Final 2 Flashcards

1
Q

Radial Nerve Root Level

A

C6,7,8

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2
Q

Median Nerve Root Level

A

C6,7,8,T1

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3
Q

Ulnar Nerve Root Level

A

C8, T1

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4
Q

Axillary Nerve Root Level

A

C5,6

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5
Q

Dorsal Scapular Nerve Root Level

A

C5

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6
Q

Musculocutaneous Nerve Root Level

A

C5,6,7

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7
Q

Long Thoracic Nerve Root Level

A

C5,6,7

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8
Q

Thoracodorsal Nerve Root Level

A

C6,7,8

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9
Q

Suprascapular Nerve Root Level

A

C5,6

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10
Q

Femoral Nerve Root Level

A

L2,3,4

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11
Q

Tibial Nerve Root Level

A

L4,5,S1,2

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12
Q

Medial Plantar Nerve Root Level

A

L4,5

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13
Q

Lateral Plantar Nerve Root Level

A

S1,2

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14
Q

Deep Peroneal Nerve Root Level

A

L4,5

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15
Q

Superficial Peroneal Nerve Root Level

A

L4,5,S1

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16
Q

The shoulder joint is which type of joint?

A

Ball and socket

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17
Q

What is the name of the shoulder joint?

A

Glenohumeral

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18
Q

What does the shoulder girdle consist of?

A

Acromioclavicular
Sternoclavicular
Scapularthoracic Interface

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19
Q

What kind of joint is the acromioclavicular?

A

gliding joint

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20
Q

What kind of joint is the sternoclavicular?

A

saddle joint

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21
Q

Where is the resting position of the scapular interface located?

A

Between the 2nd through 7th ribs and two inches from the midline. It does not lie in the frontal plane and it wings 30-45 degrees toward sagittal.

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22
Q

What is the average range of movement for elevation and depression of the scapula?

A

10-12cm

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23
Q

What is the average range of movement for abduction and adduction (protraction/retraction) of the scapula?

A

15cm

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24
Q

What is the average range of movement for rotation upwards and downwards of the scapula?

A

60 degrees

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25
Q

What are the two parts of the coracoclavicular ligament?

A

Conoid (medial) and Trapezoid (lateral)

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26
Q

What are the functions of the coracoclavicular ligament?

A
  1. contributes to vertical and horizontal stability
  2. assists in transmission of compression from scapula to clavicle- to SC
  3. Functions to produce longitudinal rotation in clavicle during elevation
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27
Q

Scapulohumeral Rhythm functions?

A
  1. Permits more range of motion with less compromise to stability
  2. Maintains maximal congruency of GH joint and reduces shear forces
  3. Permits muscles acting on the humerus to maintain a good length tension relationship and minimizes active insufficiency of the GH muscles
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28
Q

What is scapulohumeral rhythm?

A

The synergistic movement of the shoulder joint and shoulder girdle to produce 180 degree arm abduction

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29
Q

What is the ratio for the 180 degrees in scapulohumeral rhythm?

A

120 degrees shoulder abduction and 60 degrees of shoulder girdle movement to produce a 2:1 ratio

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30
Q

What is the first 30 degrees of abduction termed in scapulohumeral rhythm?

A

The setting phase.

-scapular movement varies during this phase, but most often involves slight upward rotation which is accompanied by clavicular rotation (12-15 degrees)

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31
Q

Scapular movement is more noticeable after the _____ ____.

A

setting phase

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32
Q

Where is the axis of rotation located for the 1st 30 of 60 degrees of scapular upward rotation in scapulohumeral rhythm?

A

on the spine of the scapula at the vertebral border

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33
Q

The upward rotation of the scapula is accompanied by ______ ______.

A

clavicular elevation (30-36 degrees)

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34
Q

As the scapula continues to upwardly rotate, the axis of rotation moves along the _____ to the ______ joint.

A

spine

acromioclavicular

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35
Q

As the scapula upwardly rotates, the clavicle _____ _____ along its longitudinal axis to facilitate the scapular upward rotation.

A

rotates posteriorly

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36
Q

The shoulder joint (humerus) externally rotates during scapula upward rotation so that _______.

