UL + LL + BACK Clinical Questions

A35-year-old man is admitted to the emergency department after a severe car crash. After examining the patient the emergency medicine physician observes a winged scapula. Which of the following nerves is most likely injured? a.long thoracic b. Axillary c. Spinal accessory d. Dorsal scapular e. Thoracodorsal

A. ( innervates Serratus anterior --> protracts and upwardly rotates the scapula. Injury will lead to their scapula protrude on the back. )

What are the only structures in the body that are both mobilizing and stabilizing?

Accessory fibrocartilaginous structures

What is the only ligament that not only checks movements, but also induces it?

Coracoclavicular

What may a "winged Scapula" indicate?

Damage to the Long Thoracic Nerve (or weakness to Serratus Ant.)

What muscles cause extension of the 2nd digit?

ED, Lumbricals, PADs, DABs, EI

What type of joint allows for NO rotation?

Ellipsoidal

T/F: There are 2 muscle attachments to the olecranon of the ulna?

False, 3: Anconeus, triceps (Insertion), FCU (origin)

T/F: All superficial back muscles assist in retraction?

False, the Levator Scapula does not

T/F: The capsule of the elbow joint encloses 2 bones/1 joint, and attaches to 1 ligament?

False: 1 Capsule, 2 Joints (proximal and distal RUJ)

What seperates the 2 heads of the pronator teres?

Median Nerve

What is the "Unhook the Brassier" Muscle?

Pectoralis Minor

What are the branches of the ulnar nerve?

Superficial, Deep, Palmar, Dorsal

Of the 6 tunnels, which one(s) have muscle origins in the posterior aspect of the Radius and Ulna?

Tunnel #1, 3, 4

The articular disk of the wrist is between the ulna and the proximal row of carpal bones. Why can't the ulna directly attach to the carpal bones?

Ulna does not move during pronation & supination (wouldn't affect the carpals)

If a patient shows symptoms of the "claw hand" when they try to fully extend, they have damage to what nerve?

Ulnar nerve

Most ligaments of the SCJ check what movement?

depression

Loss of medial and lateral pectoral nerves only cause the loss of one function? What is it?

shoulder stability and upward + lateral movements

What does the lower subscapular nerve innervate?

subscapularis and teres major muscles

What kind of muscle weakness does Erb's Palsy cause?

"Tip Takers" (No arm flexion or wrist extension)

How many muscles of the posterior compartment attach directly to the bones of the digits?

1 (Extensor Digitorum)

How many muscles insert on carpal bones?

1. Flexor Carpi Ulnaris

How many nerves innervate the skin of the UE?

11: axillary, radial, musculocutaneous, medial brachial cutaneous, medial antibrachial cutaneous, median, superficial ulnar, superficial radial, palmar cutaneous, dorsal cutaneous, intercostal brachial nerve.

How many muscles attach to the Extensor Expansions?

13: PADs (3), DABs (4), Lumbricals (13), Extensor Indices, Ext. Digiti Minimi

How many muscles have superficial innervations in the UE?

2 (serratus anterior, flexor digitorum profundus)

How many ligaments are half intrinsic and half extrinsic?

2: Intervlavicular (SCJ), Coracohumeral (GHJ)

How many muscles pass through the carpal tunnel?

3 (Flexor Digitorum Profundus, Flexor Digitorum Superficialis, Flexor Pollicis Longus)

How many different types of joints are associated with the ulna?

3: Elbow (ginglymus), Distal&Prox. RUJ (Trochoid), Middle RUJ (syndesmosis) *NOTE: the ulna does not articulate with carpal bones!

How many types of joints are in the hand?

4 (Planar, Sellar, Condyloid, Synovial Ginglymus)

How many ligaments check the movement of the GHJ?

4 (Superior GHL, Mid. GHL, Inferior GHL, Coracohumeral Ligament)

How many muscles and ligaments induce/cause posterior rotation at the SCJ?

5 (Coracoclavicular Ligament, Pec. Minor, Serratus Anterior, Lower Trap., Upper Trap) *NOTE: anything that causes ABduction @ ACJ will induce Posterior Rotation @ SCJ

How many/what muscles cause acromioclavicular external rotation?

5 (Low Trap, Mid Trap, Lat Dorsi, Rhomboids, Serratus Anterior)

How many joints come together to form the hand?

6 (DIPS, PIPs, MPJs, CMCJs, Inter MC, Intercarpal

How many muscles originate from the lateral epicondyle?

