Scapular Region: Learning Objectives and Review Questions

True/False

1. The transverse cervical artery (superficial branch) passes the lateral border of the levator scapula as the artery enters the scapular region.
2. The spinal accessory nerve (cranial accessory nerve or CN X1) passes the medial border of the levator scapula as the nerve enters the scapular region.
3. The dorsal scapular nerve (nerve to the rhomboids) passes the medial border of the levator scapula as the nerve enters the scapular region.
4. The superior fibers of trapezius attach to the lateral aspect of the spine of the scapula and to the acromion.
5. Contraction of the superior fibers of trapezius together with contraction of the inferior fibers causes downward rotation of the scapula.
6. A lesion of the suprascapular nerve would cause an uncompensated loss of 0 - (15-20) deg of arm abduction.
7. A lesion of the suprascapular nerve would weaken medial rotation
8. A lesion of the dorsal scapular nerve causes retraction of the scapula.
9. A lesion of the spinal accessory nerve causes weakened flexion of the neck.
10. The circumflex scapular artery passes superior to the superior transverse scapular ligament.
11. During ligation of the axillary artery there will be reversal of blood flow (retrograde) in the posterior and lateral intercostal arteries.
12. The omohyoid muscle takes origin about 1 cm medial to the superior transverse scapular notch.
13. The triangular interval provides a communication between the axilla and the infraspinous fossa
14. A lesion of the axillary nerve results in non-compensated loss of lateral rotation.
15. The upper lateral cutaneous nerve of the arm can be used to test the integrity of the dorsal scapular nerve
16. The quadrangular space transmits the motor branch to the teres minor muscle.
17. The infraspinous fossa participates in the rich anastomotic network of arteries that surround the elbow joint.
18. The latissimus dorsi muscle general has an insertion on the inferior angle of the scapula.
19. Teres major inserts on the medial lip of the intertubercular sulcus at the crest of the lesser tubercle.
20. Levator scapula is innervated, in part, by the dorsal scapular nerve and arises from the spinous processes of cervical vertebrae.

Short Answer and Definitions

1. Spine of the scapula
2. Quadrangular space
3. Triangular space
4. Triangular interval
5. Circumflex scapular artery
6. Transverse scapular ligament

Essay

1. Discuss the anatomy of the scapular region. Include fascial specializations, vasculature, innervation, lymphatics, muscles and movements, and compensation in the case of nerve injury.
2. Discuss the surface anatomy of the upper limb.
3. Discuss the definitions for parts of the upper limb.
4. Discuss the clinical significance of the cubital fossa.
5. Discuss anatomical position with reference to the upper limb.
6. Discuss the cutaneous innervation to the upper limb. Include the parent nerves and how paresthesias of the upper limb can aid diagnosis.
7. Discuss the superficial venous drainage of the upper limb. Provide mention of clinical significance.
8. Discuss the anatomy of the deltoid muscle. Include fascial specializations, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
9. Discuss the anatomy of the supraspinatus muscle. Include fascial specializations, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
10. Discuss the anatomy of the infraspinatus muscle. Include fascial specializations, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
11. Discuss the anatomy of the teres minor muscle. Include fascial specializations, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
12. Discuss the anatomy of the teres major muscle. Include fascial specializations, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
13. Discuss the scapular anastomosis. Include discussion of blood flow in the normal case and in the case of ligation of the axillary artery.