Chapter 7 Shoulder

Question 1

Joints of the shoulder/

Answer 1

Scapulothoracic (pseudo-joint), AC joint, glenohumeral, SC joint

Question 2

Primary flexor?

Answer 2

Deltoid (anterior portion)

Question 3

Primary extensors?

Answer 3

Lat dorsi, teres major, deltoid (posterior portion)

Question 4

Primary external rotators?

Answer 4

Infraspinatus, teres minor

Question 5

Subclavian artery passes bt which 2 muscles?

Answer 5

Anterior and middle scalenes–contracture of these muscles affects arterial supply but not venous drainage

Question 6

When does subclavian a become axillary a?

Answer 6

Lateral border of 1st rib

Question 7

1st major branch of brachial a?

Answer 7

Profunda brachial a–accompanies radial n in its posterior course of radial groove

Question 8

What becomes the deep palmar arterial arch?

Answer 8

Radial a

Question 9

Tx technique to relieve lymph congestion of UE?

Answer 9

1) Open thoracic inlet
2) Redome diaphragm
3) Posterior axillary fold technique

Question 10

Degrees of motion during arm abduction?

Answer 10

120 degrees due to glenohumeral motion, 60 degree due to scapulothoracic motion

Question 11

Most common somatic dysfunction of shoulder?

Answer 11

Restriction in internal and external rotation

Question 12

Least common somatic dysfunction of shoulder?

Answer 12

Restriction in extension

Question 13

Most common somatic dysfunction of SC joint?

Answer 13

Clavicle anterior and superior on sternum

Question 14

“Step-off” seen at the AC joint?

Answer 14

Superior and lateral clavicle on acromion

Question 15

Pathogenesis of supraspinatus tendinitis?

Answer 15

Continuous impingement of greater tuberosity against acromion as arm is flexed and internally rotated

Question 16

“Painful arc”?

Answer 16

Pain exacerbated by abduction from 60-120 degrees in supraspinatus tendinitis

Question 17

Aggravating factors in bicipital tenosynovitis?

Answer 17

Elbow flexion or supination

Question 18

Location of pain in rotator cuff tear?

Answer 18

Tenderness just below tip of acromion

Question 19

Etiology of frozen shoulder?

Answer 19

Prolonged immobility of shoulder

Question 20

Most common shoulder dislocation?

Answer 20

Anterior and inferior–affects axillary n

Question 21

Most common brachial plexus injury?

Answer 21

Erb-Duchenne’s palsy

Question 22

What is paralyzed in Erb-Duchenne’s?

Answer 22

Abduction, external rotation, flexion, supination

Question 23

Crutch palsy?

Answer 23

Radial n

Question 24

Saturday night palsy?

Answer 24

Compression of radial n against humerus as arm is draped over back of chair

Question 25

Most common cause of injury to radial n?

Answer 25

Humeral fracture

Question 26

Most commonly affected nerve injured in UE due to direct trauma?

Answer 26

Radial n

Question 27

Erb-Duchenne's?

Answer 27

Upper trunk (C5-6)

Question 28

Pathogenesis of winging of scapula?

Answer 28

Weakness of anterior serratus due to long thoracic n injury

Question 29

When is pain elicited in frozen shoulder?

Answer 29

End of ROM

Question 30

Motions most often affected in adhesive capsulitis?

Answer 30

Abduction, internal and external rotation (extension is preserved)

Question 31

Most commonly affected rotator cuff muscle?

Answer 31

Supraspinatus

Question 32

Pathogenesis of bicipital tenosynovitis?

Answer 32

Inflammation of tendon and its sheath of long head of biceps

Question 33

Site of pain in supraspinatus tendinitis?

Answer 33

Tip of acromion

Question 34

Sites of compression of nv bundle in thoracic outlet syndrome?

Answer 34

1) Bt anterior and middle scalenes 2) Bt clavicle and 1st rib 3) Bt pectoralis minor and upper ribs

Question 35

Most common somatic dysfunction of AC joint?

Answer 35

Clavicle superior and lateral on acromion

Question 36

Motion of clavicle during internal/external rotation?

Answer 36

Around transverse axis

Question 37

Second most common somatic dysfunction of shoulder?

Answer 37

Restriction in abduction

Question 38

For every 3 degrees of abduction...

Answer 38

Glenohumeral joint moves 2 degrees and the scapulothoracic joint moves 1 degree

Question 39

Nerve roots of brachial plexus?

Answer 39

C5-T1

Question 40

What becomes the superficial palmar arterial arch?

Answer 40

Ulnar a (Ulnar is Up in the palm)

Question 41

Where does brachial a divide into ulnar and radial aa?

Answer 41

Under bicipital aponeurosis

Question 42

When does the axillary a become the brachial a?

Answer 42

Inferior border of teres minor

Question 43

Subclavian vein passes where?

Answer 43

Anterior to anterior scalene

Question 44

Primary internal rotator?

Answer 44

Subscapularis

Question 45

Primary adductors?

Answer 45

Pec major, lat dorsi

Question 46

Primary abductor?

Answer 46

Deltoid (middle portion)

Question 47

Rotator cuff muscles?

Answer 47

Supraspinatus, Infraspinatus, teres minor, Subscapularis (SItS)

Question 48

Bones making up the shoulder?

Answer 48

Clavicle, scapula, humerus