6 (ECRB, ECU, ED, EDM, Anconeus, Supinator)

How many muscles make attachments to the Interosseous Membrane?

6 (FPL, FDP, EPL, EPB, APL, EI)

How many muscles attach to the borders of the scapula?

6 (Long Head Triceps, Teres Minor, Serratus Ant., Levator, Rhomboids, Teres Major)

How many nerves innervate muscles of the axillary wall?

6 (Posterior Border = Upper Subscapular, Thoracodorsal, Lower Subscapular. Anterior Border = Lateral Pectoral, Medial Pectoral. Median Border = Long Thoracic)

How many muscles in the UE have more than one head?

7: Biceps(L/S), FCU (H/U), PT (H/U), Triceps (Long, Lat, Med), FPB (Superficial/Deep), Pec. Major (Sternocostal/Clavicular), Adductor Policis (Oblique/Transverse)

What are the contents of the Deltopectoral Triangle?

7: Coracoid Process, Pe Minor, Axillary Artery/Vein, Cords of the Brachial Plexus, Lymph Nodes, Tendon of the Subscapularis

Of the muscles that attach to the scapula, how many affect the GHJ?

9 (T. Major/minor, supraspinatus, infraspinatus, subscapularis, coracobrachialis, S/L head biceps, long head triceps, and deltoid)

30. A 65-year-old man is injured when a vehicle trav- eling at a high rate of speed hits his car from behind. Radiologic examination reveals that two of his articular processes are now locked together, a condition known as "jumped facets." In which region of the spine is this injury most likely to occur? A. Cervical B. Thoracic C. Lumbar D. Lumbosacral E. Sacral

A

9. A 39-year-old man presents with severe neck pain after a whiplash injury, sustained when his car was struck from behind. Radiologic studies reveal trauma to the ligament lying on the anterior surface of the cervical vertebral bodies. Which ligament is most likely disrupted? A. Anterior longitudinal ligament B. Ligamentum flavum C. Nuchal ligament D. Posterior longitudinal ligament E. Transverse cervical ligament

A

A 12-year-old child was brought to the emergency department by his parents because he has been suffer- ing from a very high fever and severe stiffness in his back. The initial diagnosis is meningitis. The attending physician orders a lumbar puncture to confirm the diagnosis. Upon microscopic examination of the cere- brospinal fluid, hematopoietic cells are seen. Which of the following ligaments was most likely penetrated by the needle? A. Supraspinous B. Denticulate C. Anterior longitudinal D. Posterior longitudinal E. Nuchal ligament

A

A 22-year-old woman is diagnosed with Ray- naud's disease. In such a case, the patient suffers chronic vasospasm in response to cold. This can lead to arterial constriction and painful ischemia, especially in the fingers or toes. Relief from the symptoms in the hands would require surgical division of which of the following neural elements? A.Lower cervical and upper thoracic sympathetic fibers B. Lower cervical and upper thoracic ventral roots C. Lower cervical and upper thoracic dorsal roots D. Lower cervical and upper thoracic spinal nerves E. Bilateral spinal accessory nerves

A

A 27-year-old man is admitted to the emergency department after a car crash. Physical examination reveals weakness during medial rotation and adduction of the humerus. Which of the following nerves was most probably injured? A. Thoracodorsal B. Axillary C. Dorsal scapular D. Spinal accessory E. Radial

A

A young resident complains of an itch on his back that appears to be caused by an insect bite. Which nerve fibers carry the sensation of a mosquito bite on the back, just lateral to the spinous process of the T4 vertebra? A. Somatic afferent B. Somatic efferent C. Visceral afferent D. Visceral efferent E. Somatic efferent and visceral afferent

A

What muscles in the posterior forearm are innervated by the radial nerve?

Aconeus, Extensor Carpi Radialis longus, Brachioradialis

If a person lost motor capability of the intrinsic hand muscles, as well as sensory capacity in 5th digit and ulnar half of 4th digit, where is the ulnar nerve damaged?

After Guoyans' Canal

What are the borders of the deltopectoral triangle?

Anterior Deltoid, Lateral Clavicular head of Pectoralis Major, Clavicle

Latissimus Dorsi would be innervated by what type of rami/nerve?

Anterior Rami, Thoracodorsal (C6,C7,C8)

The muscles of which compartment are affected in carpal tunnel syndrome?

