UPPER EXTREMITY Flashcards by Cath A.

Common direction of shoulder dislocation:
a. anterosuperior
b. posterosuperior
c. anteroinferior
d. posteroinferior

c. anteroinferior

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The foramen of Rouvier is seen:
a. between middle and inferior GH ligament
b. between superior and middle GH ligament
c. between superior and inferior GH ligament
d. between anterior and posterior capsule
e. between the coracoacromial ligament and the subacromial bursa

a. between middle and inferior GH ligament

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Nerve root of Axillary nerve:
a. C5, C6, C7
b. C5, C6, C7, C8, T1
c. C5, C6
d. C5, C6, C7, C8
e. NOTA

c. C5, C6

A: MSK n.
B. median n. (or C6-T1) and radial n.

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The largest branch of the brachial plexus is:
a. median n.
b. radial n.
c. axillary n.
d. long thoracic n.
e. ulnar n.

b. radial n.

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Medial winging of the scapula is typically seen in:
a. weakness of serratus anterior
b. upper trunk nerve injuries
c. blunt trauma to long thoracic nerve
d. A and C
e. all of these

d. A and C

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The lateral cord continues as the:
a. median n.
b. radial n.
c. axillary n.
d. long thoracic n.
e. musculocutaneous n.

e. musculocutaneous n.

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A patient who underwent radical mastectomy should be assessed for weakness of the:
a. deltoid muscles
b. rhomboids
c. rotator cuff muscles
d. serratus anterior
e. latissimus dorsi

d. serratus anterior

(radical neck dissection: SCM/ trapezius)

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The following are requirements to fully elevate the shoulder with the exception of:
a. rotation of the clavicle
b. IR of the humerus
c. upward rotation of the scapula
d. ER of the humerus

b. IR of the humerus

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The nearly equal superior and inferior translator forces of these muscles approximate an almost perfect rotation of humeral head important during arm elevation:
a. deltoids and supraspinatus
b. deltoids and pectoralis major muscle
c. deltoids and infraspinatus, teres minor, subscapularis
d. deltoids and supraspinatus and infraspinatus
e. NOTA

c. deltoids and infraspinatus, ters minor, subscapularis

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Conoid and trapezoid ligaments connect the:
a. clavicle and sternum
b. acromoin and clavicle
c. coracoids and humerus
d. coracoids and clavicle
e. humerus and scapula

d. coracoids and clavicle

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Fourteen weeks after surgical repair of the rotator cuff, a patient presents with significant deltoid weakness. Range of motion is within normal limits and equal bilaterally. Internal and external rotation strength is equal bilaterally; flexion and abduction strength is significantly reduced. What is the most likely cause of this dysfunction?
a. poor compliance with a home exercise program
b. tightness of the inferior shoulder capsule
c. surgical damage to the musculocutaneous nerve
d. surgical damage to the axillary nerve

d. surgical damage to the axillary nerve

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Which of the following joints are pertained in the 2:1 ratio of the scapulohumeral rhythm?
a. glenohumeral joint : sternoclavicular joint
b. glenohumeral joint : scapulothoracic joint
c. acromioclavicular joint : sternoclavicular joint
d. scapulothoracic joint : glenohumeral joint

b. glenohumeral joint : scapulothoracic joint

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This is the extension of the acromion process medially:
a. superior angle of the scapula
b. spine of the scapula
c. glenoid fossa
d. acromion
e. NOTA

b. spine of the scapula

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Ligament that connects the coracoid process and acromion process that prevents superior translation of the humerus:
a. Coracohumeral ligament
b. Coracolavicular ligament
c. Coracoacromial ligament
d. Costoclavicular ligament

c. coracoacromial ligament

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The only joint that acts as a strut to connect the upper extremity with the axial skeleton:
a. the SC joint
b. the AC joint
c. the GH joint
d. AOTA

a. the SC joint

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Spine of the scapula is used to locate what structures?
a. supraspinous fossa
b. subscapular fossa
c. infraspinous fossa
d. A & C
e. AOTA

d. A & C

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Which of the following rotator cuff muscles insert at the greater tuberosity?
a. supraspinatus, teres minor, infraspinatus
b. supraspinatus, teres minor, subscapularis
c. infraspinatus, teres minor, subscapularis
d. subscapularis, supraspinatus, infraspinatus

