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Kinesiology > Review questions: Upper extremity > Flashcards

Review questions: Upper extremity Flashcards

Shoulder, Elbow, Forearm, Wrist, Hand

1
Q

How many places does the upper extremity articulate with the axial skeleton:

A. 2
B. 3
C. 4
D. None of the above
A

D. none of the above

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2
Q

Which of the following statements is true about the glenohumeral joint capsule and ligaments:

A. Taut throughout the entire range of shoulder motion
B. Provide the primary source of stability in the mid-ranges of shoulder motion
C. Prevent excessive humeral head translation at end-ranges of shoulder motion
D. All of the above are true

A

C. Prevent excessive humeral head translation at end ranges of shoulder motion

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3
Q

To protect the anterior band of the inferior glenohumeral ligament complex after an anterior dislocation you would avoid the following positions:

A. Abduction and external rotation
B. Adduction and external rotation
C. Flexion and internal rotation
D. Adduction and internal rotation
A

A. Abduction and external rotation

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4
Q

When the shoulder is in full forward elevation, the scapula should be in all of the following positions, EXCEPT:

A. Upward rotation
B. Anterior tilt
C. Posterior tilt
D. Retraction
A

B. anterior tilt

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5
Q

All of the following could contribute to inferior shoulder subluxation after CVA, EXCEPT:

A.  Serratus anterior paralysis
B.  Spasticity of the supraspinatus
C.  Deltoid paralysis
D.  Upper trapezius paralysis
A

B. Spasticity of the supraspinatus

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6
Q

Which of the following is most important in providing dynamic posterior glenohumeral joint stability:

A. Infraspinatus
B. Subscapularis
C. Supraspinatus
D. Teres major
A

A. Infraspinatus

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7
Q

The most likely cause of loss of upward rotation of the scapula during shoulder elevation would be:

A. Weakness of lower traps
B. Weakness of rhomboids
C. Weakness of serratus anterior
D. Weakness of upper traps
A

C. Weakness of serratus anterior

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8
Q
  1. A tear of the supraspinatus would likely result in:

A. Increased superior translation of the humeral head
B. Weakness in shoulder elevation
C. Altered scapulohumeral rhythm
D. All of the above

A

D. All of the above

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9
Q
  1. Your patient has significant loss of BOTH active and passive external rotation. The most likely cause of this would be:A. Weakness of the infraspinatus
    B. Contracture of the axillary pouch
    C. Weakness of the subscapularis
    D. Contracture of the anterior capsule
A

D. Contracture of the anterior capsule

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10
Q
  1. Which of the following statements about the shoulder complex is FALSE:

A. Upward rotation of the scapula is accomplished by a force couple between
upper traps, lower traps and serratus anterior

B. Strengthening of periscapular muscles should be an essential part of treatment
of shoulder instability

C. Contracture of the axillary pouch would result in loss of adduction

D. Tear of anterior labrum could result in anterior shoulder instability

A

C. Contracture of the axillary pouch would result in loss of adduction

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11
Q

Use the following key for questions 11-14 to match the structure to loss of motion after contracture:

A. Rotator interval
B. Anterior band of inferior glenohumeral ligament complex
C. Posterior band of inferior glenohumeral ligament complex D. Posterior-superior glenohumeral capsule E. Axillary pouch F. Middle glenohumeral ligament
  1. Shoulder abduction ____
  2. Internal rotation with arm at the side ____
  3. External rotation with arm at the side ____
  4. External rotation in 90 degrees abduction ____
A
  1. E, 12. D, 13. A, 14. B
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12
Q

Which of the following is true regarding excessive cubitus varus:

A. Likely involves damage to the medial collateral ligament
B. Likely involves damage to the lateral collateral ligament
C. Would result in increased compression at the humeroradial joint
D. Would result in increased gapping at the medial elbow

A

B. Likely involves damage to the lateral collateral ligament

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13
Q

Loss of full extension of the elbow would be most likely due to:

A. Tightness in the posterior joint capsule

B. Tightness in the posterior band of the MCL

C. Tightness in the anterior band of the MCL

D. Tightness in the triceps muscle

A

C. Tightness in the anterior band of the MCL

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14
Q

Which of the following statements is true about the role of the interosseous membrane in the forearm:

A. Not particularly important for stability of the forearm

B. Transfers load from the ulna to the radius

C. Provides resistance to longitudinal distraction of the radius

D. None of the above are true

A

D. None of the above are true

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15
Q

Clicking during pronation and supination and increased translation between the distal radius and ulna is most likely due to:

A. Injury to the radial collateral ligament of the wrist
B. Injury to the ulnar collateral ligament of the wrist
C. Injury to the distal radial-ulnar ligaments of TFC
D. Injury to the ulnocarpal ligaments

A

C. Injury to the distal radial-ulnar ligaments of TFC

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16
Q

A muscle that attaches on the humerus and the ulna can theoretically do all of the following, EXCEPT:

A. Flex the elbow
B. Extend the elbow
C. Supinate the forearm
D. Could do all of the above

A

C. Supinate the forearm

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17
Q

To maximally shorten the biceps brachii muscle, you would:

A. Flex the shoulder; flex the elbow; supinate the forearm
B. Flex the shoulder; flex the elbow; pronate the forearm
C. Extend the shoulder; extend the elbow; pronate the forearm
D. Extend the elbow; flex the elbow; supinate the forearm

A

A. Flex the shoulder; flex the elbow; supinate the forearm

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18
Q

To maximally stretch the biceps muscle you would:

A. Flex the shoulder; flex the elbow; supinate the forearm
B. Flex the shoulder; flex the elbow; pronate the forearm
C. Extend the shoulder; extend the elbow; pronate the forearm
D. Extend the elbow; flex the elbow; supinate the forearm

A

C. Extend the shoulder; extend the elbow; pronate the forearm

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19
Q

To maximally stretch the triceps muscle you must fully supinate the forearm:

A. True 
B. False
A

B. False

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20
Q

Tightness/contracture of which of the following would result in loss of elbow flexion:

A. Brachialis
B. Anterior capsule
C. Posterior capsule
D. None of the above

A

C. Posterior capsule

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21
Q

The brachialis produces the greatest amount of flexion torque with the forearm in which of the following positions:

A. Pronation
B. Supination
C. Neutral
D. Position of the forearm is not relevant
A

D. Position of the forearm is not relevant

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22
Q

The triceps would be active during high powered supination activities:

A. True
B. False
A

A. true

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23
Q

The sequela of a tear of the MCL of the elbow could include:

A. Excessive cubitus varus
B. Increased gapping/separation of the medial side of the elbow
C. Increased compression on the medial side of the elbow
D. Increased gapping/separation on the lateral side of the elbow

A

B. Increased gapping/separation of the medial side of the elbow

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24
Q

Contracture (shortening) of the volar radiocarpal ligaments would most significantly limit which of the following wrist motions:

A.  Wrist extension
B.  Wrist flexion
C.  Radial deviation
D.  Ulnar deviation
A

A. Wrist extension

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25
Q

An extreme amount of force delivered in which of the following directions would damage the ulnar collateral ligament of the wrist:

A.  Wrist flexion
B.  Radial deviation
C.  Wrist extension
D.  Ulnar deviation
A

B. Radial deviation

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26
Q

Loss of wrist extensor muscle function results in:

A. Impairment of the wrist only
B. Minimal changes in hand function
C. Significant impairment in grip strength
D. No major loss of either wrist or hand function

A

C. Significant impairment in grip strength

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27
Q

The inability to perform pure flexion of the wrist without unwanted associated ulnar deviation occurring simultaneously indicates dysfunction of:

A.  Flexor carpi ulnaris
B.  Flexor carpi radialis
C.  Extensor carpi radialis longus
D.  Extensor carpi ulnaris
A

B. Flexor carpi radialis

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28
Q

Contracture/shortening of the dorsal radiocarpal ligaments would result in loss of wrist extension:

A. True
B. False
A

B. False

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29
Q

The inability to perform pure ulnar deviation without unwanted associated extension of the wrist indicates dysfunction of the:

A. Extensor carpi ulnaris
B. Extensor carpi radialis longus
C. Flexor carpi ulnaris
D. Flexor carpi radialis
A

C. Flexor carpi ulnaris

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30
Q

The FDS, FDP, FCU and FCR are ALL considered potent wrist flexors:

A. True
B. False
A

A. true

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31
Q

Positive ulnar variance:

A. Results in increased pressure on radiocarpal joint

B. Results in increased pressure on ulnocarpal joint

C. Results in even pressure on both radio- and ulnocarpal joints

D. Is the normal relationship between the distal radius and ulna

A

B. Results in increased pressure on ulnocarpal joint

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32
Q

In general, when the forearm is in the neutral position, ____% of the load is accepted by the radius and ____% of the load is accepted by the ulna:

A.  60; 40
B.  40; 60
C.  80; 20
D.  20; 80
A

C. 80; 20

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33
Q

Pure radial deviation of the wrist is accomplished by ____________ and the _____________

A. ECRL; FCU
B. ECRL; FCR
C. ECRB; FCU
D. ECU; FCR
A

B. ECRL; FCR

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34
Q

Your patient’s PIP joints cannot be extended beyond 40 degrees of flexion REGARDLESS of the position of the MP or wrist joint. The most likely cause is:

A.  Extrinsic finger flexor tightness
B.  Volar plate tightness
C.  Lumbrical/interossei tightness
D.  Extrinsic extensor tightness
A

B. Volar plate tightness

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35
Q

Your patient’s PIP joints cannot be extended beyond 40 degrees of flexion
REGARDLESS of the position of the MP or wrist joint. When making a splint for the above patient designed to stretch the involved tissue, you would:

A.  Include the wrist in neutral
B.  Include the wrist in flexion
C.  Include the wrist in extension
D.  Not have to include the wrist at all
A

D. Not have to include the wrist at all

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36
Q

After damage to the flexor pulley system, the following could occur:

A. Increased tendon excursion/gliding
B. Decreased moment arms of finger flexors
C. Increased finger flexion range of motion
D. None of the above

A

D. None of the above

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37
Q

Ulnar deviation deformity of the MP joints of the fingers can involve which of the following tissue:

A. Sagittal bands
B. Radial collateral ligaments of the MCP joints
C. Extrinsic wrist ligaments
D. All of the above

A

D. All of the above

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38
Q

Your patient has full passive flexion of the digits but no active motion at all. The causes could include:

A.  Tightness of extrinsic extensors
B.  Weakness of extrinsic extensors
C.  MP/IP joint stiffness
D.  Paralysis of extrinsic flexors
A

D. Paralysis of extrinsic flexors

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39
Q

Which of the following would favor successful development of a functional tenodesis grasp:

A. Overstretched finger flexors
B. Strong wrist flexion
C. Increased passive tension in finger flexors
D. None of the above

A

C. Increased passive tension in finger flexors

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40
Q

The inability to extend the MP joints of the fingers could be due to all of the following, EXCEPT:

A. Tightness in extrinsic flexors
B. Weakness of extrinsic flexors
C. Rupture of the sagittal bands
D. Paralysis of the extrinsic extensors

A

B. Weakness of extrinsic flexors

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41
Q

The lumbrical muscles would be at their SHORTEST length in which of the following positions:

A.  MP flexion; IP flexion
B.  MP flexion; IP extension
C.  MP extension; IP flexion
D.  MP extension; IP extension
A

B. MP flexion; IP extension

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42
Q

All of the following positions could be assumed by independent action of either the intrinsics OR extrinsics, EXCEPT:

A.  MP flexion; IP extension
B.  MP flexion; IP flexion
C.  MP extension; IP extension
D.  MP extension; IP flexion
A

C. MP extension; IP extension

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43
Q

Your patient’s PIP joints cannot be extended beyond 40 degrees of flexion with the wrist and MCP joints EXTENDED. HOWEVER, the PIP joints can be fully extended when the wrist and MCP joints are FLEXED. The likely cause of this is:

A.  Extrinsic extensor tightness
B.  Volar plate tightness
C.  Extrinsic flexor tightness
D.  Lumbrical/interossei tightness
A

C. Extrinsic flexor tightness

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44
Q

Your patient has significantly limited MP flexion due to collateral ligament contracture after being immobilized incorrectly in a cast. The likely reason for the contracture is that the MP joints were in _____________ in the cast:

A. Flexion
    B. Extension
    C. Abduction
    D. Adduction
A

B. Extension

45
Q

Activation of the extrinsic hand muscles causes MP ______ and IP ______:

A.  flexion; flexion
B.  extension; extension
C.  flexion;  extension
D.  extension;  flexion
A

D. extension; flexion

46
Q

Activation of the intrinsic hand muscles causes MP ______ and IP ______:

A.  flexion; flexion
B.  extension; extension
C.  flexion;  extension
D.  extension;  flexion
A

C. flexion; extension

47
Q

Your patient lacerated a tendon over the dorsum of the PIP joint. The PIP joint would rest in ________ because of the imbalance caused by the laceration of the __________.

A.  Extension; central slip
B.  Flexion; terminal tendon
C.  Flexion; central slip
D. Extension; terminal tendon
A

C. Flexion; central slip

48
Q

Your patient has 60 degrees of total arm elevation but only 20-30 degrees of glenohumeral rotation. What’s the problem?

