Test 1 Shoulder

Question 1

6 muscles that support and move the scapula

Answer 1

1) trapezius 2) rhomboids 3) levator scapulae 4) serratus

anterior 5) Latissimus Dorsi 6) Pectoralis Minor

Question 2

3 types of acromion morphology

Answer 2

1) flat undersurface
2) slightly convex
3) hooked, which
can predispose the
shoulder to rotator
cuff pathology

Question 3

Coracoid process is a lever for the ___ to help stabilize the ___

Answer 3

pectoralis major

scapula

Question 4

What attaches at the greater tuberosity of humerus?

Answer 4

Supraspinatus, infraspinatus, teres minor

Question 5

What attaches at lesser tuberosity?

Answer 5

Subscapularis

Question 6

Superior GH ligament limits which motions?

Answer 6

external rotation and inferior translation of humeral head with arm at the side

Question 7

Middle GH ligament limits which motions?

Answer 7

External rotation and anterior translations of humeral head with arm in 0 degrees and 45 degrees of abduction

Question 8

Inferior GH ligament consists of a __ and __ band and an ___ with varying functions

Answer 8

Anterior
Posterior
Axillary pouch

Question 9

Coracohumeral ligament covers the __ ligament ___, and fills the space beween the tendons of __ and __ muscles, uniting these tendons to complete the rotator cuff in this area.

Answer 9

GH
anterior-superiorly
supraspinatus
subscapularis

Question 10

Coracoacromial ligament function

Answer 10

Prevents separation of A-C joint surfaces

Question 11

What forms the coracoacromial arch?

Answer 11

Anterior-inferior sapect of acromion, coracoacromial ligament, inferior surface of AC joint

Question 12

When is the Suprahumeral/subacromial space at it’s narrowest?

Answer 12

Between 60-120 degrees of scaption

Question 13

Muscle imbalances or capsular contractures can cause increases in superior translation in __ and narrow the suprahumeral soace, leading to ___.

Answer 13

humeral head

Subacromial impingemet syndrome

Question 14

Impingement syndrome definition

Answer 14

pain in subacromial space when the humerus is elevated or internally rotated

Question 15

What are the ranges of the pain arc of abduction (glenohumeral joint)?

Answer 15

from 45-60 degrees to 110-120 degrees

Question 16

What are the ranges for the acromioclavicular painful arc?

Answer 16

170-180 degrees

Question 17

Impingement syndrome: During ___ ___ the ___ tendon and __ become entrapped between the __ corner of the ___ and ___.

Answer 17

humeral flexion
supraspinatus
bursa
anteroinferior
acromion
greater tuberosity

Question 18

Where is the hypovascular zone of the supraspinatus tendon?

Answer 18

Critical zone just proximal to the supraspinatus insertion point

Question 19

Once the supraspinatus (and infraspinatus) tendon is disrupted there will often be further impingement and irritation which can lead to __ and further ___

Answer 19

biceps tendonitis

rupture

Question 20

Impingement Syndrome pain is often worse at ___, as the ___ becomes ___

Answer 20

night
subacromial bursa
hyperemic

Question 21

Subacromial Bursa provides two smooth ___ layers, one of which adheres to the overlying ___ muscle and the other to the ___ beneath.

Answer 21

serosal
deltoid
rotator cuff

Question 22

Erbs palsy is an ____ brachial plexus injury can be from forceful ___ of the shoulder during birth or trauma later in life. Patient presents with a ___ and ___ shoulder. ___ reflex is lost.

Answer 22

Upper
depression
internally rotated
adducted 
biceps

Question 23

Klumpke’s Palsy is a ___ brachial plexus injury from forceful pulling of the ___ during birth. This impairs ___ ___ and movements of the ___ muscles of the ___

Answer 23

Lower (C8 & T1)
upper arm
wrist flexion
intrinsic
hand

Question 24

Vascular supply to the rotator cuff muscles

Answer 24

Thoracoacromial A
Suprahumeral A
Subscapular A

Question 25

The ___ artery provides the dominant arterial supply to each of the two heads of the biceps.

Answer 25

brachial

Question 26

Describe the close packed position of the GH joint

Answer 26

90 degrees of glenohumeral abduction and full external rotation, or full abduction and external rotation

Question 27

Describe the open packed position of the GH joint.

Answer 27

55 degrees of semi-abduction and 30 degrees of horizontal abduction

Question 28

The AC joint serves as the main articulation suspending the upper extremity from the trunk, and it is at this joint about which the ___ moves

Answer 28

scapula

Question 29

The ___ and ___ ligaments are the primary support for the AC joint. These ligaments provide mainly ___ stability, with control of ___ and ___ translation as well as ___ ___ rotation

Answer 29

``` Conoid Trapezoid vertical superior anterior anterior axial ```

Question 30

AC joint innervation

Answer 30

Suprascapular N Lat. Pectoral N Axllary N.

Question 31

AC joint blood supply

Answer 31

Branches of Suprascapular and Thoracoacromial Arteries

Question 32

At the SC joint in close-packed position, the joint is maximum arm ___ and ___

Answer 32

elevation | protraction

Question 33

At the __ joint in open-packed position is yet to be determined, but is likely to be when the arm is by the ___.

Answer 33

SC | side

Question 34

Name the ligaments that support the SC joint

Answer 34

Anterior Sternoclavicular Posterior Sternoclavicular Interclavicular Costoclavicular

Question 35

Tzitze's Syndrome AKA ___: Etiology is ___. Pain and swelling of one or more ___ may occur gradually or suddenly. Pain may radiate to _(3)_. ___ and ___ can irritate the junctions.

Answer 35

``` Costochondritis unknown costocartilages shoulder, neck, arm direct trauma coughing ```

Question 36

What muscles are the scapular pivoters?