a. supraspinatus, teres minor, infraspinatus

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The sternoclavicular joint is what type of joint?
a. saddle
b. sellar
c. ovoid
d. A and B

d. A and B

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This ligament, in company with the supraspinatus muscle prevents the downward dislocation of the humeral head. This is known to greatly limit external rotation when involved in adhesive capsulitis:
a. interclavicular ligament
b. sternoclavicular ligament
c. coracoacromial ligament
d. coracohumeral ligament

d. coracohumeral ligament

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Which assessing the standing posture of a patient, the therapist notes that a spinous process in the thoracic region is shifted laterally. The therapist estimates that T2 is the involved vertebra because he or she notes that it is at the approximate level of the
a. inferior angle of the scapula
b. superior angle of the scapula
c. spine of the scapula
d. NOTA

b. superior angle of the scapula

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Mechanism of injury of clavicular fracture:
a. FOOSH
b. FOS
c. medially directed blow to the shoulder
d. AOTA

d. AOTA

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There is a weakness in the capsule between the superior and middle GH ligaments. This weak capsular region is the ___, a frequent site of anterior dislocation of the joint.
a. foramen of Rouvier
b. foramen of Weitbrecht
c. foramen of Luschka
d. AOTA

b. foramen of Weitbrecht

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Painful arc of impingement syndrome:
a. 30 to 60 degrees
b. 60 to 90 degreees
c. 60 to 120 degrees
d. 90 to 180 degrees

c. 60 to 120 degrees

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This joint attaches the scapula to the clavicle. It is generally described as a plane synovial joint with three rotational and three translational degrees of freedom.
a. SC joint
b. AC joint
c. GH joint
d. bicipital groove

b. AC joint

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Which of the following statements is incorrect regarding the GH joint: a. The glenoid fossa of the scapula serves as the distal articular surface for this joint. b. The GH joint is a ball and socket synovial joint. c. Because the glenoid fossa of the scapula is the proximal segment of the GH joint, any motions of the scapula (and its interdependent SC and AC linkages) may influence GH joint function. d. The GH joint has sacrificed articular congruency to serve the mobility needs.

a. The glenoid fossa of the scapula serves as the distal articular surface for this joint. x distal, / proximal distal is for humeral head

The posterior deltoid muscle fibers produce which of the following shoulder motions? a. abduction, external rotation, and extension b. extension and external rotation c. flexion and extension d. extension and abduction

b. extension and external rotation

Weakness of full extension commonly implies weakness of the posterior deltoid in one arm and is sometimes called the: a. sign of Pace and Nagel b. Freiberg sign c. Aysoda sign d. Swallow tail sign

d. Swallow tail sign A, B, and C are for piriformis syndrome

The following statements describe the sternoclavicular joint EXCEPT: a. An articular disk is present between the end of the clavicle and the articular notch of the sternum. b. The only joint that connects the upper extremity directly with the thorax. c. Motions that occur are elevation and depression, protraction and retraction, and transverse rotation d. A stellar joint with two degrees of freedom.

d. A stellar joint with two degrees of freedom. x two degrees, / three degrees

Which of the following structures provide stability of the AC joint? i. shape of the joint ii. AC ligament iii. strong joint capsule iv. conoid and trapezoid a. I and II b. I and III c. IV only d. II and IV

b. I and III

GH joint is what type of joint? a. synovial joint b. synovial hinge c. universal joint d. saddle joint e. AOTA

c. universal joint

The most important joint in the upper extremity for spatial placement is: a. atlantoaxial joint b. hip joint c. shoulder joint d. wrist joint

c. shoulder joint

Limits excessive depression: a. interclavicular ligament b. costoclavicular ligament c. sternoclavicular ligament d. AOTA

a. interclavicular ligament

The lateral third of the clavicle is oriented in this manner: a. convex antero-posteriorly b. concave antero-posteriorly c. convex posteriorly, concave anteriorly d. concave posteriorly, convex anteriorly

c. convex posteriorly, concave anteriorly

The medial boundary of the bicipital groove is formed by: a. Latissimus dorsi b. Pectoralis major c. Teres major d. NOTA

c. Teres major

Which of the following is a common direction of the fractured segment of the clavicle: a. medial segment is pulled inferiorly by the pectoralis major muscle b. lateral segment is upward by the SCM muscle c. medial segment is pulled laterally by the subclavius muscle d. lateral segment is pulled medially by the pectoralis major muscle

