18371646
| Question | Answer |
| Where does the clavicle fracture the easiest? | Junction of medial 2/3 and lateral 1/3. |
| Which ligamenr prevents upward displacement of humeral head? | Coracoclavicular ligament. |
| Locate the two bands of the coracoclavicular ligament. | More lateral: trapezoid band More medial: conoid band |
| Which ligament covers the superior aspect of the AC joint? | Acromioclavicular ligament. |
| Which ligamentous structures prevent the anterior translation of the humerus of the GH joint? | The 3 glenohumeral ligaments (superior, middle, inferior). |
| What does the coracohumeral ligament prevent? | Inferior translation and ER of the humeral head. |
| During the first 90 deg of shoulder abduction, how much does the clavicle elevat? | 35 - 45 deg. |
| How many degrees of backward rotation is required for full scapular upward rotation? | 45 - 50 deg |
| Which two muscles cause upward scapular rotation during arm elevation? | Trapezius and serratus anterior. |
| A wood chopper has to purposefully extend his arm and hence requires downward rotation of his scapulae. Which muscles need to be strong to help him? | 1. rhomboids 2. levator scapulae 3. pec minor |
| Muscles for scapular protraction | 1. serratus anterior 2. pec minor |
| Muscles for scapular retraction | 1. rhomboids 2. middle and lower traps |
| Muscles for elevation of scapulae. | 1. upper traps 2. levator scapulae |
| Muscles for scapular depression | 1. lats 2. pec minor |
| 'carrying angle' in women and men. | Women 20 - 25 Men 10 - 15 |
| Arthrokinematic coupling at the ulnohumeral joint during 1. elbow extension 2. elbow flexion 3. supination and pronation | 1. medial gapping 2. lateral gapping 3. lateral gliding |
| Which two structures stabilize the middle radioulnar joint? | 1. interosseous ligament (during pushing) 2. oblique cord (during pulling, resists distal displacement of the radius) |
| Muscles contributing to elbow flexion. | 1. biceps brachii 2. Brachioradialis 3. brachialis 4. flexor carpi ulnaris 5. pronator teres |
| Which muscle flexes the elbow despite elbow and shoulder positions? | Brachialis |
| When lifting weights >2lb, which muscle flexes the elbow during supination? | Biceps brachii |
| Which elbow flexor muscle stabilizes the elbow in supination/pronation during strong resistance? | Brachioradialis |
| Mian extensor of the elbow and assisting muscle. | Mainly triceps. Assisted by anconeus. |
| Which muscle provides elbow stability during pronation and supination? | 1. brachioradialis 2. anconeus |
| Which muscle assists elbow extension during push-ups? | 1. Pectoralis major 2. anterior deltoid |
| Which muscle supinates the elbow when it is flexed to 90 deg? | biceps brachii |
| Which muscle pronates the elbow during low loads? | Pronator quadratus |
| Action of the pronator teres | 1. Pronation of the elbow 2. stabilizing the elbow in flexion |
| Name the special tests for shoulder impingement. | 1. Neer's 2. Hawkins - Kennedy test 3. painful arc |
| Name the special tests for rotator cuff injury | 1. drop arm 2. ERLS 3. lift-off 4. Hornblower sign (for infraspinatus) |
| Name the special tests for shoulder instability | 1. sulcus sign 2. anterior apprehension test 3. relocation test 4. anterior drawer 5. jerk test for posterior instability |
| Tests for AC joint | 1. horizontal adduction 2. Paxino's sign |
| Special tests for labrum. | 1. crank test 2. biceps load II 3. anterior slide 4. compression rotation test 5. O'Brien's active compression test 6. Yergason's test 7. Speed's test |
| Special test for the cubital tunnel: | 1. pressure provocation test 2. elbow flexion test 3. Tinel's sign |
| Verbalize the moving valgus stress test. | ? |
| At which angle is the painful arc positive for subacromial impingement? | 60 - 120 |
| Direction of pressure during the Paxino's test. | 1. Thumb placement at posterior acromion, press anterior and superiorly. 2. Other fingers at the shaft of the clavicle, press inferiorly. |
| Which position should pain be provoked is the patient has a SLAP lesion? | When arms in 90 deg flexion and full IR. |
| Starting position of the Yergason test. Resistance and positive result. | Elbow in 90 deg flex, forearm pronated. Resist supination of forearm and ER of shoulder. Positive: 'pop out' of biceps long head tendon. Pain reproduction. |
| What is a specific test for the ulnar collateral ligament of the elbow? | Moving valgus stress test (reproduction of pain at 70 - 120 deg elbow flexion) |
| Which neuromuscular structure does the pinch grip test assess? | Anterior interosseous nerve |
