Exam 3 Upper Extremity Shoulder/clavicle

Front 1

what do these have to do with?

Glenohumeral joint
Deltoid
Trapezius
Scapula +assoc mm.
AC joint
Clavicular pain
Bicipital tendonitis
Neuropathy

Back 1

"shoulder" pain

Front 2

what is the only bony attachment of the upper extremity?

Back 2

clavicle

Front 3

what is this?
-ball and socket
-allows greatest amount of mobility
-most frequently dislocated joint in body

Back 3

glenohumeral joint

Front 4

...: forward movement away from the midline of the body. Scapula moves away from the spine. Abduction

Back 4

Protraction

Front 5

...: Backward movement toward the midline of the body. Scapula moves toward the spine. Adduction

Back 5

Retraction

Front 6

...: inferior movement of scapula

Back 6

Depression

Front 7

...: superior movement of scapula

Back 7

Elevation

Front 8

Upward Rotation: inferior angle moves ... with scapular elevation
Downward Rotation: inferior angle moves ... with depression of scapula

Back 8

laterally
medially

Front 9

... lymphatic duct- drains RUE and R side of head/neck

... lymphatic duct (... duct)- drains everything else (Lower extremities, visceral organs, pelvis, abdomen, thorax, L side of head/neck)

Back 9

right
left
thoracic

Front 10

what is this?

bony ring made of 1st thoracic vertebra, 1st ribs and manubrium

Back 10

thoracic inlet or outlet

Front 11

what is this?

-bony ring made of 1st thoracic vertebra, 1st ribs and manubrium
-space on top of 1st rib and under clavical (as far as for syndromes)

Back 11

thoracic inlet (or outlet)

Front 12

the 4 structures that pass through the thoracic outlet (inlet) are ...

Back 12

brachial plexus
subclavian artery
subclavian vein
lymphatic tissue

Front 13

what is this?

Compression of neurovascular structures at the superior aperture of the thorax

Most commonly involves lower nerve roots C8-T1 (paresthesia in ulnar n distribution)

Subclavian artery and vein involvement will lead to pallor/ischemia or edema, respectively

Back 13

thoracic outlet syndrome

Front 14

you can get ... if you block arterial flow

Back 14

ischemia

Front 15

you can get ... when you compress the nerve

Back 15

paresthesia

Front 16

Most common sites of brachial plexus injury:

-between anterior and middle scalenes

-between clavicle and first rib

-between ... m. and upper ribs

Back 16

pectoralis minor

Front 17

what kind of lesions will spasm the scalene muscles?

Back 17

C spine lesions (whiplash)

Front 18

pectoralis minor mm.

-attachments: Ribs ... to coracoid process

-Frequently ... with poor posture

Back 18

3-5
shortened

Front 19

thoracic cage:

Elevated rib 1 lesions will compress ...

Depressed rib 1 lesions will stretch ...

Ribs 3-5 lesions will involve ... mm.

Back 19

brachial plexus
anterior/middle scalene muscles
pectoralis minor

Front 20

what is this?

Contents:
-Long head of biceps tendon
-Supraspinatus mm and tendon
-Subacromial bursa

Internal rotation of humerus or depression of clavicle will compress space

Back 20

subacromial space

Front 21

Subacromial bursitis, Bicipital tenosynovitis, and Supraspinatus tendonitis can lead to ... syndrome

Back 21

anterior impingement

Front 22

What is this?

-C5-6 nerve root injury most commonly during childbirth
-Also can occur due to fall or direct blow to shoulder
-Involves suprascapular n., musculocutaneous n. axillary n.

Back 22

Erb's Palsy

other names: Erb-Duchenne Palsy, Brachial plexus palsy, shoulder dystocia

Front 23

Erb-Duchenne Palsy

-Lose ... rotation of humerus, ... and ... of forearm, abduction of shoulder: --> waiter's tip deformity

Paralysis of
-Supraspinatus
-Infraspinatus
-Teres minor
-Biceps brachii
-Brachioradialis
-Deltoid

Back 23

external
flexion
supination

Front 24

sympathetic innervation to the upper extremity arises from ...-... sympathetic chain ganglia

Back 24

T2-T8

Front 25

What is this called?

Sympathetic overactivity (unchecked by parasympathetics)
-Burning pain
-Sweating
-Edema

Can be linked to chronic injury or injury in opposite extremity

Pain sets off the sympathetic nervous system

Nerve injury will alter afferent activity

Back 25

Reflex Sympathetic Dystrophy (RSD)

Front 26

which joint has greater freedom of motion than any other joint in the body?

Back 26

glenohumeral joint

Front 27

Major stabilization of the glenohumeral joint is through ... (specifically, the ... )

Back 27

muscles
rotator cuff muscles

Front 28

what is this called?

Frozen shoulder

Inflammation of joint capsule with pain and stiffness of joint

Cause not well understood
-related to autoimmune processes
-following injury or surgery
-following immobilization

Treat with mobilization, OMT, NSAIDS, steroids

Back 28

adhesive capsulitis

Front 29

3 phases of shoulder abduction:

0-90: ...+...
-ends with greater tuberosity hitting superior margin of glenoid

90-150: ...+...
-rotate at SC and AC joints
-ends due to resistance of stretched lats and pecs

150-180: contralateral ... muscles contract
-spinal column displaced laterally

Back 29

deltoid
supraspinatus

trapezius
serratus anterior

paraspinal

Front 30

Scapula rotates ... as humerus elevates

For every 15 degrees abduction, # degrees occurs at scapula

# of abduction is due to free scapulothoracic motion; # is due to glenohumeral motion

Must have freedom of motion of clavicle, scapula, humerus

Back 30

laterally
5
1/3
2/3

Front 31

what is the most commonly fractured bone in the body?

Back 31

clavicle

Front 32

what test is this?

-Evaluates motion at glenohumeral joint
-Patient attempts to touch hands together behind back

abduction and ... rotation

adduction and ... rotation

Back 32

Apley Scratch Test

external
internal

Front 33

Winging of the scapula involves injury to the ... nerve, which innervates the ... muscle

Back 33

long thoracic
serratus anterior

Front 34

shoulder dislocation is usually an .../... dislocation

Back 34

anterior/inferior