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Upper Eval > Shoulder > Flashcards

Shoulder Flashcards

1
Q

The upper extremity’s only attachment to the axial skeleton occurs at which of the following?

A

Sternoclavicular joint (SC) joint

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2
Q

What is known as the indented superior region of the manubrium?

A

Sternal notch or jugular notch

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3
Q

The angle of inclination-the relationship between the humerous and the humeral head in the frontal plane-should normally have a range of which of the following?

A

130-150 degrees

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4
Q

Which ligament is responsible for restricting superior movement of the clavicle at the AC joint?

A

Conoid Ligament

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5
Q

What is a weak site in the GH capsule that is often torn during an anterior GH dislocation?

A

Weitbrecht’s Foramen

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6
Q

Which position would place the GH joint in its closed-pack position?

A

90 degrees abduction with external rotation

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7
Q

Injury to what nerve would be indicated by scapular winging?

A

Long Thoracic Nerve

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8
Q

A weakness of which muscle in the shoulder complex can result in scapular winging?

A

Serratus Anterior

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9
Q

Which fibers of the trapezius muscle are responsible for scapular retraction?

A

middle trapezius

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10
Q

What is the only member of the rotator cuff group that internally rotates the humerus?

A

Subscapularis

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11
Q

Which of the following describes the ratio that exists between GH elevation and upward scapular rotation?

A

2 to 1

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12
Q

What is the pain during the follow-through phase of the pitching motion commonly associated with?

A

Rotator Cuff pathology

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13
Q

What is the pain in the cocked position during the pithing motion commonly associated with?

A

Instability or impingement

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14
Q

What is the pain during the deceleration phase of the pitching motion commonly associated with?

A

SLAP lesion or biceps tendon pathology

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15
Q

Bilateral or unilateral depression of the shoulder complexes as a result of decreased upper trapezius muscle tone predisposes an athlete to which of the following?

A

Thoracic outlet syndrome

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16
Q

Injury or trauma to what nerve roots may be indicated by atrophy of the deltoid muscle group?

A

C5 and C6

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17
Q

Injury or trauma to what nerve may be indicated by atrophy of the deltoid muscle group?

A

Axillary nerve

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18
Q

The superior angle should sit at what spinous process level during observation of the vertebral borders of the scapula?

A

T2

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19
Q

The inferior angel should sit at what spinous process level during observation of the vertebral borders of the scapula?

A

T7

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20
Q

What traumatic injury to the shoulder complex would constitute a medical emergency?

A

Posterior SC joint dislocation

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21
Q

What special test evaluates for the shoulder impingement?

A

Neer’s Sign

Hawkin’s Kennedy

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22
Q

For which muscle does the coracoid precess serve as the point of insertion?

A

Pectoralis minor

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23
Q

What is the strength ration of internal to external rotators for concentric contractions for profession baseball pitchers?

A

3 to 2

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24
Q

What is the most common sit for fractures of the clavicle?

A

Junction of the convex and concave curvature of the clavicle, middle 2/3

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25
Q

What is the last growth plate in the body to close?

A

Medial clavicular epiphysis

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26
Q

What makes the SC joint different from other joints in the body?

A

It has the poorest boney stability of any joint in the body

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27
Q

What muscle internally rotates the humerus

A

Subscapularis

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28
Q

A patient that exhibits a painful arc during abduction will usually experience pain in what range

A

between 60 and 120 degrees

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29
Q

Rotator cuff muscles

A

Formed by four muscles arising off the scapula: (SITS) Supraspinatus -assists in abd & ER humerus
Infraspinatus - ER humerus & assists horizontal abd
Teres minor - same as infraspinatus but assists ext GH joint
Subscapularis - IR humerus

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30
Q

What does a positive Gerber’s lift-off test indicate

A

Tear of the subscapularis

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31
Q

If the scapula cannot achieve a posterior tilt, it is due to tightness of what muscle

A

Pectoralis minor

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32
Q

A “separated” shoulder is a common name for which injury

A

AC sprain

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33
Q

A Bankart lesion can be formed by which ligament pulling off with a portion of the labrum

A

Inferior GH ligament

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34
Q

Which two tests can be used to evaluate posterior GH instability

A

Jerk Test and posterior apprehension test

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35
Q

Tears most commonly occur in which rotator cuff muscle

A

Supraspinatus

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36
Q

What best describes the plane of the scapula

A

30 degrees into the frontal plane

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37
Q

When palpating the bicipital groove, the __________ is lateral to the groove, while the __________ is on the medial aspect of the groove.