d. lateral segment is pulled medially by the pectoralis major muscle

External rotators of the shoulder: a. infraspinatus, teres minor, posterior deltoid b. suscapularis, teres major, latissimus dorsi c. pectoralis major, anterior deltoid, subscapularis d. trapezius, thomboid, levator scapula e. rhomboids, teres minor, teres major

a. infraspinatus, teres minor, posterior deltoid

Orientation of the acromion process: a. medially, superiorly, and posteriorly b. posteriorly, laterally, and inferiorly c. posteriorly, laterally, and superiorly d. medially, superiorly, and anteriorly

c. posteriorly, laterally, and superiorly

Ligament of the sternoclavicular joint that is critical in protecting important structure such as the brachial plexus, subclavian artery which pass under the clavicle and 1st rib: a. IC ligament b. anterior SC ligament c. posterior SC ligament d. costoclavicular ligament e. NOTA

a. IC ligament

During ROM assessment, the patient was unable to achieve full shoulder flexion while maintaining posterior pelvic tilt. What could be the problem? a. triceps tightness b. latissimus dorsi tightness c. quadratus lomborum tightness c. patient is malingering d. shoulder flexors are weak

b. latissimus dorsi tightness

This forms part of the medial wall of the axilla: a. brachial plexus and axillary artery b. 2-6 ribs and serratus anterior c. Pectoralis major, subclavius, subscapularis d. latissimus dorsi, scapula, humerus e. serratus anterior and bicipital groove

b. 2-6 ribs and serratus anterior

A patiet is referred to therapy with a diagnosis of frozen adhesive capsulitis of the right shoulder. You perform therapy for 1 week and now you are going to remeasure joint range of motion. Which of the following would you expect the capsular pattern of restriction to be in the glenohumeral joint for this patient? a. internal rotation is limited more than external rotation b. external rotation is limited more than internal rotation c. adduction is limited more than external rotation d. flexion is limited more than external rotation

b. external rotation is limited more than internal rotation

PNF that is contraindicated in anterior shoulder dislocation: a. D1 flexion b. D1 extension c. D2 flexion d. D2 extension

c. D2 flexion

Which of the following is/are true regarding the costoclavicular space except? a. Structures passing through the costoclavicular space are subclavian artery and brachial plexus. b. When a person falls on outstretched hand, clavicle might fracture completely and it may jeopardize the anterior structures such as the brachial artery and brachial plexus. c. Formed by the clavicle and 1st rib d. A and C e. NOTA

b. When a person falls on outstretched hand, clavicle might fracture completely and it may jeopardize the anterior structures such as the brachial artery and brachial plexus. x anterior structures; / posterior structures

Which structure passes through the triangular space? a. circumflex scapular artery b. posterior humeral circumflex artery c. axillary nerve d. radial nerve e. NOTA

a. circumflex scapular artery

A patient was referred to therapy due to shoulder pain. Based on assessment, every time the patient abducts his/her shoulder, the patient feels pain on the lateral portion of the shoulder. As an amazing therapist, you know that the structure most likely affected is: a. lesser tuberosity b. greater tuberosity c. spiral groove d. spine of the scapula e. NOTA

b. greater tuberosity

The head of the humerus in relation to the glenoid cavity is oriented in this manner: a. medially, posteriorly, superiorly b. laterally, anteriorly, superiorly c. medially, posteriorly, inferiorly d. laterally, anteriorly, inferiorly

a. medially, posteriorly, superiorly

To palpate for the lesser tuberosity of the humerus, the best arm position would be: a. ER b. IR c. slight ABD d. full EXT e. slight ADD

a. ER

Which of the following causes a negative translatory force: a. infraspinatus b. gravity c. supraspinatus d. subscapulairs e. all except C

e. all except C

During what phase of the scapulohumeral rhythm will you expect posterior rotation of the clavicle? a. Phase I b. Phase II c. Phase III d. Phase IV

c. Phase III

A therapist obtains the past medical history of a patient recently referred to therapy after being diagnosed with adhesive capsulitis. Which medical condition is associated with an increased incidence of adhesive capsulitis? a. Diabetes mellitus b. Peripheral vascular disease c. Hemophilia d. Osteomalacia

a. Diabetes mellitus

To best observe and palpate the brachioradialis muscle, resistance should be given to: a. 90 degrees of elbow flexion, forearm supinated b. 90 degrees of elbow flexion, forearm in midposition c. 90 degrees of elbow flexion, forearm pronated d. any of these

b. 90 degrees of elbow flexion, forearm in midposition a - biceps brachii c - brachialis

