Quiz # 9-10: Shoulder Girdle and Joint

The pectoralis major, latissimus dorsi, and teres major have which of the following shoulder motions in common?

Adduction

Your next client has shoulder pain and loss of motion due to inflammation and fibrosis of the shoulder joint. The most likely diagnosis from this information is which of the following?

Adhesive capsulitis

Pectoralis minor is enclosed by the:

Clavipectoral fascia

You are asked to palpate for tenderness at the coracoid process of the scapula. If you locate tenderness at this spot, the patient may have soft tissue inflammation at the origin of which of the following muscles?

Coracobrachialis

Pectoralis minor insertion:

Coracoid process

Pectoralis minor action:

Draw the scapula anteriorly and inferiorly against the thoracic wall, stabilizes the scapula

Supraspinatus tear tests:

Drop arm Full can Empty can -Can't slowly adduct arm

The subacromial bursa separates the superior surface of the supraspinatus tendon from the acromion, the coracoid, and the coraco-acromial ligament and the deltoid muscle which lie above. The bursa is important in providing _________of the supraspinatus tendon.

Fluid motion

Impingement syndrome Neer test moves a patients arm

For shoulder flexion and forearm pronation

In most glenohumeral joint dislocations, the head of humerus is driven

Inferiorly and anteriorly

"Frozen Shoulder" is the result of inflammation, scarring, thickening, and shrinkage of the capsule that surrounds the joint Caused by injury to ________ Occur more frequently in patients with _________-

Joint capsule Diabetes, chronic inflammatory arthritis

Pectoralis major innervation:

Lateral and medial pectoral nerve

Pectoralis major insertion:

Lateral lip of intertuburcular groove

Serratus anterior origin:

Lateral surface of upper 8 ribs

Serratus anterior innervation:

Long thoracic nerve

Pectoralis major origin:

Medial 1/3 of clavicle, sternum

Serratus anterior action:

Scapular protraction and upward rotation

Which muscle is responsible for scapular protraction?

Serratus anterior

Winging of the scapula is caused by weakness of which shoulder girdle muscle?

Serratus anterior

Impingement syndrome: what sort of activities put someone at risk?

Serving tennis, baseball players

Pectoralis major action:

Shoulder adduction, medial rotation, and horizontal adduction

The rotator cuff muscles serve to hold the humeral head against the glenoid fossa and best serve to facilitate which arthrokinematic motion of the shoulder joint?

Spin

Horizontal abduction of the shoulder occurs in which plane?

Transverse plane

The acromioclavicular joint and the sternoclavicular joint contribute to scapular motions.

True

The axilla is a pyramidal-shaped region at the junction of the _______ and thorax

Upper extremity

When the long thoracic nerve is damaged, the medial border and inferior angle of the scapula move away from the thoracic wall, especially when the patient pushes forward against resistance, this is

Winging of the scapula

In other words, in full abduction or flexion of the arm the scapula rotates upward ___° for each ____° of movement at the glenohumeral joint

1 2

Since the humeral head is three to four times larger than the glenoid fossa, only approximately _________ of the humeral head is in contact with the glenoid fossa at any point in time.

25%

The scapular plane or scaption is approximately ____________ degrees forward of the frontal plane.

30

GH joint is most suseptible to dislocations in what rotations?

Abduction and external rotation

Shoulder separation is dislocation of the ____ joint

Acromioclavicular

The acromioclavicular joint has a weak capsule that is strengthened superiorly by the _________ ligament

Acromioclavicular

The subacromial bursa, as the name suggests, is located below the ______. In most individuals it communicates with the subdeltoid bursa to form the subacromial-subdeltoid bursa.

Acromion

A person experiencing pain on the superior lateral aspect of the scapula may have pathology involving which of the following structures?

Acromion process

Frozen shoulder is characterized by significant loss of its range of motion in

All direction

Damage to which of the following nerves could result in weakness of the deltoid muscle?