A

Greater tubercle, lesser tubercle

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38
Q

What ligament creates the coracoacromial arch

A

Coracoaromial ligament

Helps prevent superior dislocation of GH joint

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39
Q

What is the function of the Transverse Humeral Ligament

A

To stabilize the long head of the biceps within the bicipital groove

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40
Q

What rotator cuff muscle is not a GH-joint internal rotator

A

Supraspinatus

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41
Q

What special test evaluates ROM of the upper extremity

A

Apley’s

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42
Q

Name the two bursa at the GH-joint

A

Subacromial & subscapular

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43
Q

What does Yergason’s Test assess

A

Bicipital groove tendonitis

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44
Q

This muscle is a main GH-joint extender

A

latissimus dorsi

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45
Q

What special test evaluates for a shoulder labral tear

A

O’Brian’s test

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46
Q

What special tests evaluate for a shoulder dislocation

A

Apprehension test, jobe relocation, posterior apprehension test

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47
Q

What special test evaluates for a shoulder impingement syndrome

A

Hawkins-kennedy Test

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48
Q

What is a Bankart Lesion

A

A Bankart lesion is a tear to the anterior inferior labrum where the glenohumeral ligament attaches

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49
Q

How is the relocation test conducted?

A

posteriorly directed force is applied to the humeral head with patient in abduction and ER (Apprehension Test Position). Positive result is relief of the feeling of impending dislocation

50
Q

How is the apprehension test conducted?

A

examiner applies anteriorly directed force to the humeral head with the shoulder in abdcution and ER. Positive result is the patient feeling that the shoulder is going to dislocate

51
Q

Bony Bankart Lesion

A

Fracture of the inferior glenoid rim

52
Q

What is a Hills-Sachs Lesion

A

Impression fracture at the humeral articular surface

53
Q

Bankart Lesions signs and symptoms

A

Clicking, popping, sense of instability, repeat dislocation, achiness

54
Q

What is the most common mechanism of injury to the shoulder?

A

Acute anterior dislocation

55
Q

What does SLAP stand for?

A

Superior Labrum Anterior Posterior

56
Q

Most likely reason for case study diagnosis to be a POSSIBLE SLAP lesion?

A

Tear didn’t show on MRI

57
Q

What is the biceps anchor?

A

Where the biceps tendon attaches to the superior aspect of glenoid (Superior Genoid Tubercle).

58
Q

Coined the name SLAP lesion and established four classifications

A

Stephen Snyder

59
Q

Why has detection and accuracy in diagnosis increased in past decades?

A

Advances in imaging

60
Q

How many types of tears are there?

A

7

61
Q

Type one tear is…

A

fraying of superior labrum

62
Q

Type two tear is…

A

biceps tendon and superior labrum are torn from glenoid

63
Q

Type three tear is…

A

bucket-handle tear

64
Q

Type four tear is…

A

bucket-handle tear extending into biceps tendon

65
Q

Type five tear is…

A

Tear extending into inferior labrum

66
Q

Type six tear is…

A

“flap” of the superior labrum

67
Q

Type seven tear is…

A

tear that extends into the capsule

68
Q

Two types of injury onset

A

Acute and chronic

69
Q

What type of athlete gets SLAP lesions most often?

A

Baseball pitcher

70
Q

Action of latissumus dorsi

A

Depression of shoulder girdle, IR, EXT, and ADD of Humerus

71
Q

Action of Levator Scapulae

A

Elevation, downward rotation of scap, EXT and rotation of C-spin

72
Q

Action of Rhomboid Major

A

Scapular retraction and elevation, and downward rotation of scapula

73
Q

Action of Rhomboid Minor

A

Scapular retraction and elevation

74
Q

Action of Serratus Anterior

A

Upward rotation, protraction, depression, elevation, and fixation of scap to thorax

75
Q

Action of Trapezius (upper 1/3)

A

Elevation and upward rotation of scap, rotation and EXT of C-spine

76
Q

Action of Trapezius (middle 1/3)

A

Retraction of scapula and fixation of thoracic spine

77
Q

Action of Trapezius (lower 1/3)

A

Depression and retraction of scap, fixation of throracic spine

78
Q

Action of Pectoralis Major

A

Depression of shoulder girdle, ADD, horizontal ADD, flexion, and IR of Humerus

79
Q

Action of Pectoralis Minor

A

Forward (anterior) tilting

80
Q

Origin and insertion of Latissumus Dorsi

A

O: Spinous process of T6-T12, posterior iliac crest, and the lumbar vertebrae via fascia.
I: Intertubercular groove of Humerus

81
Q

Origin and insertion levator scapulae

A

O:Transverse processes of cervical vertebrae C1-C4
I:Superior medial angle of scap

82
Q

Origin and insertion rhomboid major

A

O:Spinous process of T2,T3,T4, and T5
I:Vertebral border of scapula (Lower 2/3)

83
Q

Origin and insertion rhomboid minor

A

O:Inferior portion of the ligamentum nuchae and spinous processes C70C1
I:Vertebral border of scap

84
Q

Origin and insertion serratus anterior

A

O:Anterior portion of the ribs and aponeroses of the intercostal muscles.
I:Costal surface of the:superior angle of scap, vertebral border of scap, and inferrer angle of scapus

85
Q

Origin and insertion Trapezius (upper1/3)

A

O:Occipital protuberance, superior nuchal line, upper portion of ligamentum nuchae, and spinous process of C7
I:Distal/lateral 1/3 of clavicle, acromion process, and scapular spine

86
Q

Origin and Insertion Trapezius (middle 1/3)

A

O:Lower portion of ligamentum nuchae, spinous process of the 7th cervical vertebral and T1-T5.
I:Acromion process and spine of scapula.