Where can you palpate the brachial artery in the cubital fossa? a. immediately medial to the brachialis b. immediately lateral to the medial epicondyle c. medial to the biceps tendon d. brachial artery cannot palpated

c. medial to the biceps tendon

True regarding the pisiform bone: a. forms the guyon's canal in which radial nerve passes b. last to ossify among the carpal bones c. connected to the distal carpal row via the pisocapitate ligament d. A and B e. NOTA

b. last to ossify among the carpal bones a: ulnar nerve c: pisohamate

Trigger finger is said to be a mechanical locking of what pulley? a. A1 b. A3 c. A2 d. A4

a. A1

A therapist reviews the surface anatomy of the hand in preparation for a patient status post wrist arthrodesis. Which bony structure does not articulate with the lunate? a. trapezium b. capitate c. radius d. scaphoid

a. trapezium

A therapist instructs a patient to make a fist. The patient can make a fist, but is unable to flex the distal phalanx of the ring finer. This clinical finding can BEST be explained by: a. A ruptured flexor carpi radialis endon. b. A ruptured flexor digitorum superficialis tendon. c. A ruptured flexor digitorum profundus tendon. d. A ruptured extensor digitorum communis tendon.

c. A ruptured flexor digitorum profundus tendon.

The tendon of this muscle is primarily involved in lateral epicondylitis: a. ECRL b. EDC c. Supinator d. ECRB

d. ECRB a: lat. supracondylar ridge

A positive Murphy's sign is indicative of: a. lunate dislocation b. Panner's disease c. Kienbock's disease d. Preiser's disease

a. lunate dislocation

Contents of the antecubital fossa, EXCEPT: a. biceps tendon b. median nerve c. brachioradialis d. brachial artery

c. brachialis

Which among the primary elbow flexors insert at the ulna? a. biceps tendon b. brachioradialis c. brachialis d. NOTA

c. brachialis

Which of the following is correct regarding the carrying angle? a. Carrying angle disappears at flexion beyond 30 degrees. b. Carrying angle can still be seen when the forearem is supinated and elbow is flexed to 40 degrees. c. Can still be seen when arm is extended and forearm is pronated. d. A and B e. NOTA

a. Carrying angle disappears at flexion beyond 30 degrees.

The chief pronator muscle a. Pronator Teres b. Pronator Quadratus c. both A and B d. brachioradialis e. ECRL

b. Pronator Quadratus

The ligament forms 4/5 of a ring around the radius: a. oblique ligament b. MCL c. annlar ligament d. interosseous membrane e. quadrate ligament

c. annular ligament

The lateral boundary of the anatomical snuffbox is: a. abductor pollicis longus b. extensor pollicis brevis c. extensor pollicis longus d. A and C e. A and B

e. A and B

To isolate the supinator muscle, the therapist should position the elbow in: a. 90 degrees elbow flexion b. terminal elbow flexion c. midway between pronation and supination d. 60 degrees elbow flexion e. 90 degrees elbow flexion, shoulder slightly extended

b. terminal elbow flexion

A person's grip is weaker if his wrist is in a flexed position because of: a. Passive insufficiency of finger extensors and active insufficiency of finger flexors b. Passive insufficiency of finger flexors and extensors c. Active insufficiency of finger flexors and extensors d. Passive insufficiency of finger flexors and active insufficiency of finger extensors e. No insufficiency is present

a. Passive insufficiency of finger extensors and active insufficiency of finger flexors

The muscle responsible for light hand closure is: a. flexor digitorum profundus b. flexor digitorum superficialis c. flexor pollicis longus d. both a and b e. all of these

a. flexor digitorum profundus b: forceful

The following are true about elbow flexors: a. The brachialis is considered as the primary elbow flexor due to its insertion at the radius. b. Pratient with musculocutaneous nerve injury will still be able to flex the elbow joint because of the spared biceps brachii which is innervated by the radial nerve. c. Brachioradialis is an example of a shunt muscle. d. Pronator quadratus muscle, although the strongest pronator, is considered a weak elbow flexor.

