Randy

Question 1

What 2 exercise is used if a patient has upper back /ribcage restriction

Answer 1

Crime scence pose or seated posterior rib expansion

Question 2

What 2 exercises are used if a patient has lower chest restriction

Answer 2

Swiss ball backward bend - elbows up

Crocodile breathing with pads

Question 3

What exercise would you use if a patient has upper chest restriction

Answer 3

Swiss ball backwards bend- hands down

Question 4

What exercise would a patient do if they have lower back restriction

Answer 4

Crocodile breathing with pads

Question 5

What are 3 exercises u could give a pateint for thoracic flexion

Answer 5

Seated thoracic flexion in a chair

Rock back thoracic flexion

Segmental thoracic flexion

Question 6

What 2 exercises could u give a patient to help with thoracic extension

Answer 6

Thoracic extension over chair

Thoracic extension over foam roll- short lever

Question 7

What exercseis could u give a pateint to work on thoracic rotation

Answer 7

Open book w knees bend

Threading the needle

Seated thoracic rotation

Wall windmill

Question 8

How to test anterior/middle scalence flexibility

Answer 8

Extend , SB away and rotate towards

Question 9

How do u check levator scap and posterior scalence flexibility

Answer 9

Flex, SB and rotate away

Stabilize ipsilateral scap

Question 10

How to test flexibility for the upper trap

Answer 10

Flex andSB away

Stabilize ipsilateral scap

Question 11

What is the chin tuck progression for deep neck flexors ? And what are the 3 deep neck flexors

Answer 11

Chin tuck in supine → chin tuck on INCLINE → chin tuck on TOWEL ROLL → chin tuck w HEAD LIFT → chin tuck in PRONE → chin tuck QUADRUPED (w resistance band)

Longus capittus
Longus colli
Rectus capits

Question 12

How would u perform cervical training using a pressure biofeedback unit

Answer 12

Starts at 20mmHg , chin tuck to 22 mmHg and hold 10 seconds , if successful then repeat by increments of 2 mmHg up to 30 mmHg

Question 13

What are some C spine isometrics/strengthening exercises

Answer 13

Self isometrics

Banded isometrics

Ball against wall

Ninja turtles w chin tuck

Wall slides with chin tuck

Wall angles with chin tuck

Question 14

What are apart of the rotator cuff

Answer 14

Supra - abduction
Infra- ER
Sub - IR
Minor - ER `

Question 15

What is the main action of the lower trap and lower fibers of serratus anterior

Answer 15

Upward rotation of the scap

Question 16

What is the upper SA best suited for

Answer 16

Scap abduction and protraction

Question 17

During arm elevation what is happened at the AC and SC joint

Answer 17

AC joint: going into posterior rotation (upward)

SC joint: going into elevation

Question 18

Why may. A patient have limited IR during AAROM IR exercises

Answer 18

Bc of dysfucntion of the upper ribs expansion which will not allow the scap to anteriorly tilt like it should w IR

Question 19

What compensations could we see when a patient is doing sidelying ER? What mm are we trying to target

Answer 19

We could see movement at the scap when we dont want to

Trying to activate the infraspinatus

Question 20

What mm is the serratus punch mainly hitting

Answer 20

Upper SA

Question 21

What exercises could u do to hit lower traps

Answer 21

Lift offs

W in prone

Question 22

What mm is posteriorly tilting the scap during Y and I exercises in front

Answer 22

Lower trap

Question 23

What mm tilts scap anteriorly

Answer 23

Pec minor

Question 24

What exercises are good for shoulder activation

Answer 24

Wall walks
Stability ball against a wall
Ball flips at 90/90
Snow devils
Sidelying IR and ER

Question 25

What closed chain exercseis can u progress a shoulder patient to for stability and proprioception

Answer 25

Shoulder taps on knees Quadruped walk Mountain climbers Serratus plus Plank on BOSU Turkish get ups

Question 26

What is the coupling motion at the lower c spine (C3-T4_

Answer 26

Ipsilateral

Question 27

What are the unicate process invovled w

Answer 27

SB at C3-C7

Question 28

During bilateral shoulder elevation what happens at the thoracic spine

Answer 28

Extension

Question 29

During unilateral arm elevation what happens at the thoracic spine

Answer 29

Ipsilateral rotation and lateral flexion

Question 30

What angle do that facets face in the thoracic spine

Answer 30

60°

Question 31

How is the coupling of movement at the upper and lower thoracic spine

Answer 31

Upper: ipsilateral coupling of rotation and SB Lower: contralateral coupling of rotation and SB

