Practical Exam 1

Question 1

Scapula

Answer 1

Start by finding medial border– 2 inches from spinous processes
Palpate inferior to inferior angle, then up to superior angle (will be harder to palpate)
Lateral border– from inferior angle up and out, but will disappear as it it covered by the latissimus dorsi and the teres major
Spine: across from T3, pinch laterally, becomes the acromion process

Question 2

Acromion

Answer 2

From spine of scapula (underneath/inferior edge), follow to posterior corner of acromion. Palpate lateral edge, but don’t go to far because you’ll land on the greater tubercle
*pull on the humerus
Follow acromion ventrally where it meets the clavicle

Question 3

Clavicle

Answer 3

Start inferior aspect of clavicle medially, follow laterally…but don’t get lost in anterior v notch
Come on superior aspect of clavicle and palpate laterally and posteriorly

Question 4

Supraspinatus

Answer 4

Humeral abduction
O: supraspinous fossa
I: upper facet of the greater tubercle

Question 5

Infraspinatus

Answer 5

External rotation with arm in 90 degrees of abduction
O: infraspinous fossa
I: middle facet of the greater tubercle

Question 6

Rhomboid Major

Answer 6

Prone, arm behind back with dorsum of hand resting on sacrum. Lift hand to ceiling
O: TV2-5
I: medial border, at and below root of spine

Question 7

Rhomboid Minor

Answer 7

O: nuchal ligament, CV7, TV1
I: medial border, at root of spine

Question 8

Teres Major

Answer 8

In prone, arm off side of table, internally rotate arm
O: inferior angle
I: middle lip of the intertubercular groove

Question 9

Lower trapezius

Answer 9

In prone, arms elevate to 120 degrees, lift arms up
O: TV4-TV12
I: spine of scapula

Question 10

Subscapularis

Answer 10

Supine, forearm on forehead
Fingers on anterior surface of scapula between lat dorsi and rib cage
Patient internally rotates shoulder

Question 11

Lateral Epicondyle

Answer 11

Slide laterally from olecranon

Question 12

Medial Epicondyle

Answer 12

Find olecranon, follow medially. Will be larger than olecranon

Question 13

Radial Head

Answer 13

Move distally from lateral epicondyle until a concavity representing space between the humerus and the radius
Keep going distally until on a convexity
Passive pronation and supination. This will move under finger!

Question 14

ECRL

Answer 14

Extend and radially deviate. Egg
O: lateral supracondylar ridge of humerus
I: base of 2nd MC

Question 15

ECRB

Answer 15

Where ECRL ends, continue giving radial deviation resistance
Long muscle belly
O: Lateral epicondyle
I: base of 3rd MC

Question 16

Common flexor tendon

Answer 16

5mm at anterior surface of medial epicondyle
Slight wrist and finger flexion

Question 17

Triceps

Answer 17

Prone, arm off side of table
Find olecranon process
Extend elbow as you apply resistance to forearm
Other hand slides off olecranon moving proximally

Question 18

Ulnar n

Answer 18

Dives behind medial epicondyle

Question 19

Median n

Answer 19

Medial to brachial a

Question 20

Brachial a

Answer 20

Contract biceps, feel brachial a
Follow to cubital fossa

Question 21

Capitate

Answer 21

Palpate base of 3rd metacarpal, slide finger proximally until a large cavity
This takes up the width of the 3rd metacarpal and has a slight connection with the 2nd and 4th MC
Takes up distal 2/3 of space between proximal and distal borders of the carpus

Question 22

Scaphoid

Answer 22

Extend thumb and ulnar deviate
Distal anatomical snuff box gets filled in

Question 23

Scaphoid tubercle

Answer 23

Activate FCR, follow tendon to base of 2nd MCP
Ulnar and radial deviation

Question 24

Pisiform

Answer 24

Start at flexor crease, slide to pinky side
Small circles
Flex and ulnar deviate to activate FCU and follow tendon

Question 25

Ulnar styloid process

Answer 25

Start at olecranon, palpate distally down posterior border Is covered by ECU when pronated so slightly supinated Palpate distal to proximal

Question 26

Radial styloid process

Answer 26

From proximal to distal down shaft of radius until ending at a round prominence Palpate during slight flexion and ulnar deviation

Question 27

Abductor pollicis longus

Answer 27

Thumb radial abduction, create anatomical snuff box Attaches to base of 1st MC

Question 28

Extensor pollicis brevis

Answer 28

Anatomical snuff box More prominent than APL Attached to base of 1st phalanx

Question 29

Extensor pollicis longus

Answer 29

Dorsal leg of anatomical snuff box Curves around Listers Tubercle

Question 30

Extensor carpi radialis longus/brevis

Answer 30

Radial to Lister's Tubercle Thumb relaxes, slight resistance into extension and radial deviation ECRL egg shaped, ECRB continues from

Question 31

Flexor carpi radialis

Answer 31

Flex and radially deviate wrist Follow to base of 2nd MCP

Question 32

Flexor carpi ulnaris

Answer 32

Flex and ulnar deviate wrist Follow to insertion on pisiform

Question 33

FDS

Answer 33

Radial from FCU Alternating finger flexion

Question 34

Median n

Question 35

C2

Answer 35

First bony prominence from occiput

Question 36

C3

Answer 36

Find hyoid (under mandible, drops down when swallow) Posterior= C3

Question 37

C4

Answer 37

V notch of thyroid (find hyoid, come down a little)

Question 38

C5

Answer 38

Thyroid cartilage, end plates

Question 39

C6

Answer 39

Cricoid cartilage, sideways tire Keep finger on 6 and 7, extend head, C6 will disappear, C7 will stay

Question 40

C7

Question 41

T1

Question 42

SCM

Answer 42

Resisted contralateral isometric rotation and or lateral flexion

Question 43

Subclavian a

Answer 43

Immediately posterior to anterior scalene with the brachial plexus

Question 44

Carotid a

Answer 44

Below mandible, anterior/medial to SCM