c. Brachioradialis is an example of a shunt muscle. a: ulna b: brachioradialis d: teres

The extensor tunnel separates the extensor tendons into six different compartments. The third compartment includes: a. EPoL b. ECRL, EPB c. APL, ECRL d. ECRL, ECRB e. ECU, EDM

a. EPoL

Anatomically part of the proximal carpal row but does not participate in radiocarpal articulation a. lunate b. scaphoid c. triquetrum d. pisiform e. NOTA

d. pisiform

Which among the proximal carpal row shows the greatest motion? a. lunate b. scaphoid c. triquetrum d. pisiform e. NOTA

b. scaphoid

Which of the following is/are true regarding the biceps brachii? i. affected by forearm position ii. unaffected by forearm position iii. affected by shoulder position iv. unaffected by shoulder position a. I and II b. II and IV c. I and III d. I and IV

c. I and III

Which of the following is/are true regarding the brachialis muscle: a. As a primary elbow flexor, brachialis is affected by forearm and shoulder position. b. As a primary elbow flexor, brachialis is affected by forearm but unaffected by shoulder position. c. As a primary elbow flexor, brachialis is unaffected by forearm and shoulder position. d. Brachialis is the strongest elbow flexor due to its large cross section.

c. As a primary elbow flexor, brachialis is unaffected by forearm and shoulder position.

Which of the following fibers of medial collateral ligament is the primary restraint for valgus stress from 20 to 120 degrees of elbow flexion? a. anterior b. posterior c. transverse d. NOTA

a. anterior

This muscle assists elbow extension and acts as a stabilizer during pronation and supination. a. brachioradialis b. anconeus c. biceps brachii d. coracobrachialis

b. anconeus

Which of the following statements describe the flexor digitorum superficialis? i. It flexes the distal interphalangeal joint. ii. The chief joint that if lexes is the proximal interphalangeal joint. iii. Both the superficialis and profundus act to clench the fist. iv. Either the superficialis or profundus can act to clench the fist. v. It is supplied by the median nerve. a. I, III, and IV b. I, IV, and V c. II, III, and V d. I, II, and III

c. II, III, and V iv: both

The following applies to radio-ulnar articulation EXCEPT the: a. proximal joint lies within the capsule of the elbow joint b. axis of motion is represented proximally by a line through the center of head of the ulna and distally through the center of the head of the radius c. radius rotate in relation to the ulna due to the connection between them d. one degree of freedom allows pronation and supination only

b. axis of motion is represented proximally by a line through the center of head of the ulna and distally through the center of the head of the radius inverted, should be proximally through the head of the RADIUS and distally through the center of the head of the ULNA

Which muscle does NOT flex the hand at the wrist joint? a. flexor carpi ulnaris b. pronator teres c. palmaris longus d. flexor carpi radialis

b. pronator teres FREM flexion-radiocarpal (1st lihok)-extension-midcarpal (1st lihok)

During wrist flexion at what joint(s) does the motion occur? a. midcarpal joint only b. majority at the radiocarpal joint with some motion at the midcarpal joint c. majority at the midcarpal joint with some motion at the radiocarpal joint d. radiocarpal joint only

b. majority at the radiocarpal joint with some motion at the midcarpal joint

This muscle is a pure flexor of the elbow when the forearm is in midposition. a. biceps brachii b. brachialis c. brachioradialis d. anconeus

c. brachioradialis

Which of the following describes the humeroulnar joint? a. a modified hinge joint b. reinforced by the LCL c. articulating surfaces are trochear notch of humerus and trochlea of ulna d. NOTA

a. a modified hinge joint b: MCL c: trochlea; trochlear notch

True about extensor mechanism: a. lateral slip inserts at the middle phalanx b. central slip inserts at the proximal phalanx c. extensor digitorum communis is actively assisted by lumbricals and interossei muscles to achieve flexion of IP joints d. NOTA

d. NOTA

The carpal bone that forms the floor of the anatomic snuffbox which is usually tender when there is fracture: a. navicular b. lunate c. trapezoid d. pisiform e. hamate

a. navicular or scaphoid

You are attempting to palpate for the lunate. Which of the following is the correct way? a. distal to the lister's tubercle, with wrist extended b. proximal to the lister's tubercle, wrist extended c. distal to the lister's tubercle, wrist flexed d. proximal to the lister's tubercle, wrist flexed e. the lunate is not palpable

c. distal to the lister's tubercle, wrist flexed

You are testing for the muscle strength of your patient's digital muscles. You are pulling the fingers from adduction to abduction while the patient resists. What muscle are you testing? a. dorsal interossei b. palmar interossei c. lumbricals d. abductor pollicis brevis e. adductor pollicis brevis

b. palmar interossei P-AD-D-AB (palmar inter.) (adduction) - (dosal inter.) (abduction)