| Which position should the patient hold during the elbow flexion test? | Supine, bilateral shoulder full ER and elbow actively held in maximal flexion and wrist in maximal extension. Positive is symptoms in ulnar distribution. |
| What is the capsular pattern for the GH joint? | ER limited the most, followed by abduction and internal rotation. |
| Capsular pattern for sternoclavicular joint. | Full elevation limited. Pain at extreme ROM. |
| T/F: AC joint capsular pattern is same as SC joint. | T. Both limited elevation and pain at extreme ROM. |
| Capsular pattern for humeroulnar joint. | Loss of flexion is affected the most, then extension. (Think about extension limited more by bony structures). |
| Capsular pattern for humeroradial joint. | Flexion affected more than extension |
| What is the common capsular pattern for both proximal and distal radioulnar joints? | Both pronation and supination are equally limited. |
| List the following for upper trap 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. shoulder shrug, scapular downward rotation 2. spinal accessory nerve 3. C1-4 |
| List the following for pec major and minor 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. shoulder horizontal adduction 2. Medial and lateral pectoral 3. C5-8, T1 |
| List the following for Serratus anterior 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. shoulder protraction, scapular up rotation 2. long thoracic nerve 3. C5-C7 |
| List the following for Levator scapulae 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. scapular elevation, scapular downward rotation 2. dorsal scapular nerve 3. C5 |
| List the following for rhomboids 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. scapular adduction, elevation and downward rotation 2. Dorsal scapular nerve 3. C4-5 |
| List the following for supraspinatus 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. shoulder abduction 2. suprascapular nerve 3. C4-6 |
| List the following for infraspinatus 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. shoulder ER 2. suprascapular nerve 3. C4-6 |
| List the following for lats, teres major and subscapularis 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. shoulder IR, adduction 2. subscapular and thoracodorsal nerves 3. C5-C8 |
| List the following for the deltoids 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. shoulder flexion (anterior), abduction (superior) and extension (posterior) 2. Axillary nerve 3. C5-6 |
| List the following for teres minor 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. shoulder ER 2. axillary nerve 3. C4-5 |
| List the following for bceps brachii 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. elbow flexion, forearm supination 2. musculocutaneous nerve 3. C5-6 |
| List the following for choracobrachialis 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. shoulder flexion, shoulder adduction 2. musculocutaneous nerve 3. C6-7 |
| List the following for brachialis 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. elbow flexion 2. musculocutaneous nerve 3. C5-6 |
| List the following for pronator teres and quadratus 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. forearm pronation 2. median nerve 3. C6-7 |
| List the following for brachoiradialis 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. elbow flexion 2. radial nerve 3. C5-6 |
| List the following for triceps brachii and anconeus 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. shoulder extension (triceps only), elbow extension 2. radial nerve 3. C6-8 |
| List the following for supinator 1. Action 2. Peripheral nerve 3. Cord segmentation | 1. forearm supination 2. radial nerve 3. C5-6 |
| For the apprehension relocation tests, which group has greater apprehension and which group has greater pain? | 1. traumatic group more apprehension 2. atraumatic group more pain |
| How long should the athlete avoid the apprehension position (90/90 abduction) after glenoid labrum repair? | 12 weeks. |
| Which structures are compressed if the patient has a thoracic outlet syndrome? | 1. brachial plexus 2. subclavian artery and vein 3. vagus and phrenic nerves 4. sympathetic trunk |
| Special tests for TOS? | 1. Adson's test 2. Roos test 3. Wright test 4. Costoclavicular test |
| Provide the degrees of AC separation. | |
| If a patient has positive painful arc, they should avoid ____________ during the acute stage post subacromial decompression. | shoulder elevation more than 90 deg |
