, 6, 7

What is the nerve innervation of the pectoralis minor?

Medial pectoral, with fibers from a communicating of the lateral pectoral C6, 7, 8, T1

What is the nerve innervation for the bicpes brachii?

Musculocutaneous C5, 6, 7

What is the nerve innervation for the coracobrachialis?

Musculocutaneous C5, 6, 7

What is the origin and insertion of the pectoralis major?

O: Medial half of clavicle, sternum, and cartilage of first through sixth ribs I: Crest of greater tubercle of humerus

What is the origin and insertion of the rhomboid minor?

O: spinous process of C-7 and T-1 I: Upper portion of medial border of the scapula across from spine of the scapula

What is the origin and insertion of the rhomboid major?

O: spinous processes of T-2 to T-5 I: Medial border of the scapula between the spine of the scapula and inferior angle

What is the origin and insertion of the long head of the biceps brachii?

O: supraglenoid tubercle of scapula I: tuberosity of the radius and aponeurosis of the biceps brachii

What is the nerve innervation for the triceps brachii?

Radial C5, 6,7, 8, T1

Because the articulation of the scapulothoracic joint does not have any of the usual joint components it is considered what?

a false joint

What is the primary muscle of forearm supination?

biceps brachii

Between which two bony landmarks can the coracoclavicular ligament be located?

clavcle and coracoid process

The pectoralis major is divided into what three segments?

clavicular, sternal, coastal

The most important aspect when palpating near breast tissue is what?

communicating your intentions to your partner

What ligament attaches the scapula's coracoid process to its acromian?

coracoacromial ligament

What is the small tubular muscle located in the axilla, often known as the "armpit" muscle?

coracobrachialis

If you follow the fibers of the pectoralis major laterally, they blend with the fibers of which muscle?

deltoid

As you follow the biceps brachii belly proximally, it becomes deep to which muscle?

deltoid (anterior fibers)

What action could you ask your partner to perform to feel the contraction of the long head of the triceps brachii?

extend the elbow (against your resistance)

What is the action of ALL the heads of the triceps brachii?

extend the elbow (humeroulnar joint)

How can you position the arm to bring the subacromial bursa closer to the surface?

extend the shoulder

What actions do the lower fibers of the pectoralis major perform?

extend the shoulder (G/H joint)

What is the actions of the long head of the triceps brachii?

extend the shoulder (glenohumeral joint)

How can you position the shoulder to bring the belly of the coracobrachialis to a superficial position?

laterally rotate and abduct the shoulder 45 degrees

Most of the serratus anterior is deep to the scapula and which two muscles?

latissimus dorsi and pectoralis major

Would passive abduction lengthen or shorten the coracobrachialis?

lengthen

Would passive extension of the shoulder lengthen or shorten the biceps brachii?

lengthen

Would passive flexion of the shoulder lengthen or shorten the triceps brachii?

lengthen

Would pronation of the fore arm lengthen or shorten the biceps brachii?

lengthen

Which head of the boceps brachii passes through the intertubercular groove?

long head

What are the three heads of the triceps called?

long, lateral, and medial

To outline the distal tendon of the triceps brachii, which bony landmark do you want to locate?

olecranon process

What makes up the anterior wall of the axilla?

pectoralis major

The only direct attachment to the upper extremity to the axial skeleton is what joint?

sternoclavicular joint

What is the fluid sac that's lateral portion creates a smooth surface for the acromian and deltoid to glide over the head of the humerus and rotator cuff tendons and whose medial art cushions the coracoacromial ligament from the supraspinatus tendon?

subacromial bursa (subdeltoid bursa)

What makes up the lateral wall of the axilla?

the biceps brachii and coracobrachialis

What tendon dives into the antecubital space (inner elbow) to attach to the radius allowing the biceps brachii to be the primary muscle of forearm supination?

the distal tendon of the biceps

The coracoclavicular joint is composed of what two smaller ligaments?

the trapezoid and conoid

What two joints provide stability for the acromioclavicular joint and form a strong bridge between the scapula and clavicle?

the trapezoid and conoid ligaments (compose the coracoclavicular joint)

The rhomboids are deep to what muscle?

trapezius

Name one action in which the rhomboids and trapezius are antagonists.

trapezius upwardly rotates scapula; rhomboids downwardly rotate the scapula

What is the origin and insertion of the pectoralis minor?

O: Third, fourth, and fifth ribs I: Medial surface of coracoid process of the scapula

What actions does the serratus anterior perform?

(with origins fixed) -abduct the scapula (scapulothoracic joint -upwardly rotate the scapula (S/T joint) -Depress the scapula (S/T joint) -Hold the medial border of the scapula against the rib cage (with the scapula fixed) -may act to elevate the thorax during forced inhalation

What is the action of ALL the fibers of the pectoralis major?

-adduct the shoulder (glenohumeral joint) -medially rotate the shoulder (G/H joint) -Assist to elevate the thorax during forced inhalation (with arm fixed)

Flexing the shoulder and pulling it anteriorly while you palpate the pectoralis major in a sidelying position has which two benefits?

-brings the pectoralis major off the breast wall, -allows breast tissue to fall away

What actions does the pectoralis minor perform?

-depress the scapula (scapulothoracic joint) -abduct the scapula (S/T joint) -downwardly rotate the scapula (S/T joint) (with the scapula fixed) -assist to elevate the thorax during forced inhalation

What actions can the sternoclavicular joint perfom?

-elevation/ depression -protraction/ retraction

What actions do the biceps brachii perform?

-flex the elbow (humeroulnar joint) -supinate the forearm (radioulnar joint) -flex the shoulder (glenohumeral joint)

What actions do the upper fibers of the pectoralis major perform?