Anterior compartments (approximately layers 2 and 3)

Where does scaption occur (what joint) & what muscles perform this action?

At the GHJ (Anterior and middle deltoid, Supraspinatus, Pec. Major -Clavicular head, Coracobrachialis, Biceps).

A 10yr old fractures her humerus @ surgical neck. What damage should you check for & how?

Axillary Nerve Damage. Profound atrophy in Deltoid, check stars/stripes of skin

A 19-year-old man is diagnosed with a herniated disc but he has no symptoms of spinal cord injury. In the event of intervertebral disc herniation in the cervi- cal region, which of the following ligaments is in an anatomic position to protect the spinal cord from direct compression? A. Supraspinous B. Posterior longitudinal C. Anterior longitudinal D. Ligamentum flavum E. Nuchal ligament

B

A 25-year-old male racing car driver is admitted to the emergency department after a severe car crash. Radiologic studies reveal damage to the tip of the trans- verse process of the third cervical vertebra, with a significantly large pulsating hematoma. What artery is the most likely to have been damaged? A. Anterior spinal artery B. Vertebral artery C. Ascending cervical artery D. Deep cervical artery E. Posterior spinal arteries

B

A 42-year-old woman complains of pain and stiff- ness in her neck. She was injured sliding into second base headfirst during her company's softball game. Radiographs reveal no fractures of her spine. However, upon physical examination, her right shoulder is droop- ing and she has difficulty in elevating that shoulder. If you ordered an MRI, it would most likely reveal soft tissue damage involving which of the following nerves? A. Thoracodorsal nerve B. Spinal accessory nerve C. Dorsal scapular nerve D. Greater occipital nerve E. Axillary nerve

B

A 53-year-old man was in a head-on vehicle col- lision that resulted in compression of his spinal cord by the dens (odontoid process) of the axis, with result- ing quadriplegia. Which of the following ligaments was most probably torn? A. Anterior longitudinal ligament B. Transverse ligament of the atlas C. Ligamentum flavum D. Supraspinous ligament E. Nuchal ligament

B

A 64-year-old man arrived at the clinic with a painful rash and skin eruptions that are localized entirely on one side of his body, closely following the dermatome level of the spinal nerve C7. The patient was diagnosed with the a herpes zoster virus infection known as "shingles." In what structure has the virus most likely proliferated to cause the patient's current condition? A. The sympathetic chain B. The dorsal root ganglion of the C7 spinal nerve C. The lateral horn of the C7 spinal cord segment D. The posterior cutaneous branch of the dorsal primary ramus of C7 E.The ventral horn of the C7 spinal cord segment

B

A 65-year-old man complains of severe back pain and the inability to move his left lower limb. Radiologic studies demonstrate compression of nerve elements at the intervertebral foramen between vertebrae L5 and S1. Which structure is most likely responsible for this space-occupying lesion? A. Anulus fibrosus B. Nucleus pulposus C. Posterior longitudinal ligament D. Anterior longitudinal ligament E. Ligamentum flavum

B

A 68-year-old man is admitted to the hospital due to severe back pain. Radiologic examination reveals severe osteoporosis of the vertebral column, with com- pression fractures to vertebrae L4 and L5. Which of the following parts of the vertebrae are most likely to be fractured in this patient? A. Spinous process B. Vertebral bodies C. Transverse process D. Superior articular process E. Intervertebral disc

B

A 79-year-old man, a retired military veteran, presents to the outpatient clinic with an abnormal cur- vature of the vertebral column. He complains that it has become increasingly painful to walk around town. Upon physical examination, he has an abnormally increased convexity to his thoracic curvature resulting from osteoporosis. Which of the following is the most likely clinical condition of this patient's spine? A. Scoliosis B. Hyperkyphosis C. Spinal stenosis D. Lordosis E. Herniated disc

B

An 18-year-old woman passenger injured in a rollover car crash was rushed to the emergency depart- ment. After the patient is stabilized, she undergoes physical examination. She demonstrates considerable weakness in her ability to flex her neck, associated with injury to CN XI. Which of the following muscles is most probably affected by nerve trauma? A. Iliocostalis thoracis B. Sternocleidomastoid C. Rhomboid major D. Rhomboid minor E. Teres major

B

When a lumbar puncture is performed to sample cerebrospinal fluid, which of the following external landmarks is the most reliable to determine the position of the L4 vertebral spine? A. The inferior angles of the scapulae B. The highest points of the iliac crests C. The lowest pair of ribs bilaterally D. The sacral hiatus E. The posterior inferior iliac spines