The carpal tunnel consists of the following structures except: a. flexor digitorum profundus b. flexor digitorum superficialis c. flexor pollicis longus d. flexor carpi radialis e. median nerve

d. flexor carpi radialis

These carpal bones participate in forming the radiocarpal joint. i. scaphoid ii. lunate iii. pisiform iv. hamate v. trapezium a. I and III b. I and II c. II and IV d. I, II, and IV

d. I, II, and IV

Just proximal to the capitate, this is the most often dislocated as well as the second most often fractured bone in the wrist. a. capitate b. navicular c. lunate d. base of third metacarpal e. hamate

c. lunate

The following statements are true of the anatomic snuffbox, EXCEPT: a. The radial border is composed of the abductor pollicis longus and the extensor pollicis brevis tendons. b. Tenderness elicited on the floor of the snuffbox may suggest scaphoid fracture. c. It lies just dorsal and distal to the radial styloid process. d. The ulnar border is the extensor pollicis brevis tendon.

d. The ulnar border is the extensor pollicis brevis tendon.

The proximal IP joint of the hand is stabilized in order to test this muscle: a. flexor digitorum superficialis b. flexor digitorum profundus c. flexor carpi radialis d. extensor carpi ulnaris e. NOTA

b. flexor digitorum profundus

A forearm muscle that belongs to the extensor group but flexes the elbow is the: a. anconeus b. extensor carpi ulnaris c. brachioradialis d. supinator

c. brachioradialis

Importance of the ulna lies at the: a. elbow joint b. wrist joint c. shoulder joint d. NOTA

a. elbow joint b: radius

The muscle that is largely responsible for MCP and IP extension is: a. extensor digitorum b. extensor carpi radialis brevis c. extensor carpi ulnaris d. extensor carpi radialis longus e. extensor digiti minimi

a. extensor digitorum

The most commonly dislocated carpal bone is the: a. lunate b. scaphoid c. trapezium d. hamate e. trapezoid

a. lunate

The first carpal bone to ossify: a. navicular bone b. lesser multangular c. greater multangular d. os magnum e. pisiform

d. os magnum A.K.A. capitate

How can you BEST distinguish the lateral epicondyle from the medial epicondyle during palpation? a. The lateral epicondyle is larger and more palpable. b. It is palpated close to the body when the arm is externally rotated. c. The extensor carpi radialis can be felt to overlie this point. d. Tendernes in this area occurs during golfer's elbow.

c. The extensor carpi radialis can be felt to overlie this point. a: medial b: away d: medial epicondylitis

The carrying angle in males is: a. o to 10 degrees b. 0 to 5 degrees c. 5 to 10 degrees d. 10 to 15 degrees e. 15 to 20 degrees

c. 5 to 10 degrees d: for females

In which of the following conditions is the "carrying angle" of the elbow BEST observed? a. with the elbow extended and the arm externally rotated b. during forearm supination and elbow flexion c. at the side of the body with the forearm pronated d. A and B

a. with the elbow extended and the arm externally rotated

The strongest supinator of the elbow is: a. supinator b. anconeus c. biceps brachii d. brachioradialis e. brachialis

c. biceps brachii

Which of the following BEST explains why the brachialis muscle is considered as the "chief" elbow flexor? a. This is the only shunt muscle with a strong stabilizing component. b. The brachialis is the only two-jointed muscle among the elbow flexors. c. This muscle's distal point lies close to the elbow joint axis. d. It is the strongest elbow flexor due to the dual innervation. e. Its insertion to the ulna permits it to be active in all forearm positions.

e. Its insertion to the ulna permits it to be active in all forearm positions. e: chief elbow flexor c: spurt

UPPER EXTREMITY Flashcards

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