Axillary nerve

The sternoclavicular joint is so stable that the ________ usually will fracture before the SC joint will dislocate; however, if the joint should dislocate posteriorly, it may compress the trachea, esophagus, or large blood vessels of the root of the neck

Clavicle

Stability of Acromioclavicular joint is a function of the _______ ligaments

Coracoclavicular

The acromioclavicular joint may be dislocated (shoulder separation) with rupture of the _______ ligament, usually by a fall onto the point of the shoulder

Coracoclavicular

An example of a muscle group that forms a force couple is which of the following? A. Serratus anterior and pectoralis minor B. Rhomboids, upper trapezius, levator scapula C. Upper trapezius, lower trapezius, levator scapula D. Levator scapula, rhomboids, pectoralis minor

D. Levator scapula, rhomboids, pectoralis minor

Result of impingement syndrome:

Degenerative tendonitis and/or bursitis

The posterior deltoid, latissimus dorsi, and teres major have which of the following shoulder motions in common?

Extension

When a convex joint surface rolls on a concave joint surface, the roll must be accompanied by a ______ movement or the joint will dislocate; the rotator cuff muscles mainly perform this function at the ______ joint

Gliding Glenohumeral

The reason you have your client laterally rotate his shoulder when moving between 90 - 180 degrees of shoulder abduction is to prevent what structure from hitting the acromion process?

Greater tubercle

Functions of the rotator cuff muscles: Compress and depress the _______ within the glenoid fossa, to prevent it from spinning, sliding and rolling off the top of the _______ and striking up against the undersurface of the ______

Humeral head Glenoid fossa Acromion process

Impingement syndrome Hawkins-Kennedy test has a patient put their arm flexed in 90 degrees and the examiner

Internally rotates the patients arm

Which muscle originates from the spinous processes of T4-T12 and inserts at the base of the scapular spine?

Lower trapezious

Pectoralis minor innervation:

Medial pectoral nerve

The latissimus dorsi, subscapularis, and the anterior deltoid have which of the following shoulder motions in common?

Medial rotation

A client who needs scapular depressor strengthening would need attention to which of the following muscles?

Pectoralis major and lower trapezius

Treatment of a frozen shoulder requires an aggressive combination of anti-inflammatory medication and ______ Without aggressive treatment, a frozen shoulder can be permanent

Physical therapy

Which muscle originates from the spinous processes of C7-T5 and inserts on the vertebral border of the scapula between the inferior angle and the spine of the scapula?

Rhomboids

Pectoralis minor origin:

Ribs 3-5

Sensations of painful clicking and/or popping with shoulder movement Loss of glenohumeral internal rotation range of motion Pain with overhead motions Loss of rotator cuff muscular strength and endurance Loss of scapular stabilizer muscle strength and endurance Inability to lie on the affected shoulder

SLAP lesion -Superior labrum tears from anterior or posterior

A client you needs to stretch the middle trapezius and rhomboids must position the scapula in which of the following positions?

Scapular protraction

Treatment of clavicle fractures most commonly involves resting the affected extremity with strategic use of

Slings

_________ joint Is the only point of bony union between the axial skeleton and the appendicular skeleton of the upper extremity

Sternoclavicular

After fracture of the clavicle, the _________ muscle typically elevates the medial fragment of the bone. The trapezius is unable to hold up the lateral fragment owing to the weight of the UE and thus the shoulder drops.

Sternocleidomastoid

Glenohumeral (shoulder) subluxation, a frequent complication for patients with a poststroke hemiplegia, is reported to be present in up to 81 percent of patients with hemiplegia following a

Stroke

A common painful shoulder condition arises when this bursa becomes inflamed - subacromial bursitis, which is often part of impingement syndrome where the tendons of the rotator cuff muscles become inflamed as they pass through the _________ space.

Subachromial

Which muscle originates on the anterior surface of the scapula and inserts on the lesser tubercle of the humerus?

Subscapularis

Rotator cuff muscles:

Supraspinatus Infraspinatus Teres minor Subscapularis

Impingement syndrome: what structures are at risk?

Supraspinatus Subacromial bursa Tendon of long head of bicep

The axilla transmits nerves and vessels between the ______ distally and the neck and thorax proximally

Upper extremity

The upper trapezius, serratus anterior and lower trapezius all have which of the following actions in common?

Upward rotation of scapula

Serratus anterior insertion:

Vertebral border of scapula