| T/F: If the patient has adhesive capsulitis of the shoulder, they should have pain to palpation. | F. No palpation to pain, unless capsule is being stretched. |
| Shoulder ROM: 1. flexion 2. extension 3. abduction 4. adduction 5. ER 6. IR 7. horizontal abduction 8. horizontal adduction | 1. flexion 160 - 180 2. extension 50 - 60 3. abduction 170 - 180 4. adduction 50 - 75 5. ER 80 - 90 6. IR 60 - 100 7. horizontal abduction 130 8. horizontal adduciton 45 |
| Patient is unable to abduct arm beyond 90 deg, which peripheral nerve might be affected? | Spinal accessary nerve |
| Patient is unable to flex fully extended arm, and demonstrates scapular winging at 90 deg shoulder flexion. Which peripheral nerve might be involved? | Long thoracic nerve. |
| Patient had pain during forward shoulder flexion and is very weak with shoulder movements. Her pain increases when she turns her head towards the unaffected side. Which peripheral nerve might be affected? | Suprascapular nerve. |
| Patient is unable to adduct his arm in a neutral rotation. Which peripheral nerve might be affected? | Axillary nerve |
| If a patient has elbow contracture due to capsule tightness, which motion is restricted the most? | flexion. (capsular pattern. |
| Which conditions may case loss of elbow ROM in non-capsular pattern? | 1. loose body in the joint 2. ligamentous sprain 3. CRPS |
| Most affected tendon in tennis elbow. (lateral epicondylopathy) | extensor carpi radialis brevis tendon. |
| Movements that load the ECRB the most? | 1. repetitive wrist extension 2. strong grip with wrist extended |
| Competing DDx for lateral epicondylopathy? | 1. cervical spine conditions 2. radial nerve entrapment |
| Structures affected the most in golfer's elbow (medial epicondylopathy) | 1. pronator teres 2. flexor carpi radialis |
| Sports that are closely associated with golfer's elbow. | 1. baseball pitching 2. golf swing 3. swimming |
| Osteochondrosis of humeral capitellum occurs mostly in adolescents between ________. It is caused by repetitive compressive force between ______ and ______, resulting in osteochondral bone fragment forming loose body in the joint. | Osteochondrosis of humeral capitellum occurs mostly in adolescents between [12 - 15]. It is caused by repetitive compressive force between [head of radius] and [humeral capitellum] , resulting in osteochondral bone fragment forming loose body in the joint. |
| T/F: If a child is under 10 and has pain and crepitus in elbow joint, without any repetitive MOI, he/she is still highly possible to have osteochondrosis of humeral capitellum. | F. More likely Panner's disease. (avascular necrosis of the capitellum). |
| Which structures may cause ulnar nerve entrapment? | 1. thickened retinaculum 2. hypertrophy of flexor carpi ulnaris |
| Which structures may cause median nerve entrapment? | 1. pronator teres 2. superficial head of flexor digitorum superficialis |
| [Adhesive capsulitis CPG] (examprep pg 63): Demographics? | women 45-60 y.o. most likely. |
| [Adhesive capsulitis CPG] (examprep pg 63): Common co-morbidities? | diabetes, or thyroid disease |
| What is the strongly recommended treatment for adhesive capsulitis?[Adhesive capsulitis CPG] (examprep pg 63) | Corticosteroid injection (level I) Should combine with ROM exercises, |
| Resting position for humeroulnar joint | 70 flex, 10 supination |
| Close-packed position for humeroulnar joint | full extension and supination |
| Loose pack for humeroradial joint. | full extension and supination. |
| Close pack position for humeroradial joint. | 90 flexion and 5 supination. |
| Loose pack for proximal radioulnar joint | 70 flexion, 35 supination |
| Close pack position for proximal radioulnar joint | 5 supination |
| Loose pack for distal radioulnar joint | 10 supination |
| Close pack for distal radioulnar joint | 5 supination. |
| 2 differences between ULTT1 an 2 | 1: In ULTT1, shoulder is 110 deg abducted, while in 2 it is only 10 deg abducted. 2. in ULTT2, the shoulder is maximally externally rotated. |
| Patient comes in with severe, disabling palin in deltoid region without any relief with rest, swelling UE and painful arc from 90 - 120, no red flags. What do you suspect? | Calcific supraspinatus tendonitis |
| Following a humerus fracture, you palpated a painful mass around the brachialis muscle. What do you suspect? | Myositis ossificans. |
| Which artery is affected in Volkmann's contracture? | Brachial artery. |
| Which muscles go into contracture most often in Volkmann's contracture? | wrist flexors . |
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