A

the greater tubercle doesnt impinge on the acromion process

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37
Q

Phase 1 (60 GH and 30 Scap)

A
  • Upward rotation by Serratus Anterior and upper and lower Traps
  • Coravoclavicular tension- transmit to Sternoclavicular and Clavicle elevates to about 30 degrees
  • Clavicular elevation results in scapular upward rotation of about 30 degrees
  • Clavicular elevation is restrained by costoclavicular ligament
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38
Q

Phase 2

A
  • Continues Traps and Serratus Anterior pull

- Scapula still restrained by coracoclavicular and costoclavicular

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39
Q

_______ _______ of deltoid increases as arm elevates.

A

Mechanical advantage

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40
Q

EMG activity peaks between ________ degrees elevation when the muscle fibers maximally shorten and then plateaus after that.

A

90-120

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41
Q

When the scapula is restricted, it can barely achieve and maintain _____________.

A

90 degrees of glenohumeral abduction

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42
Q

When Serratus Anterior is paralyzed and Trapezius intact, _____ of the arm can occur through its full range of motion, but _________.

A

abduction

weakened

43
Q

When Trapezius is paralyzed and Serratus Anterior intact, _______ of the arm is weakened and limited to about ____ degrees.

A

abduction

75

44
Q

Without the Traps or the Serratus Anterior, the scapula lies in a _____ ______ position. This increases when the ______ contracts.

A

downwardly rotated

Deltoid

45
Q

The Trapezius and Serratus Anterior produce desired _____ ______ ______, while preventing undesired movement by the ______ as it elevates the ________ joint

A

scapular upward rotation
Deltoid
Glenohumeral

46
Q

What is the function of the middle Traps and Rhomboids with the scapula?

A

Function as stabilizing synergists to the muscles that rotates the scapula

47
Q

Middle Traps and Rhomboids contract _________ to control the change in position of the scapula produced by the upper and lower Trapezius and Serratus Anterior.

A

eccentrically

48
Q

Paralysis of Rhomboids and Middle Traps causes what?

A

Disruption of scapulohumeral rhythm and may decrease range of motion

49
Q

What does the Lats do to the scapula?

A

Adducts and depresses the scapula, and causes compression of the GH joint when is the arm is above horizontal

50
Q

What does the clavicular portion of Pec Major do to assist the Deltoid?

A

Assists in flexion of GH joint

51
Q

What does the sternal portion of Pec Major do in conjunction with the Lats?

A

Causes depression, particularly when WB on hands

52
Q

Pec Minor assists in ______ ______.

A

scapular depression

53
Q

What does the Teres Major do to the Humerus?

A

Adducts, internally rotates, and extends it

54
Q

Function of Teres Major on the scapula is strongly dependent on activity of the _______.

A

Rhomboids

55
Q

Unopposed the Teres Major would _______ _______ the scapula. But the Rhomboids offset this force.

A

upwardly rotate

56
Q

GH Dynamics (deltoid)?

A
  • The translatory force (dislocating) greater than rotary force
  • Jam into arch
  • Impingement would prevent most rotary motion
  • Must exceed gravity force for rotation to occur
57
Q

Muscles of rotator cuff?

A

Supraspinatus
Infrapsinatus
Teres Minor
Subscapularis

58
Q

What does the Supraspinatus do?

A

Superior translation, compression, abduction

59
Q

What do the Infraspinatus, Teres Minor, and Subscapularis do?

A

Inferior translation nearly offsets positive pull of deltoid

60
Q

Teres Minor and Infraspinatus provide ______ _____ to prevent __________.

A

lateral rotation

impingement

61
Q

What muscle has the largest mechanical advantage of the cuff muscles?

A

Supraspinatus

62
Q

Supraspinatus combined with gravity does what?

A

Stabilizes joint by causing downward sliding of head necessary for full range of motion

63
Q

Vertical steerer?

A

Supraspinatus

64
Q

The shoulder capsule is approximately ___ ________ than the humeral head.

A

2x larger

65
Q

What is the weakest part of the shoulder capsule? why?