Question 32

During breathing what happens at the ribs

Answer 32

Upper ribs elevate in the anterior part and lower ribs elevate in the lateral part Upper: pump Lower: bucket

Question 33

How is the scapulothoracic joint angled and why

Answer 33

30-45° from the coronal plan to place the glenoid fossa anteriorly —> scapation

Question 34

How much does the scap upwardly rotate adn anteriorly tilt

Answer 34

10-20°

Question 35

What acts as a lever arm for the deltoid and articulates w the lateral end of the clavicle

Answer 35

Acromion

Question 36

What motions at the GH produce a Anterior roll and posterior glide

Answer 36

Flexion IR Horizontal ADD

Question 37

What motions at the GH produce a POsterior roll and anterior glide

Answer 37

Extension ER Horixtonal ABD

Question 38

What is the roll and glide for shoulder abduction

Answer 38

Superior roll Inferior glide

Question 39

What is the roll and glide for shoulder adduction

Answer 39

Inferior roll Superior glide

Question 40

What is the roll and glide for shoulder adduction

Answer 40

Inferior roll Superior glide

Question 41

What mm work together to provide inferior stability and compress the humeral head

Answer 41

Subscapularis Infraspinatus Teres minor

Question 42

What is the concavity sompression mechanism created by

Answer 42

Anterior base of subscapularis Posterior base of infra Teres minor

Question 43

How do u test each quadrant of the ribs

Answer 43

Upper chest: behind the back- lower Lower chest: ER at 90° upper back: ER by side Lower back: behind the back- upper

Question 44

What posture has short neck extensors , HF and Lower back

Answer 44

Lordotic

Question 45

What posture has lengthen and weak EO , HF , neck flexors and upper back extensors

Answer 45

Sway back

Question 46

How does the humeral. Head side

Answer 46

Anterior to acromion by 1/3

Question 47

What happens if the subclavian is tight

Answer 47

Will pull down 1st rib and lock down the clavicle

Question 48

What happens when the pec minor is tight with shoulder elevaiotn

Answer 48

It will create a anterior tipping when there should be a posterior tilt to allow ER to clear the joint

Question 49

What mm could be affected if the ribs have a dysfucntion

Answer 49

The SA bc it connect to the first 8 ribs

Question 50

If a patient is unable to get arm elevation over head what should we think about

Answer 50

SA and lower traps Clavicle movements GH joint

Question 51

How many someone want to compensate when doing sidelying ER

Answer 51

Doing scapular retraction —> hitting rhomboids and middle trap instead of the infraspinatus

Question 52

What is the thoraci outlet

Answer 52

Groups of 3 spaces between eh clavicle adn 1st rib that the brachial plexus , subclavian artery and subclavian vein travel thru

Question 53

What are teh 3 anatomical locations in which compression of the brachial plexus and or subclavian vasculature can occur

Answer 53

Interscalence triangle (created by the anterior , middle and 1st rib) Costoclavicular space ( subclavius , 1st rib , anterior scalene) Subcoracoid space (pec minor , ribs 2-4, coracoid)

Question 54

What the most common type of TOS

Answer 54

Nerve involvement (nTOS)

Question 55

What is impinged with nTOS

Answer 55

BP

Question 56

What TOS is characterized by upper extremity paresthesia, neck pain, trapezius pain, shoulder and/or arm pain, supraclavicular pain, chest pain, occipital headache, and paresthesias in various finger patterns

Answer 56

Neurogenic

Question 57

Where may pain radiate with nTOS

Answer 57

Along anterior or posterior shoulder

Question 58

NTOS is most common in whom

Answer 58

Women

Question 59

What is impinged with venous involvement of TOS

Answer 59

Subclavian vein

Question 60

What is impinged with the arterial invovled

Answer 60

Subclavian artery

Question 61

There is a high change of ___ ___ ___ with TOS anf carpal tunnel syndrome

Answer 61

Double crush syndrome

Question 62

What are the most common provocative diagnostic test for TOS

Answer 62

Adson Elevated arm stress test Upper limb tension test

Question 63

What are surgical candidates for TOS

Answer 63

Patients who have failed conservative treatment (4-6 months) NTOS patients who present with uncontrolled pain or worse UE weakness Patients w aTOS or vTOS

Question 64

Should u do shoulder activation or strength ting first

Answer 64

Activation—> rhymthic stabilized in supine

Question 65

What does wall slides encourage

Answer 65

ER throughout and encourage activation of posterior cuff mm and ST movement

Question 67

C5-C7 compression may create referred pain where

Answer 67

Posteriorly to the rhomboid area across the anterior clavicle and laterally through the deltoid and traps mm and down the outer aspect of the arm

