what are the upper arm regions
shoulder
axilla
arm
cubital fossa
what surface of the elbow is the cubital fossa
anterior
where does the pectoral girdle wrap around
axial skeleton
what does the pectoral girdle articulate with
humerus
what consists the bony architecture of the deltoid region
pectoral girdle
humerus
what bones are part of the pectoral girdle
clavicle
scapula
what does the spine of the scapula end in
acromion proces
where is the acromion process
seen most laterally
where is the coracoid process
seen most anteriorly, serves as attachment point for some muscles
where is the greater tubercle on the humerus
more lateral
where is the lesser tubercle on the humberus
more medial
what is between the greater and lesser tubercles
intratrabecular groove/sulcus
what are the anterior axioappendicular muscles
pec major
pec minor
subclavius
serratus anterior
a. subclavius
b. pec major
c. serratus anterior
a. serratus anterior
a. descending part of trapezius
b. middle part of trapezius
c. deltoid
d. teres major
e. ascending part of trapezius
f. latissimus dorsi
g. teres major
h. rhomboid major
i. rhomboid minor
j. levator scapulae
k. teres minor
what is the action of the anterior axioappendicular msucles
move pectoral girdle
where does pec major insert
anterior humerus
what are the actions of pec marjo
adduction and flexion of arm
depress scapula also
a. sternocostal head of pec major
b. clavicular head of pec major
what levels does the pec major clavicular head use
C5-C6 (lateral pectoral , but not C7)
what levels does the sternocostal pec major head use
C7-T1 (C7 lateral and medial pectoral n)
where does teh clavicular head of pec major come off of
clavicle
where does the sternocostal head of the pec major come off
sternum and ribs
what is the action of pec minor
stabilizes scapula
what does pec minor attach to
ribs 3, 4, 5 to coracoid process
what innervates pec minor
medial pectoral nerve
what levels make up the medial pectoral nerve
C8-T1
where is the subclavius
small muscle under clavicle
what does the subclavius do
holds clavicle down
what nerve innervates subclavius and what are its levels
nerve to subclavius (C5-C6)
what is the action of serratus anterior
draws scapula anteriorly along thoracic cage and hold it against thoracic wall (winged scapula when long thoracic nerve injured)
where does the serratus anterior come off
medial border of scapula then forward to attach to the ribs
what are the superficial posterior axioappendicular muscles (extrinsic shoulder)
trapezius and latissimus dorsi
where do superficial posterior axioappendicular msucles originate from
axial skeleton
what is the role of the trapezius
elevate, depress, retract scapula
what innervates the trapezius
spinal accessry nerve
what supplies the sensory to the trapezius
C3 and C4
what is the role of the latissimus dorsi
extend, adducts arm
where does the lat attach
to humerus distal to shoulder joint
what innervates the lat and what are its levels
thoracodorsal nerve C6-C8
what are teh deep posterior axioappendicular msucles
levator scapulae
rhomboid major
rhomboid minor
what do the deep posteiror axioappendicular msucles do
help rotate scapula
what does tehe levator scapula do
elevate scapula and rotate scapula
what does the rhomboid major do
retract scapula and rotate scapula
what does the rhomboid minor do
retract scapula and rotate scapula
what innervates the deep posterior axioappendicular muscles
dorsal scapular nerve C5
where do the scapulohumeral muscles originate
pectoral girdle
what do the scapulohumeral muscles act on
shoulder region
what are the actions of the deltoid
abducts, flexes, extends arm
why is the deltoid so powerful
multipennate structure with several central tendons with lots of fibers angled into it
which part of the delt flexes the arm
frontal
which part of the delt extends the arm
rear
what innervates the delt and what levels
axillary nerve C5-C6
where is teres major
above latissimus dorsi
what innervates teres major (nerve and levels)
C5-C6 lower subscapular nerve
what is the actino of teres major
helps adduct the arm and does some rotation?
what are the rotator cuff muscles
supraspinatus
infraspinatus
teres major
subscapularis
a. supraspinatus
b. subscapularis
(anterior view)
a. infraspinatus
b. teres minor
c. supraspinatus
where is the supraspinatus
superior to spine of scapula
does the supraspinatus rotate
no
what does supraspinatus do
helps initiate abduction until in a more advantageous position so deltoid can help
what usually gets hurt in rotator cuff injuries
supraspinatus
where is infraspinatus
below spine of scapula
what is the action of infraspinatus
lateral rotator of arm
where is teres major
inferior border of scapula
what does teres minor do
lateral rotator
what innervates teres minor
axillary nerve C5-C6
where is subscapularis
in subscapular fossa between scapula and thoracic cage
what does subscapularis do
provides medial rotation
helps decelerate arm after a throw (eccentric contractions help slow arm down)
what innervates the subscapularis
upper and lower subscapular nerve C5-C7
what is the axilla
pyramidal space just inferior to glenohumeral joint
a. pec minor
b. coracobrachialis
c. short head of biceps brachii
d. long head of biceps brachii
e. deltoid
f. infraspinatus bursa
g. infraspinatus
h. subscapularis
i. serratus anterior
j. long thoracic nerve
k. pectoralis major muscle
what is the apex of the axilla
open space between axilla and posterior triangle of neck
what bones are in the apex of the axilla
scapula
clavicle
first rib
what makes up the base of the axilla
skin and fascia: concave, forming axillary fossa
what makes up the anterior wall of the axilla
pec major
pec minor
anterior axillary fold is the most inferior part
what makes up the posterior wall of the axilla
scapula
subscapularis
teres major
latissimus dorsi
posterior axillary fold is most inferior part
what makes up the medial wall of the axilla
thoracic wall and serratus anterior
what makes up the lateral wall of the axilla
intertubecular sulcus on humerus where muscles insert around on medial side of humerus
wht are the neurovascular contents of the axilla
axillary vein
brachial plexus
axillary artery
where is the first part of the axillary artery
between first rib and medial border of pec minor
what artery comes off the first part of the axillary artery
superior thoracic artery
...