B

1. A 55-year-old man with severe coughing is admitted to the hospital. Radiologic examination is consistent with tuberculosis of the right lung, with extension to the thoracic vertebral bodies of T6 and T7, producing a "gibbus deformity." Which of the following conditions is most likely also to be confirmed by radio- logic examination? A. Hyperlordosis B. Hyperkyphosis C. Scoliosis D. Spina bifida E. Osteoarthritis

B. (

A35-year-old man is admitted to the emergency department after a severe car crash. After examining the patient the emergency medicine physician observes a winged scapula. Which of the following muscles is most like injured? A. levator scapulae B. Serratus anterior C. Trapezius D.Rhomboid major and min E. Serratus posterior superior

B. ( It pulls the scapula forward and keeps the costal surface of the scapula closely opposed to the thoracic wall, preventing winging.)

If radial nerve is cut at the lateral intermuscular septum, what will be affected?

Brachioradialis (ECRL), all posterior compartment muscles (except anconeus), dorsum 1st web space (cutaneous problems) (**NOTE: Not the posterior forearm because that branch has already been split before the cut)

A 1-year-old girl is brought to the clinic for a routine checkup. The child appears normal except for a dimpling of the skin in the midline of the lumbar region with a tuft of hair growing over the dimple. What is this relatively common condition that results from incomplete embryologic development? A. Meningomyelocele B. Meningocele C. Spina bifida occulta D. Spina bifida cystica E. Rachischisis

C

A 23-year-old man was killed in a high-speed motor vehicle collision after racing his friend on a local highway. When the medical examiner arrives at the scene, it is determined that the most likely cause of death was a spinal cord injury. Upon confirmation by autopsy, the medical examiner officially reports that the patient's cause of death was a fracture of the pedicles of the axis (C2). Breaking of which of the following ligaments would be most likely implicated in this fatal injury? A.Ligamentum flavum B.Nuchal ligament C. Cruciform ligament D. Posterior longitudinal ligament E. Supraspinous ligament

C

A 28-year-old pregnant woman is admitted to the obstetrics department for delivery. In the final stages of labor, a caudal anesthetic is administered via the sacral hiatus. Into which of the following spaces in the sacral canal is the anesthetic placed? A. Vertebral canal B. Vertebral venous plexus C. Epidural space D. Subarachnoid space E. Subdural space

C

A 35-year-old man is admitted to the hospital after a severe car crash. Radiologic examination reveals an injury to the dorsal surface of the neck and a fracture of the medial border of the right scapula. During physi- cal examination, the patient presents with the scapula retracted laterally on the affected side. Which of the following nerves has most likely been injured on that side? A. Axillary B. Long thoracic C. Dorsal scapular D. Greater occipital E. Suprascapular

C

A 39-year-old woman complains of an inability to reach the top of her head to brush her hair with her right hand. History reveals that she had undergone a mastectomy procedure of her right breast 2 months earlier. Physical examination demonstrates winging of her right scapula. Which nerves were most likely damaged during surgery? A. Axillary B. Spinal accessory C. Long thoracic D. Dorsal scapular E. Thoracodorsal

C

A 42-year-old woman is diagnosed with stenosis of the cervical vertebral canal. A laminectomy of two vertebrae is performed. Which of the following liga- ments will most likely also be removed? A. Anterior longitudinal B. Denticulate C. Ligamentum flavum D. Nuchal E. Cruciate

C

A 45-year-old man is admitted to the hospital because of severe pain in the back and lower limb. Radiologic examination reveals spinal canal stenosis syndrome. Which of the following conditions is most likely to be confirmed by a magnetic resonance imaging (MRI) examination? A. Hypertrophy of supraspinous ligament B. Hypertrophy of interspinous ligament C. Hypertrophy of ligamentum flavum D. Hypertrophy of anterior longitudinal ligament E. Hypertrophy of nuchal ligament

C

In spinal anesthesia, the needle is often inserted between the spinous processes of the L4 and L5 verte- brae to ensure that the spinal cord is not injured. This level is safe because in the adult the spinal cord usually terminates at the disc between which of the following vertebral levels? A. T11 and T12 B. T12 and L1 C. L1 and L2 D. L2 and L3 E. L3 and L4

C

All of the SCJ ( sternoclavicular joint) ligaments check depression except which one?

