Upper Quarter

Question 1

Upper quadrant

Answer 1

Occiput
Cervical and upper thoracic vertebrae
Shoulder girdle
Upper limbs
Related tissue
Related nervous and circulatory systems

Question 2

Shoulder girdle

Answer 2

Clavicle, humerus, scapula
Support for larger muscles that allow mobility

Question 3

Clavicles

Answer 3

In only bone that connects the shoulder girdle with axial skeletal system

Question 4

Cervical fascia

Answer 4

Start at the superior nuchal line
Mastoid process
Mandibles
Acromion
Clavicle
Manubrium sterni

Question 5

Posture

Answer 5

Dynamic : refers to positional change that occurs during function
Static: position of the subject while relaxed standing sitting or lying down

Question 6

Maintenance of normal posture from neurophysiology perspective

Answer 6

Weight bearing and physiological processes
*Vestibular sensation: located inner ear and help with balance and orientation and the orientation of semicircular canals detected rotational movements of and maintaining balance
*Proprioceptive impulses: ability body sense its position and they come from nerve endings in ligaments joint capsule tendons and muscles
*Muscle spindle: specialized receptors with in the muscle that respond to stretching

Question 7

Scapulohumeral rhythm

Answer 7

Is depend on smooth synchronous motion
So to do full ROM
60 degrees I’d scapula rotation and 120 degrees of glenohumeral elevation and the ratio is 1:2

Question 8

Upper crossed syndrome

Answer 8

• Facilitated : muscle are tight or overactive ( upper trapezius abs levator scapul for back and neck and scm for neck and pectorals for chest muscles
• Inhibition: muscles that are weak or under active ( deep cervical flexors of the neck and lower trapezius and serratus anterior which helps to stabilize the shoulder bladder

Question 9

Lower crossed syndrome

Answer 9

Facilitated: refers to thoracolumber extensor and muscle of lower back and the ilipsoas and rectus femoris which are hip flexors muscles
Inhibited: gluteus medius/ minimum and maximum and abdominal which are often weak and under active in this syndrome

Question 10

Long term posture impairment

Answer 10

Loss of glycosaminoglycan and water
Abnormal cross linking
Infiltration of joint by fibrofatty material
Increased joint stiffness
Altered arrhrokinematics
Joint capsules tightened

Question 11

Forward head posture

Answer 11

Protracted and medically rotated scapulae
Internal rotation at the glenohumeral joint
Increased kyphosis of upper thoracic spine
Increase cervical spine lordosis
Craniomandibular backward bending

Question 12

Craniocervical anglee

Answer 12

Forward head posture
Angle that btw c7 tragus and c7 horizontal line
Anterior tilt increase as angle degree decreases

Question 13

Kyphosis

Answer 13

Abduct or protract of the scapula
Shorten of serratus anterior , latissimus dorsi
The humerus rotatss internally, shortening glenohumeral ligaments and anterior shoulder capsules

Question 14

Rotation cuff muscles

Answer 14

Function is to maintain the humoral head at the glenoid fossa and resisting the upward pull of the deltoid is lost

Question 15

Tos

Answer 15

Compression neuro vascular structure as they exist through the thoracic outlet

Question 16

The two main categories of tos

Answer 16

Vascular form :
Neurological forms

Question 17

Epidemiology of tos

Answer 17

Frequency to some 3-4 times
Btw 20 to 50 age
Mostly are affect the brachial plexus and others affect vascular structure

Question 18

Congenital factors

Answer 18

Prolonged transverse process
Anomalous muscle
Abnormalities of the insertion of scalena muscle

Question 19

Acquired condition

Answer 19

Posture factors
Dropped shoulder
Wrong work posture
Trauma
Clavicle or rib fracture
Whiplash

Question 20

Muscles couses tos

Answer 20

Scalene hyper trophy
Increase of muscle tone of the Upper trapezius ,Levatorscapular and Pectoral muscle
Weakness of rhomboid and mid/lower trapeziu

Question 21

Symptoms of tos

Answer 21

It’s get worse when the arm is abd overhead and externally rotated

Question 22

Neurogenic tos

Answer 22

Most common and compression of branial plexus
For pain = you will feel it from neck face occipital chest shoulder and upper extremity
paresthesia in upper extremity

altered or absent sensation, weakness, fatigue, a feeling of heaviness in the arm and hand

Question 23

Upper plexus c5,6,7 involvement of tos

Answer 23

Pain the side of the neck and radiate to ear and face
Pain = supraclavicular and parascapular ipsilaterly
And pain may move to later radia nerve area
Weakness= extensor muscle of the forearm, triceps and deltoid

Question 24

Lower plexus involvement c8,t1

Answer 24

Pain  anterior and posterior shoulder region and radiate down the ulnar side of the forearm into the hand, the ring and small fingers.
Weakness  flexor muscles of the forearm
Atrophy  abductor pollicis brevis,, hypothenar muscles
Parasthesia  ulnar side of the forearm
Some patients  feel pain like angina pectoris

Question 25

Vascular semptom

Answer 25

Arterial tos =
Venous

Question 26

Venous

Answer 26

Because of one or more of the vein under the clavicle is compressed resulting of blood clots
Symptoms are
feeling heaviness, cyanosis, parasthesia in fingers and hand
Edema of the arm

Question 27

Arterial

Answer 27

Young adult with vigorous arm activity
Pain in the hand

Claudication = pain occures after repetitive activities, disappears in rest
Pallor
Cold intolerance
Paresthesias

Question 28

Abnormal posture

Answer 28

Forward head= depression if the anterior chest
Shoulder = internal rotation
Space btw anterior and middle scalenes is reduced
Compression in the thoracic outlet

Question 29

Examinations

Answer 29

Posture
Manual muscle test
Tendons reflex
Sensation test
Thoracic outlet text
Palpation
Resistant test
Costoclavicular test
Roos test
Ads on test

Question 30

Treatment

Answer 30

Electro physical therapy
Soft tissue mobilization
Joint mobilization
Therapeutic exercise
Neuro mobility exercises