Answer 36

Trapezius Serratus Anterior Levator Scapular Rhomboids

Question 37

What muscles are the Shoulder Protectors?

Answer 37

Rotator Cuff muscles and Biceps Brachii

Question 38

What muscles are the humeral positioners?

Answer 38

Three parts of deltoid

Question 39

Frozen Shoulder is an an inflammation of the ___ layers causing and outpouring secretion of exudate which contains ___. The microscopic layers attach from adjacent synovial layers which then multiply, thickcn, and shorten (___ process)

Answer 39

synovial protein adhesive

Question 40

With frozen shoulder, the patient will have no __ motion, only __ motion. Progressive limitation of motion continues until complete ___ stops the pain.

Answer 40

GH ST Ankylosing

Question 41

During the first 30 degrees of upward rotation of the scapula, the __ and upper and lower divisions of the ___ muscle are the principle upward rotators.

Answer 41

serratus anterior | trapezius

Question 42

3 possible causes of Shoulder Girdle Dysfunction

Answer 42

1. Compromise of passive restraint components 2. Compromise of neuromusular system's production or control of motion 3. Compromise of one or more of the neighboring joints

Question 43

Most common complaints associated with shoulder pathology

Answer 43

``` Pain Instability Swelling Stiffness Deformity ```

Question 44

Overhead exertion with repetitive motion is common in which Diagnoses?

Answer 44

Subacromial Bursitis Impingement Syndromes Rotor Cuff problems

Question 45

FOOSH injuries can result in what Diagnoses?

Answer 45

``` Sprain/Strains AC separation Clavicular fx GH fx Dislocations ```

Question 46

Most common dislocation of the GH joint

Answer 46

Anterior/Inferior

Question 47

Recurrent dislocations after initial GH joint disloction is greater than __% in pts. aged 25 years or younger. Presents with __ shoulder appearance. Recurrent dislocations can lead to __ ___.

Answer 47

95 squared degenerative Arthritis

Question 48

Grade 2 and 3 AC separations cause a considerable amount of ___. Grade 3 separations usually cause a noticeable __ on the shoulder.

Answer 48

swelling | bump

Question 49

MOI for clavicular fractures is usually __ injuries. Pt has difficulty __ the arm past __ degrees. Horizontal ___ is painful

Answer 49

FOOSH elevating 60 adduction

Question 50

What is one of the most common causes of numbness in the shoulder and down into the arm?

Answer 50

Cervical or upper thoracic nerve root involvement- either from segmental nerve roots or brachial plexus

Question 51

What are possible causes of insidious shoulder pain?

Answer 51

``` RA Lupus Gallbladder Liver Disease Chronic Resp. and CV conditions ```

Question 52

Sprengel's Deformity is a ___ abnormality characterized by a partially ___ scapula. This condition develops prior to the ___ month of skeletal development and shows a __ ratio of female predominance.

Answer 52

Congenital undescended 3rd 2:1

Question 53

In Sprengel's Deformity, pt. shows __ of scapula with reduction of ___ in the arm.

Answer 53

elevation | abduction

Question 54

Scapular winging mode of injury is usually caused by stretching during ___, severance of the nerve during surgery (___), or a direct trauma to the side of the neck to the base of the ___.

Answer 54

heavy lifting mastectomy cervical vertebrae

Question 55

Juvenile Kyphosis AKA

Answer 55

Scheuermann's Disease

Question 56

*Scheuermann's Disease is evident in mid and lower thoracic regions in which at least ___ contiguous involved vertebrae are wedged ___ more than ___ degrees. Shows a slight __ predominance and is most common from __-__ years of age

Answer 56

``` 3 anteriorly 5 males 13-17 ```

Question 57

Scheuermann's Disease etiology is ___ and shows a cosmetic deformity with a predesposition thoracic disk ___ and premature ___ changes.

Answer 57

unknown heniation degenerative

Question 58

Characteristic radiological features of Scheuermann's include ___ wedging, irregular ___, and loss of Intervertebral disc ___.

Answer 58

Anterior vertebral end plates heights

Question 59

Some __-__% of scoliosis cases occur in women. Initial complaint may be fatigue in __ region after sitting and standing for long periods. This may be followed by ___ backaches in area of strain, such as ___ pain. Pain may increase as irritation of ___ increases.

Answer 59

``` 60-80 lumbar muscular lumbosacral ligaments ```

Question 60

Many people with severe curvatures (scoliosis) suffer from __ and __ disease secondary to reduced ___ volume.

Answer 60

Cardiovascular Pulmonary Thoracic Cage

Question 61

* Functional Scoliosis is a ___ problem. There are no extra structural parts or rib problems, but ___ result in muscular problems.

Answer 61

muscular | subluxations

Question 62

*The etiology of Structural/Congenital scoliosis is ___ and results from insult to embryo at _-_ weeks of gestation. Can be classified as failure of ___ or ___, or a combination of both.

Answer 62

unknown 6-8 formation segmentation