Cass of 2016
Pectoral Region
Demonstration
Date: 5-03-12
Learning Objectives:
1. Describe surface landmarks (boundaries) of pectoral region
2. Describe cutaneous nerve supply of the skin in pectoral region
3. Describe superficial and deep fascia (deltopectoral fascia,
clavipectoral fascia)
4. Describe origin insertion nerve supply and action of Pectoralis
major, pectoralis minor, subclavious muscles
5. Describe relation of pectoralis minor muscle and axillary lymph
nodes
Scaplar Region
Date 06-03-12
Demonstration:
Learning objectives:
1. Identify the bony landmarks of the scapula and its position in the
body
2. Identify the superficial, deep and scapulohumeral muscles of
scapular region
3. State proximal and distal attachments, and main actions of
muscles of scapular region ( Trapezius, Latissmus Dorsi, Levator
Scapulae, Supraspinatus, Infraspinatus, Deltoid, Teres major
and minor, Rhomboids, Subscapularis)
4. Describe the innervation of each muscle and the specific deficits
that occur with lesions of individual nerves at different parts
along the course of each nerve. What is
"winged scapula"?
5. Explain rotator cough (SITS muscles) and its clinical significance
6. State areas of clinical importance in scapular region (triangle of
auscultation, Deltoid, common site for intramuscular injections
7. Identify the arteries that contribute to the collateral circulation
between the subclavian artery and the axillary artery:
Subscapularis, circumflex scapular, transverse cervical,
suprascapular.
8. Identify anatomic structures in radiographic studies of this region
(X-ray)
SGD
Date 06-03-12
CASE : Goalkeeper with pain in shoulder and long arm
The goalkeeper in a soccer match fell on his outstretched left arm. He
felt an immediate pain in the shoulder region and was unable to move
his arm. At the hospital the arm was abducted and the deltoid muscle
looked flat or hollow. The injured arm looked "too long", and there was
intense pain on attempting to move the arm. A plain radiograph of the
region showed that the humeral head was lying below the glenoid
labrum and that there was no fracture of the humerus. The diagnosis
was an anterior dislocation of the shoulder, and the orthopedic surgeon
recommended Kocher's maneuver for management.
Questions to consider:
1. Why did the deltoid appear flat and hollow?
2. What neurovascular structures are liable to be injured in such a condition?
How do you examine the patient to rule that out?
3. What is the anatomical principle in reducing a dislocated shoulder?
b) How is the shoulder joint formed?
c) Draw a diagram to show the relations of the shoulder joint
d) What is anterior dislocation of shoulder joint?
e) After retracting the deltoid and pectoralis major muscles from each other,
which bony part of the scapula is exposed?
f) Which long blood vessel is located in the deltopectoral groove?
g) Name the two muscles which are attached to the bony part of the conjoint
tendon?
h) Name the rotator cuff muscles and give nerve supply of each.
i) What is the significance of rotator cuff muscles?
Axilla and Brachial Plexus
Date: 07-03-12
Demonstration
Learning Objectives:
1) Describe the surface anatomy and boundaries of axilla
2) Identify the apex, base anterior and posterior, medial and lateral
wall of axilla
3) Enumerate the contents of axilla
4) Identify axillary sheath, axillary artery and its branches, axillary
vein and its tributaries, the lateral, medial, posterior cords of
brachial plexus and its branches
5) Describe axillary lymph drainage and its significance
6) State the clinical significance of Axillary artery and vein.
7) Describe the origin, important relationships, its variations and
effects of various injuries to brachial plexus