Shoulder Girdle

Question 1

What [4] muscles act to depress the scapulothoracic joint ?

Answer 1

• Lower trapezius
• Lattissimus Dorsi
• Pectoralis minor
• Subclavius

Question 2

What muscles act to protract the scapulothoracic joint [1]?

Answer 2

• Serratus Anterior

Question 3

What [3] muscles act to retract the scapulothoracic joint?

Answer 3

• Middle trapezius
• Rhomboids
• Lower trapezius

Question 4

What [2] muscles act to upwardly rotate the scapulothoracic joint?

Answer 4

• Serratus Anterior
• Upper and Lower trapezius

Question 5

What [2] muscles act to downwardly rotate the scapulothoracic joint?

Answer 5

• Rhomboids
• Pectoralis Minor

Question 6

What [3] muscles act to elevate the scapulothoracic joint?

Answer 6

• Upper trapezius
• Levator scapulae
• Rhomboids

Question 7

Rotator cuff muscle: Supraspinatus

Answer 7

• O: Supraspinous fossa of the scapula
• I: Greater Tubercle of the humerus
• A:
  
  • Abduction at GH joint
  • Stabilization of the head of the humerus
• N: Suprascapular Nerve
  
  • C5,C6 (upper trunk)

Question 8

Rotator cuff muscle: Subscapularis

Answer 8

• O: Subscapular fossa of the scapula
• I: Lesser Tubercle of the humerus
• A: Internal Rotation at GH joint
• N: Upper and Lower fibers of the subscapular nerve
  
  • C5,C6 (posterior cord)

Question 9

Rotator cuff muscle: Teres Minor

Answer 9

• O: upper 2/3 of the lateral border of the scapula
• I: Greater Tubercle of the humerus
• A:
  
  • External Rotation at GH joint
  • Adduction of GH joint
  • Stabilization of the head of humerus
• N: Axillary Nerve
  
  • C5,C6 (posterior cord)

Question 10

Rotator cuff muscle: Infraspinatus

Answer 10

• O: Infraspinous fossa of the scapula
• I: Greater Tubercle of the humerus
• A:
  
  • External Rotation at GH joint
  • Adduction of GH joint
  • Stabilization of the head of humerus
• N: Suprascapular Nerve
  
  • C5,C6 (upper trunk)

Question 11

Teres Major

Answer 11

• O: Posterior surface of the inferior angle of the scapula
• I: Medial lip of the intertubercular sulcus
• A:
  
  • Extension at GH joint
  • Adduction of GH joint
  • Medial Rotation of GH joint
• N: Lower Subscapular
  
  • C5,C6 (posterior cord)

Question 12

Primary muscles that medially rotate the shoulder [5 according to Neumann]:

Answer 12

• Subscapularis
• Teres Major
• Lattissimus Dorsi
• Pectoralis Major
• Anterior Deltoid

Question 13

Lattissimus Dorsi

Answer 13

• O:
  
  • Inferior angle of the scapula
  • spinous processes of the last 6 thoracic vertebrae
  • last 3 or 4 ribs
  • thoracolumbar aponeurosis and posterior iliac crest
• I: Intertubercular groove of the humerus
• A:
  
  • Extension at GH joint
  • Adduction of GH joint
  • Medial Rotation of the GH joint
• N: Thoracodorsal nerve
  
  • C5,C6,C7 (posterior cord)

Question 14

Convex/Concave of the scapulothoracic joint:

Answer 14

• Convex surface: Thorax
• Concave surface: Scapula

Question 15

Convex/Concave of the acromioclavicular joint

Answer 15

• Convex surface: Clavicle (Variable)
• Concave surface: Acromion (Variable)

Question 16

Convex/Concave of the sternoclavicular joint:

Answer 16

• Longitudinal diameter in Frontal plane (superior/inferior surface)
  
  • Clavicle:Convex
  • Sternum: Concave
• Transverse diameter in Transverse plane (anterior/posterior surface)
  
  • Clavicle:Concave
  • Sternum: Convex

Question 17

According to the APTA Guide to Physical Therapist Practice, patients should be classified into diagnostic groups by:

Answer 17

• groups of impairments (preferred practice patterns)
  
  • rather than specific pathologies

Question 18

Pancoast tumor:

Answer 18

• Pain at vertebral border of scapula and/or ulnar nerve distribution

Question 19

Ulnar Nerve:

• spinal segments?
• sensory distribution?
• muscles supplied?