...
...
where is the 2nd part of the axillary artery
deep to pec minor
what are the branches off the 2nd part of the axillary artery
thoracoacromial artery
lateral thoracic artery
where does the thoracoacromial artery come off the 2nd part of the axillary artery
just medial to pec minor
what re teh branches off the thoracoacromial artery
pectoral
deltoid
acromial
clavicular
where does the lateral thoracic artery extend
down thoracic cage on lateral border if not deep to pec minor
where is the third part of the axillary artery
between pec minor and teres major
what are teh branches off the 3rd part of teh axillary artery
subscapular artery
anterior circumflex artery
posterior circumflex artery
...
what does the subscapular artery soon become
circumflex scapular artery
thoracodorsal artery
where does the circumflex scapular artery go and what does it anastomose with
curls around and anastomosse with suprascapular artery in back part of shoulder
where does the thoracodorsal artery go
cursl around inferior border of scapula and anastomoses with intercostal arteries
why is there anastomosing around scapula
because it moves so much
where do the anterior and posteiror circumflex humeral arteries go
wrap around head of humerus
what do humeral fractures cause problems with arterially
anterior and posterior circumflex humeral arteries, can lead to avascular necrosis
wht type of fascia is in the arm
superficial fascia
deep fascia
what is within the superficial fascia
cutaneous nerves and superficial veins and lymphatics
what is the deep/brachial fascia continuation of
pectoral fascia, becomes deep fascia of forearm
what does the deep fascia of the arm do
divides into compartments of arm
what is the bone of the arm
humerus
what is the shared action of the anterior compartment of the arm
elbow flexion
...
what are the muscles of the anterior compartment of the arm
biceps brachii
coracobrachialis
brachialis
what is the action of biceps brachii
elbow flexion
helps flex shoulder too
where does the short head of biceps brachii insert
coracoid process
where does long head of biceps brachii insert
travels in intertrabecular groove/sulcus and attaches to superior portion of glenoid, part of scapula
does biceps brachii have an insertion on the humerus
no
what does coracobrachialis do
shoulder flexor
whwere does coracobrachialis insert
mid distal humerus
where does brachialis attach to the humerus
lower half
where does brachialis attach other than to humerus
ulna
what is the major action of the brachialis
major forearm flexor
what artery and vein supply the anteiror compartment
brachial artery and vein
what nerves run in the anterior compartment of the arm
proximal 1/2 of ulnar nerve
median nerve
musculocutaneous nerve
what doe the musculocutaneous nerve give off
lateral cutaneous nerve of forearm
what is the shared action of the posterior arm compartmetn
elbow extension
...
what are the trhee heads of the triceps brachii
long head
lateral head
medial head
where does the long head of the triceps brachii run
crosses shoulder joint and attaches to scapula
what does teh triceps brachii do
elbow extension, shoulder extension with long head
where does the lateral head of the triceps brachii attach
proximal humerus
what does the anconeus look like
triangle
where does the anconeus originate and insert
lateral epicondyle of humerus to ulna
what does the anconeus do
some elbow extension
what artery gives blood to the posterior compartment of the arm
deep brachial artery, which runs on the posterior side of the humerus
what nerve innervates the posterior compartment of the arm
radial nerve
where is teh distal 1/2 of teh ulnar nerve
very superficial, hitting elbow hits ulnar nerve
what supplies cutaneous innervation to the upper shoulder
supraclavicular nerves
...
...
...
what supplies cutaneous innervation to the upper lateral arm
cutaneous branches of axillary nerve
what supplies cutaneous innervation to medial arm
intercostobrachial nerve
what supplies cutaneous innervation to medial and anterior arm
medial brachial cutaneous nerve
what supplies cutaneous innervation to posterior and lower lateral arm
cutaneous branches of radial nerve
...
what is the cubital fossa
triangular region on anterior side of elbow joint
what is the superior border of the cubital fossa
line connecting epicondyles of humerus
what is the lateral border of the cubital fossa
brachioradialis; helps hold elbow flexion
what is the medial border of the cubital fossa
pronator teres
what is the bicipital aponeurosis
continuation of biceps brachii tendon onto the forearm fascia
what provides the arterial supply to the cubital fossa
brachial artery, divides into radial and ulnar
wht provides the venous drainage to the cubital fossa
brachial veins, typically paired
what nerves run in the cubital fossa
median nerve
radial nerve