A

Rotator cuff tear

49
Q

The patient has a rupture of the subscapularis on the right side. Why can’t he press into his belly and keep his right elbow out to the side?

A

Rupture means not abduction or lateral rotation of the subscapularis

50
Q

your patient has full passive ER with the arm at the side bit and is unable to produce any active ER. What is the source of this limitation?

A

infraspinatus torn/ ruptured (infraspinatus and teres minor are primary external rotators

51
Q

The final position of the scapula, when the shoulder is in full forward elevation, is?

A

upward rotation, elevation, external rotation, retraction, and posterior tilt

52
Q

How many places does the upper extremity articulate with the axial skeleton?

A

1
articulates at the sternoclavicular joint

53
Q

What group of muscles is perfectly suited to provide direct compression of the humeral head into the glenoid regardless of the position of the GH joint?

A

Rotator cuff muscles

54
Q

superior glenohumeral ligament limits ____ translation with the shoulder in adduction and external rotation

A

anterior

55
Q

The middle glenohumeral ligament limits anterior translation of the humeral head when the shoulder is ____ to 45 degrees and _____rotated

A

aBducted and externally rotated

56
Q

What three parts make up the inferior glenohumeral ligament complex (IGHLC)?

A

Anterior band, axillary pouch and posterior band

57
Q

What is the primary function of the anterior band of the IGHLC?

A

restrain anterior and inferior translation of the humeral head with the arm in 9o degrees of abduction and external rotation

58
Q

Contracture of the axillary pouch limits aBduction.
A. true
B. false

A

True

59
Q

A contracture of the rotator interval would result in loss of motion in which direction?

A

loss of external rotation with the arm at the side

60
Q

What group of muscles is perfectly suited to provide direct compression of the humeral head into the glenoid regardless of the position of the GH joint?

A

rotator cuff muscles

61
Q

True or false

Glenohumeral and Scapulothoracic motion occurs at a 2:1 ratio. Ex. If a person can rotate their arm 180 degrees 2/3rds is GH and 1/3rd is scapulothoracic motion.

A

True

62
Q

The final position of the scapula, when the shoulder is in full forward elevation, is?
(list five positions)

A

upward rotation, elevation, external rotation, retraction, and posterior tilt

63
Q

What are the periscapular muscles?

A

trapezius, levator scapula, rhomboids, serratus anterior and pectoralis minor

64
Q

Which muscles elevate the scapula?

A

Upper traps., levator scapula, rhomboid minor and major

65
Q

Which muscles depress the scapula?

A

lower traps, latissimus dorsi, and pectoralis minor

66
Q

Upward rotation of the scapula is a force couple of which two muscles?

A

Serratus anterior and trapezius

67
Q

Which of the following is most important in providing dynamic superior glenohumeral joint stability?
a. infraspinatus
b. subscapularis
c. supraspinatus
d. teres major

A

C. supraspinatus

68
Q

Which of the following is most important in providing dynamic anterior glenohumeral joint stability?
a. infraspinatus
b. subscapularis
c. supraspinatus
d. teres major

A

b. subscapularis

69
Q

Your patient has 60 degrees of total arm elevation but only 20-30 degrees of glenohumeral rotation. What’s the problem?

A

Rotator cuff tear

70
Q

Thinking of the Deltoid-RTC relationship,
Acting on its own( without the RTC) the deltoids pull will result in translation in what direction?
a. superior
b. inferior
c. anterior

A

a. superior

71
Q

Your patient has full passive external rotation (ER) with the arm at the side bit and is unable to produce any active ER. What is the source of the limitation?

A

infraspinatus torn/ ruptured

72
Q

Which muscles are the primary external rotators?

A

infraspinatus and teres minor

73
Q

Contracture of the dorsal radial carpal ligament results in a loss of flexion in the wrist
True
False

A

true

74
Q

Contracture of the volar radial carpal ligament results in a loss of wrist extension.
true
false

A

true

75
Q

The fiber direction of interosseous membrane allows force to be transferred from radius to ulna to shift load through humeroulnar joint.

