Deck 15: Shoulder and Upper Arm Pathologies

Question 1

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

A) 90° anterior flexion with internal rotation
B) Adduction with internal rotation
C) Adduction with external rotation
D) 90° abduction with external rotation

Answer 1

D

Question 2

Which of the following is true of the SC joint?

A) The clavicle meets directly with the manubrium.
B) It has the poorest bony stability of any major joint.
C) It has weak ligamentous structure.
D) Its fibrocartilaginous disk decreases the stability of the joint.

Answer 2

B

Question 3

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

A) Supraspinatus
B) Infraspinatus
C) Teres minor
D) Subscapularis

Answer 3

D

Question 4

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

A) Acromioclavicular (AC) joint
B) Sternoclavicular (SC) joint
C) Glenohumeral (GH) joint
D) Scapulothoracic joint

Question 5

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

A) Lateral clavicular epiphysis
B) Medial clavicular epiphysis
C) Proximal humeral epiphysis
D) Distal humeral epiphysis

Question 6

Palpation of the anterior shoulder should begin by palpating which of the following?

A) SC joint
B) Jugular notch
C) Manubrium
D) Clavicle

Question 7

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

A) Weitbrecht's foramen
B) Inferior pouch
C) Coracohumeral ligament
D) Conoid ligament

Question 8

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

A) 80° to 100°
B) 100° to 110°
C) 110° to 125°
D) 130° to 150°

Question 9

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

A) C2 and C3
B) C3 and C4
C) C5 and C6
D) C7 and C8

Question 10

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

A) T1
B) T7
C) T3
D) T12

Question 11

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

A) Junction of the convex and concave curvature of the clavicle
B) Lateral third
C) Junction of the medial third and middle third
D) Medial third

Question 12

Which of the following traumatic injuries to the shoulder complex would constitute a medical emergency?

A) Burner or stinger
B) Anterior SC joint dislocation
C) AC separation
D) Posterior SC joint dislocation

Question 13

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

A) Pectoralis major
B) Pectoralis minor
C) Anterior deltoid
D) Upper trapezius

Question 14

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

A) Rotator cuff pathology
B) Instability or impingement
C) Superior labral tear from anterior to posterior (SLAP) lesion or biceps tendon pathology
D) Limited internal rotation

Question 15

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

A) 1:2
B) 2:1
C) 2:4
D) 1:3

Question 16

A patient who exhibits a painful arc during abduction will usually experience pain in which of the following ranges?

A) Between 60° and 120°
B) Between 70° and 90°
C) Between 70° and 110°
D) Between 120° and 180°

Question 17

Weakness of which of the following muscles causes scapular winging?

A) Rhomboids
B) Trapezius
C) Serratus anterior
D) Latissimus dorsi

Question 18

Injury to what nerve would be indicated by scapular winging?

A) Axillary nerve
B) Long thoracic nerve
C) Phrenic nerve
D) Subclavian nerve

Question 19

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

A) Rotator cuff pathology
B) Instability or impingement
C) SLAP lesion or biceps tendon pathology
D) Limited internal rotation

Question 20

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

A) Upper trapezius
B) Middle trapezius
C) Lower trapezius
D) Middle deltoid

Question 21

What motion is not produced when the patient performs the portion of the Apley Scratch test where the patient touches the opposite shoulder by crossing the chest?

A) GH adduction
B) Horizontal adduction
C) Internal rotation
D) Scapular retraction

Question 22

The GH joint generally lacks bony support,but due to the ligamentous and muscular support,it is a stable joint.

Question 23

When performing GH joint play,in which position should the GH joint be placed?

A) Abducted 55° and flexed 30°
B) Abducted 90° and extended 15°
C) Abducted 55° and extended 15°
D) Abducted 90° and flexed 30°

Question 24

Scapular dyskinesis is considered a source of internal impingement.

Question 25

Which two tests can be used to evaluate posterior GH instability?

A) Posterior apprehension and surprise test
B) Jerk test and apprehension test
C) Jerk test and posterior apprehension test
D) Surprise test and sulcus test

Question 26

Which muscle is a primary mover when performing a manual muscle test for horizontal adduction of the GH joint?

A) Pectoralis major
B) Posterior deltoid
C) Infraspinatus
D) Teres minor

Question 27

Name all the muscles that have a direct action on the scapula.

Question 28

What direction of force is applied longitudinally through the humerus during the anterior slide test?

A) Anterior and superior
B) Anterior and inferior
C) Posterior and superior
D) Posterior and inferior

Question 29

Which represents the starting position for the empty can test?

A) GH abducted 90° in the frontal plane with the humerus internally rotated
B) GH abducted 90° in the frontal plane with the humerus externally rotated
C) GH abducted 90° in the scapular plane with the humerus externally rotated
D) GH abducted 90° in the scapular plane with the humerus internally rotated

Question 30

When palpating the bicipital groove,the _______ _______ is lateral to the groove,and the ________ _________ is on the medial aspect of the groove.

Question 31

Which structure is stressed when gliding the distal clavicle inferior at the AC joint?

A) Superior fibers of the AC ligament
B) Conoid ligament
C) Trapezoid ligament
D) Inferior fibers of the AC ligament

Question 32

A "separated" shoulder is a common name for which injury?

A) GH dislocation
B) AC sprain
C) SC dislocation
D) Scapulothoracic sprain

Question 33

Define the plane of the scapula.

Question 34

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

A) Anterior GH ligament
B) Middle GH ligament
C) Inferior GH ligament
D) Posterior GH ligament

Question 35

A positive Hawkins test is more indicative of pathology in which rotator cuff muscle?

A) Supraspinatus
B) Infraspinatus
C) Teres minor
D) Subscapularis

Question 36

Which represents correct information regarding Speed's test?

A) The elbow is maintained in 5° of flexion throughout the test.
B) The GH joint begins in a neutral position.
C) The forearm is stabilized just distal to the elbow.
D) The patient is asked to go through 90° of shoulder flexion during the procedure.

Question 37

The scapular retraction test is used to identify which of the following?

A) Role of scapular dysfunction in pathology
B) Presence of impingement
C) Degree of anterior GH instability
D) Strength of the rhomboid major and minor

Question 38

Tears most commonly occur in which rotator cuff muscle?

A) Supraspinatus
B) Subscapularis
C) Infraspinatus
D) Teres minor

Question 39

When performing a GH load and shift,the reliability between testers greatly improves if a two-point grading scale is used.