87
Q

Origin and Insertion Trapezius (lower 1/3)

A

O:Spinous processes and supraspinal ligaments of T8-T12.
I:Spine of the scapula

88
Q

Origin and Insertion pectoralis major

A

O:Medial 1/2 of clavicle and anterolateral portion of the sternum
I:Greater tuberosity fo the humerus (lateral lip of bicipital groove)

89
Q

Origin and Insertion pectoralis minor

A

O:Costal cartilage of ribs 6-7 and anterior portion of 3-5 ribs
I:Coracoid process of scapula

90
Q

Action of biceps Brachii

A

flexion and ABD

91
Q

Action of Coracobrachialis

A

flexion and ADD

92
Q

Action of Deltoid (anterior 1/3)

A

Flexion, ABD, horizontal ADD, and IR

93
Q

Action of Deltoid (middle 1/3)

A

ABD and flexion

94
Q

Action of Deltoid (posterior 1/3)

A

EXT, horizontal ABD, ABD, and ER

95
Q

Action of infraspinatus

A

ER, horizontal ABD, and humeral head stabilization

96
Q

Action of subscapularis

A

IR and Humeral stabilization

97
Q

Action of supraspinatus

A

ABD, ER, and humeral head stabilization

98
Q

Action of trees major

A

EXT, IR, and ADD

99
Q

Action of teres minor

A

ER and horizontal ABD

100
Q

Action of triceps brachii

A

EXT and ADD

101
Q

Origin and insertion of biceps brachii

A

O:Long Head: supraglenoid tuberosity of scap, Short head: coracoid process of scap.
I: Radial tuberosity and aponeurosis

102
Q

Origin and Insertion of coracobrachialis

A

O:Coracoid process
I:Media shaft of the humerus, adjacent tot he deltoid tuberosity

103
Q

Origin and Insertion of Deltoid (anterior)

A

O:Lateral 1/3 of clavicle
I:Deltoid tuberosity

104
Q

Origin and insertion deltoid (middle)

A

O:Acromion process
I:Deltoid tuberosity

105
Q

Origin and insertion deltoid (posterior)

A

O:Spine of scapula
I:Deltoid tuberosity

106
Q

Origin and insertion of Infraspinatus

A

O:Infraspinous fossa of scap
I:Lateral portion of the greater tuberosity of humerus and GH joint capsule

107
Q

Origin and insertion subscapularis

A

O:Anterior surface (subscapular fossa) and axillary border of the scap
I:Lesser tuberosity of the humerus and ventral portion of the GH joint capsule

108
Q

Origina and Insertion teres major

A

O:Inferior angel of scap and lower 1/3 of axillary border of the scapula
I:Medial lip of the bicipital groove

109
Q

Origin and Insertion teres minor

A

O:Lateral upper 2/3 of axillary border of the scapula
I:Lateral aspect of the greater tuberosity

110
Q

Origin and Insertion triceps Brachii

A

O:Long head: infraglenoid tuberosity. Lateral head:lateral and posterior surface of the proximal one half of the humerus. Medial head: Distal 2/3 of medial and posterior humerus.
I:Olecranon process of ulna

111
Q

Origin and Insertion supraspinatus

A

O:Supraspinous fossa of scap
I:Medial aspect of the greater tuberosity and the GH joint capsule

112
Q

What causes bicipital groove tendinitis?

A

Irritation of the transverse humeral ligament which results in pain and GH dysfunction. It can also be caused by wear and tear, direct injury, or impingement and instability

113
Q

What is a Hill-Sachs Lesion?

A

A cortical depression in the posterior superior head of the humerus bone resulting from forceful impact of the humeral head against the anteroinferior glenoid rim when the shoulder is dislocated anteriorly

114
Q

Where is referred pain of the axillary nerve?

A

The deltoid muscle cap

115
Q

What is the function of the transverse humeral ligament?

A

It acts as a retinaculum for the biceps brachia to prevent displacement

116
Q

Name two bursae in the GH joint?

A

Subdeltoid bursa, subcoracoid bursa

117
Q

What causes a torn rotator cuff?

A

Rotator cuff tendons often become inflamed from overuse, aging, or a fall on an outstretched hand or another traumatic cause. Sports or occupations requiring repetitive overhead motion or heavy lifting can also place a significant strain on rotator cuff muscles and tendons

118
Q

Patients with chronic acromioclavicular pathology describe pain where?

A

pain is described in the upper trapezius region, especially at night

119
Q

Pain in the deceleration phase of pitching relates to what structures?

A

SLAP lesion, biceps tendon pathology

120
Q

Pain in the cocked position yield what underlying pathology?

A

Instability or impingement

121
Q

What is Sprengel’s Deformity?

A

A congenitally undescended scapular. It may occur in both or one scapula.

Upper Eval (5 decks)

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