A

Inferior portion because it is stretched out in order to to stretch over the humeral head in full abduction and flexion

66
Q

What 3 ligaments is the shoulder capsule strengthened by?

A

Superior Glenohumeral
Middle Glenohumeral
Inferior Glenohumeral

67
Q

What is normal winging?

A

when the scapula moves around the thorax

68
Q

What is abnormal winging?

A

when the vertebral border moves posteriorly away from the wall of the thorax

69
Q

What is the usually the cause of winging?

A

problem with the long thoracic nerve

70
Q

What is tipping?

A

where the scapula tilts forward around a frontal axis as it reaches the top of elevation

71
Q

What causes tipping?

A

the natural curvature of the spine and the curve of the rib cage

72
Q

Lateral 1/3 of Clavicle is ______ and _______ anteriorly.

A

flattened

concave

73
Q

What does the concavity of the Clavicle do?

A

Increases resilience

74
Q

Clavicle Movement:

  • Elevation?
  • Depression?
  • Protraction/Retraction?
  • Rotation?
A

45
5-15
15
30-45

75
Q

When is the only time the Clavicle does anterior rotation?

A

to return to resting position

76
Q

What type of joint is the Sternoclavicular joint?

A

plane synovial joint with 30 of freedom

77
Q

Clavicular surface is greater ______ than ______. It overlaps sternocostal surface _______ and _______.

A

horizontally
vertically
anteriorly
posteriorly

78
Q

The sternoclavicular joint is a ___ stable joint with _____ injury rate.

A

very

low

79
Q

If dislocations occur of the sternoclavicular joint, they are usually _____.

A

anterior

80
Q

The sternoclavicular joint is capsular reinforced superiorly by the _______ ________ and anteriorly/posteriorly and inferiorly by the __________ _________.

A

interclavicular ligament

A/P sternoclavicular ligament

81
Q

The costoclavicular ligament attaches the _____ to _____.

A

clavicle

1st rib

82
Q

What does the costoclavicular ligament do?

A

Restricts movement of the medial end of the clavicle

83
Q

Where is the sternoclavicular articular disc attached?

A

superiorly to medial end of clavicle and inferiorly to sternocostal junction and cartilage

84
Q

The SC articular disc is _______ with A/P sternoclavicular ligaments.

A

continous

85
Q

What is the function of the SC articular disc?

A

prevents medial displacement of clavicle, facilitates congruence, and absorbs compression/shock forces transmitted along the clavicle

86
Q

Is AC joint strong or weak?

A

weak capsule

87
Q

The AC ligament is reinforced by what?

A

superiorly by aponeurotic fibers of Traps and Deltoid

88
Q

What does the AC ligament do?

A

controls horizontal stability

89
Q

What is a grade 1 AC joint separation?

A

damage to AC joint capsule and ligament

90
Q

What is a grade 2 AC joint separation?

A

joint capsule and Trapezoid ligament damage

91
Q

What is a grade 3 AC joint separation?

A

joint capsule, Trapezoid and Conoid ligament damage

92
Q

What does the coracoacromial arch do?

A

prevents superior dislocation

93
Q

What does the coracoacromial arch consist of?

A

anterior acromion, coracoacromial ligament and coracoid process

94
Q

What are the most referenced and critical shoulder bursae?

A

Subacromial and Subdeltoid (not distinct from one another)

95
Q

What is the function of the glenoid labrum?

A

Functions to deepen socket and increase area of joint contact

96
Q

The superior part of the glenoid labrum is not _____ to ____.

A

fixed

bone

97
Q

The Glenoid Labrum increases depth to _____ ant/post and _____ sup/inf.

A

5mm

9mm

98
Q

Depth is only ____ without the glenoid labrum.

A

2.5mm

99
Q

Bankhart Lesion?

A

the shoulder capsule is separated from the glenoid rim usually following a shoulder dislocation, it is a tearing of the anterior inferior capsule

100
Q

How many muscles cross the shoulder joint?

A

11

101
Q

How many muscles attach to the scapula?

A

17

102
Q

How many rotator cuff muscles?

A

4

103
Q

Dislocation increases risk of ______ damage.

A

axillary