-flex the shoulder (G/H joint) -horizontally adduct the shoulder (G/H joint)

What are the actions of the coracobrachialis?

-flex the shoulder (glenohumeral joint) -adduct the shoulder (G/H joint)

Can you name an everyday action in which you use your pectoralis major?

-giving a hug -doing a push up -lifting a stack of heavy books

When accessing the levator scapula in a supine position, the benefits of rotating the head 45 degrees away from the side you are palpating include:

-shifts the cervicle TVPs further -gives the levator palable tension -shortens and softens the overlying trapezius

What four walls make up the axilla?

-the lateral wall (biceps brachii and coracobrachialis) -the posterior wall (subscapularis and latissimus dorsi) -the anterior wall (pectoralis major) -the medial wall (rib cage and serratus anterior)

Can you name an everyday action in which the biceps brachii's ability to supinate the forearm would come in handy?

-turning a door knob -tightening your gasoline cap -digging in the sand

How may heads do the triceps have?

3

What is the nerve innervation of the serratus anterior?

Long thoracic C5, 6, 7, 8

What is the origin and insertion of the levator scapula?

O: Transverse processes of first through fourth cervicle vertebrae I: Medial border of scapula, between superior angle and superior portion of spine of scapula

What is the origin and insertion of the short head of the biceps brachii?

O: coracoid process of scapula I: tuberosity of the radius and aponeurosis of the biceps brachii

What is the origin and insertion of the biceps brachii?

O: coracoid process of scapula, supraglenoid tubercle of scapula I: tuberosity of the radius and aponeurosis of the biceps brachii

What is the origin and insertion of the coracobrachialis?

O: coracoid process of the scapula I: medial surface of mid-humeral shoaft

What is the origin and insertion of the serratus anterior?

O: external surfaces of upper eight or nine ribs I: anterior surface of medial border of the scapula

What is the origin and insertion of the subclavius?

O: first rib and cartilage I: inferior angle of middle one-third of clavicle

What is the origin and insertion of the long head of the triceps brachii?

O: infraglenoid tubercle of the scapula I: olecranon process of the ulna

What is the origin and insetion of the triceps brachii?

O: infraglenoid tubercle of the scapula, posterior surface of proximal half of the humerus and posterior surface of distal half of the humerus I: olecranon process of the ulna

What is the origin and insertion of the medial head of the triceps brachii?

O: posterior surface of distal half of the humerus I: olecranon process of the ulna

What is the origin and insertion of the lateral head of the triceps brachii?

O: posterior surface of proximal half of the humerus I: olecranon process of the ulna

Name two actions in which the rhomboids and trapezius are are synergists.

adduction of scapula; elevation of scapula

The upper and lower fibers of the pectoralis major perform opposing actions at the shoulder joint- flexion and extension, respectively- making this muscle what to itself?

antagonist to itself

The brachial artery and the brachial plexus (nerves) pass through what region?

axillary region

The brachial artery can be located on the medial side of the arm between which two muscles?

biceps brachii and triceps brachii

The thin sheet of fascia extending from the distal biceps brachii tendon is called what?

bicipital aponeurosis

What artery is a continuation of the axillary artery and runs between the biceps and triceps? Its pulse can be felt between these muscles on the medial side of the arm.

brachial artery

The pectoralis minor has the potential to create neurovascular compression on which three vessels?

brachial plexus, axillary artery, axillary vein

axilla-

cone-shaped area commonly called the armpit that is formed by four walls (the lateral wall, posterior wall, anterior wall, and medial wall)

The ligamentous arch that protects the rotator cuff tendons and subacromial bursa from direct trauma is formed by what ligament?

coracoacromial ligament

An action to ask your partner to perform to feel the levator scapula contract is...

elevation of the scapula

The rhomboids are superficial to what muscles?

erecter spinae muscles

To bring the coracoacromial ligament closer to the surface one must do what?

extend the arm

What should you do if your partner feels a sharp, shooting sensation down her arm while you are palpating in the axilla?

immediately release and adjust your position posteriorly

To locate the belly of the coracobrachialis, from which muscle would you slide off and into the axilla?

pectoralis major

In anatomical position, the coracobrachialis is deep to which two muscles?

pectoralis major and anterior deltoid

What lies next to the rib cage deep to the pectoralis major?

pectoralis minor

The fibers of pectoralis minor run __________ to the pectoralis major fibers.

perpendicular

The serratus anterior abducts the scapula making it an an antagonist to what muscles?

rhomboids

What makes up the medial wall of the axilla?

rib cage and serratus anterior

The scapula glides over the posterior surface of the thorax to form what joint?

scapulathoracic joint

The levator scapula is situated between which two muscles on the lateral side of the neck?

splenius capitis and posterior scalene

What makes up the posterior wall of the axilla?

subscapularis and latissimus dorsi

The glenohumeral joint is what type of joint?

synovial triaxial ball and socket

What tendon is situated in the intertubercular grooce of the humerus and runs parallel to the superficial deltoid fibers?

tendon of the long head of the biceps

The long head of the triceps brachii weaves between which two muscles before attaching at the infraglenoid tubercle?

teres major and teres minor

What two ligaments stretch from the coracoid process of the scapula to the inferior surface of the clavicle?

the trapezoid and conoid ligaments (compose the coracoclavicular joint)

Accessing the medial portion of the serratus anterior by curling your fingers around the medial border of the scapula, your fingers will inherently have to work through the bellies of what two muscles?

trapezius and rhomboids

Most of the serratus anterior abducts the scapula making it a direct antagonist to what muscles?

trapezius and rhomboids