Question 68

C8-T1 compression will create pain where

Answer 68

Alone he posterior anterior shoulder with radiculopathy down the arm and parasthesia along the ulnar nerve distribution

Question 69

when measures rib mobility , how much should rib expansion increased w inspiration

Answer 69

2-5"

Question 70

what do u want to focus on with people with TOS

Answer 70

1st rib mobilization

Question 71

narrow ISA will be present in what posture type

Answer 71

flat back

Question 72

wide ISA will be present in what posture type

Answer 72

lordotic or kyphotic

Question 73

what is the scapula movements during scapular upward rotation

Answer 73

inferior angle moves lateral and glenoid fossa rotates to face cranially

Question 74

what is the scapula movements during scapular doownward rotation

Answer 74

inferior angle moves medialy and the glenoid fossa rotates to face caudally

Question 75

How does the coracoid and inferior angle move during scapular anterior tilt

Answer 75

coracoid moves anteriorly and caudally and incferior angle moves posteriorly and cranially

Question 76

How does the coracoid and inferior angle move during scapular posterior tilt

Answer 76

coracoid moves posterirly and cranially and the inferior angle moves anteriorly and caudally

Question 77

what is the nerver root for these muscles deltpid finger flexors finger extesnors triceps biceps wrist extesnors wrist flexors

Answer 77

deltoid- C5 finger flexors - C8 finger extensors -C7 triceps - C7 biceps - C6 wrist extensors- C6 wrist flexors - C7

Question 79

What is the main reason to get the lower traps activated during rows

Answer 79

To depress and retract the scap so that it is in good position

Question 80

What are the 3 parts of the eSA

Answer 80

Upper: ribs 1-2 Middle: ribs 2-3 Lower: ribs 4-9

Question 81

What is the function of the costoclavicualr ligament

Answer 81

Acts as a fulcrum to fully elevate the clavicle so that the scapula can upwardly rotate fully Resist anterior , posterior and superior movement of the medial end of the clavicle

Question 82

What is decreased with flat back posture and how do u treat it

Answer 82

Decreased posterior upper back expansion Treat with crime scene pose or seated posterior rib expansion

Question 83

What are u trying to improve w sway back posture

Answer 83

Thoracic extension so give exercises to hit that

Question 84

What is the progression of the snow devils

Answer 84

Prone I with arm by side and thumbs up lift 10 seconds Prone field goal lift 10 seconds thumbs ip Prone T lift 10 seconds pinky up Prone start w arms by side w palm up and then make sweeping motion and end w hands down

Question 85

What 2 joints allows for gliding motions in the t spine

Answer 85

Costovertebral and costotrasnverse

Question 86

What do we need to teach ppl with flat back

Answer 86

How to flex their spine (Exercises- assisted thoracic flexion , segmental flexion)

Question 87

How would u treat someone with over active upper traps

Answer 87

They may have weak lower traps so working on lower traps in prone W or lift offs Or Could be to help the patient only turn on upper traps toward the edn range of arm elevation for upward rotation

Question 88

How do the supraspinous assist w the deltoid and supraspinatus force couple

Answer 88

Provide a direct compressive force , compressing the humeral head into the glenoid fossa

Question 89

What does teh deltoid do in the deltoid - RC force couple

Answer 89

Provides a directional force on the humerus that is upward and outward If this did not occur then the greater tuberosity would go into the under surface of the acromion each time during elevation

Question 90

During the deltoid - RC force couple the deltoid is counteracted how

Answer 90

Inferior and medial directed force created by the infraspinatus , subscapularis , teres minor

Question 91

The deltoid provides a ___ force and the RC provides a ___ force

Answer 91

Vertical Horizontal

Question 92

If the subcostal margin does not expand with arms raised inhalation what is implicated

Answer 92

Short EO

Question 93

Coupling motion at Upper c spine Lower c spine and upper t spine Lower t spine

Answer 93

Conta Ispi Conta

Question 94

How much flexion is at C0-C1 and C2-C7

Answer 94

20-25 35

Question 95

How much extension is at C0-C1 and C2-C7

Answer 95

20-25 45

Question 96

How much rotation is at C0-C2 and C2-C7

Answer 96

40-45 x2

Question 97

How much lateral bending is at C0-C1 and C2-C7

Answer 97

5-10 20-45

Question 99

The lateral symmetry line should pass thru what structures

Answer 99

External auditory meatus AC joint Humeral head GT Anterior to lateral mal