True
False

A

true

76
Q

Muscles that have distal attachments on radius have the potential to flex, extend, pronate, and supinate.

true
false

A

true

77
Q

Maximal grip strength usually occurs at ____ degrees of wrist extension?

a. 15-20 degrees
b. 30-35 degrees
c. 40-45 degrees

A

b. 30-35

78
Q

During gripping which two flexors generate a significant flexion torque that counteracts the activation of wrist extensors

A

FDS/FDP

79
Q

Patients with radial nerve palsy, have damage to the radial nerve and experience wrist drop.

true
false

A

true

80
Q

Mallet finger, refers to the patient’s inability to extend the DIP joint from a flexed position
True
False

A

True

81
Q

Lumbricals are maximally lengthened in
______ position.
a. intrinsic plus
b. Intrinsic minus

A

b. intrinsic minus

MP joints extended and pip/dip flexed

82
Q

Lumbricals are maximally shortened in
______ position.

a. intrinsic plus
b. Intrinsic minus

A

a. intrinsic plus

MP joints flexed pip/dip extended

83
Q

Palmar interossei function is
a. abduciton
b. adduction

A

b. adduction

P.A.D.

84
Q

The function of the dorsal interossei is
a. abduction
b. adduction

A

a. abduction

D.A.B

85
Q

The radial head provides resistance to _______stress, if removed the elbow develops significant deformity
a. varus
b. valgus

A

b. valgus

86
Q

What muscle allows us to put our arm behind our back?

A

Subscapularis

87
Q

What is the primary stabilizer of the distal ulnar radial joint?

A

TFCC

88
Q

If PROM is ____ then AROM there is a problem with muscle-tendon unit.
a. greater
b. less
c. the same as

A

a. greater

89
Q

true or false - If PROM and AROM are roughly the same this means stiffness is the primary problem.

A

true

90
Q

How many joints does the bicep brachii cross?

a. 1
b. 2
c. 3

A

c. 3

(proximal radial ulnar, elbow, shoulder)

91
Q

Loss of wrist extensor muscle function would result in _____ grip strength.
a. decreased
b. increased
c. the same

A

a. decreased

92
Q

What position should you immobilize the MP joints in?
a. extension
b. flexion

A

b. flexion

93
Q

Injury to the flexor pulley system can lead to?

A

bowstringing

94
Q

MCP joints in digits II-V are __ in flexion and ___ in extension.
a. taut, slack
b. slack, taut

A

a. taut, slack

95
Q

The sole extrinsic flexor of DIP joints is the?

A

Flexor digitorum profundus FDP

96
Q

The sole extrinsic flexor of the IP joints of the thumb is?

A

Flexor pollicus longus FPL

97
Q

extrinsic extensors of EDC, EIP, and EDM insert into the sagittal bands. Their primary action is ______ of the MP joint
a. extension
b. flexion

A

a. extension

Additional role of sagittal bands is to
stabilize/centralize extensor tendons
over the MP joint

98
Q

Loss of _____muscle function due to median and ulnar nerve injury results in the deformity commonly referred to as “ape hand”

a. extrinsic
b. intrinsic

A

b. intrinsic

99
Q

The primary responsibility of the thenar muscles is to
position the thumb in varying
amounts of _____?
a. opposition
b. flexion
c. extension

A

a. opposition

100
Q

Primary function of the hypothenar muscles is to “cup” the _____border of the
hand in order to deepen the concavity of the palm.

a. radial
b. ulnar

A

b. ulnar

101
Q

Loss of function due to an ulnar nerve lesion in what muscle results in a drastic decrease in pinch strength?

a. adductor pollicis
b. lumbricals
c. extensor pollicis brevis

A

a. adductor pollicis

102
Q

Radial collateral ligament is ___ during ulnar deviation.
a. taut
b. loose

A

taut

103
Q

ECRL and FCR function synergistically to perform ______ deviation while simultaneously acting as antagonists by opposing each other extension/flexion potential

a. ulnar
b. radial

A

radial

104
Q

Primary ulnar deviators are the
___ and _____

A

Flexor carpi ulnaris and extensor carpi ulnaris

105
Q

Due to the normal valgus angle of the
elbow, a fall on an outstretched
arm results in significant stress
on the _____often resulting in
rupture

a. medial collateral ligament
b. lateral collateral ligament

A

Medial collateral ligament

106
Q

Lateral collateral ligament provides ____ stability to the elbow

a. varus
b. valgus

A

a. varus

107
Q

During axial loading, contact
between the radial head and
capitulum provides an important
bony resistance against _____
force.

a. valgus
b. varus

A

a. valgus

108
Q

Three muscles involved in strong power grip are

A

Flexor digitorum profundus, interossei, extensor carpi radialis brevis

Kinesiology (1 decks)

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