Answer 19

• spinal segments:
  
  • C8-T1
• sensory distribution:
  
  • skin on the ulnar side of the hand including medial side of the ring finger and entire small finger
• muscles supplied:
  
  • Flexor carpi ulnaris
  • flexor digitorum profundis
  • Dorsal interossei
  • Plamaer interossei
  • lumbricals (medial half)

Question 20

Presentation of spinal accessory nerve palsy:

Question 21

ABSOLUTE Contrindications to manual therapy [7]:

Answer 21

• Malignancy in area of treatment
• Infectious Arthritis
• Metabolic Bone Disease
• Neoplastic Disease
• Fusion or Ankylosis
• Osteomyelitis
• Fracture or Ligament Rupture

Question 22

RELATIVE Contraintications to manual therapy [5]:

Answer 22

• Excessive pain or swelling
• Arthroplasty
• Pregnancy
• Hypermobility
• Rheumatoid arthritis

Question 23

The treatment plane lies in the _______ articular surface and is ________ to the joint surface and _____________ to the line drawn between the axis and the concave surface

Answer 23

• concave
• parallel
• perpendicular

Question 24

The axis of motion always lies in the ______ articular surface.

Answer 24

• convex

Question 25

Joint compression is:

Answer 25

* The process of approximating joint surfaces together * Passive translatoric bone movement performed perpendicular to treatment plane

Question 26

Joint Traction is:

Answer 26

* The process of separating joint surfaces away from the each other * Passive translatoric bone movement performed perpendicular to treatment plane

Question 27

What classification paradigm used with traction mobilization?

Answer 27

* Kaltenborn: * Grades 1. _Grade 1_: no appreciable joint separation. * G1 represents the force necessary to remove the compressive forces acting on the joint. 2. _Grade 2_: the slack is taken up from the tissue surrounding the joint, which are then tightened. 3. _Grade 3_: additional force is applied and the soft tissues surrounding the joint are stretched; thereby, separation of the joint surfaces is achieved.

Question 28

Joint gliding:

Answer 28

* Translatory movement where the joint surfaces are passively displaced _parallel_ to the treatment plane

Question 29

What mobilization scale to use for joint glides?

Answer 29

Maitland's * Grades I-IV * Maitland's mobilization grades chiefly apply to conditions of pain and/or limited motion * Treatment mobilizations should use Maitland, assessment uses [hypo/hypermobility] scale.

Question 30

Ligamentous restraints to the SC joint:

Answer 30

* Anterior & posterior sternoclavicular ligaments * Interclavicular ligament * Costoclavicular ligament * (...also has an Articular disc)

Question 31

Supportive structures of the AC joint:

Answer 31

* Acromioclavicular ligament * Coracoacromial ligament * Coracoclavicular ligaments * Conoid & Trapezoid Lig.

Question 32

Supporting structures of the glenohumeral joint are:

Answer 32

* Anterior - superior, middle and inferior glenohumeral ligaments * Coracohumeral ligament * Joint Capsule * Glenoid labrum * Long head of biceps

Question 33

Some tasks [5] of extended scope physical therapists:

Answer 33

* Screening orthopedic referrals * Performing orthopedic assessment and managing general practitioner referrals * Requesting and interpreting radiological studies, hematology, clinical biochemistry, electrophysiology * Referring to other professionals, including for surgery * Make musculoskeletal diagnosis