Costoclavicular ligament

31

D

A 19-year-old man is brought to the emergency department after dislocating his shoulder while playing football. Following treatment of the dislocation, he cannot initiate abduction of his arm. An MRI of the affected shoulder shows a torn muscle. Which muscle was most likely damaged by the injury? A. Coracobrachialis B. Long head of the triceps brachii C. Pectoralis minor D. Supraspinatus E. Teres major

D

A 3-year-old boy is brought by his mother to the emergency department with severe headache, high fever, malaise, and confusion. Radiologic and physical examinations reveal that the patient suffers from men- ingitis. A lumbar puncture is ordered to confirm the diagnosis. Which vertebral level is the most appropriate location for the lumbar puncture? A. T12 to L1 B. L1 to L2 C. L2 to L3 D. L4 to L5 E. L5 to S1

D

A 69-year-old woman visits her physician due to severe neck pain. Radiologic studies reveal bony growths (osteophytes) in the intervertebral foramen between vertebrae C2 and C3. Which of the following muscles would be most likely affected by this condition? A. Rhomboideus major B. Serratus anterior C. Supraspinatus D. Diaphragm E. Latissimus dorsi

D

A35-year-old man is admitted to the emergency department after a severe car crash. After examining the patient the emergency medicine physician con-cludes that the serratus anterior muscle is damaged. Which of the following functions will the patient most likely be unable to perform? A. Retraction of the scapula B. Elevation of the scapula C.Depression of the scapula D. Protraction of the capula E. Medial rotation of scapula

D.

A 15-year-old woman was suspected of having meningitis. To obtain a sample of cerebrospinal fluid by spinal tap in the lumbar region (lumbar puncture), the tip of the needle must be placed in which of the following locations? A. In the epidural space B. Between anterior and posterior longitudinal ligaments C. Superficial to the ligamentum flavum D. Between arachnoid mater and dura mater E. In the subarachnoid space

E

A 45-year-old woman states that she has experi- enced moderate pain for 2 years over her left lower back; pain that radiates to her left lower limb. She states that after lifting a case of soft drinks, the pain suddenly became intense. She was admitted to the emergency department. Radiologic examination re- vealed intervertebral disc herniation between vertebral levels L4 and L5. Which of the following nerves was most likely affected by the disc herniation? A. L1 B. L2 C. L3 D. L4 E. L5

E

A35-year-old man is admitted to the emergency department after a severe car crash. After examining the patient the emergency medicine physician observes a winged scapula. Which of the following functions will the patient most likely be unable to perform during physical examination? A.Lateral rotation of the shoulder joint B.Abduction of the shoulder joint from 0 to 90 degrees C.Flexion of the shoulder joint D.Extension of the shoulder joint E.Abduction of the shoulder joint above 90 degrees

E.

All GH ligaments check what movements of the GHJ?

External Rotation and Hyperextension

If a patient has damage to their suprascapular nerve, which action(s) would be affected?

External Rotation, ABduction, Horiz. ABduction, Inferior Glide

What muscles originate on the anterior shaft of the ulna?

FDP, FPL, PQ

Both the Brachialis and Biceps automatically fire during normal elbow flexion?

False (Biceps requires a forceful challenge!)

T/F: If the ulnar artery is cut just proximal to Guyon's canal, then all three arches in the hand will be affected?

False (dorsal branch was sent proximally to the wrist)

T/F: When the suprascapular nerve is injured in the sphinoglenoid notch, the supraspinatus and infraspinatus will be weak?

False (it already innervated the supraspinatus before the notch)

T/F: There will be profound weakness in the MPJ flexion of 4th/5th digit if the MN is cut after the cubital tunnel?

False (still have function of Lumbricals and FDP, only FDS is lost)

T/F: Glenoid Labrum is an intrinsic ligament?

False: it is not a ligament (aha! A trick question!)

How many synovial planar joints are there in the UE?

Four: Intercarpals, Intermetacarpals, ACJ, Carpometacarpals

Of the SCJ, ACJ, and GHJ, which contains the most ligaments?

GHJ ligament ( ball in socket)

What bones articulate with the Capitate?

Hamate, Lunate, Scaphoid, Trapezoid, Metacarpals 2, 3, & 4

What are the attachments for the flexor retinaculum?

Hook of Hamate, Scaphoid tubercle, Trapezoid tubercle, Tubercle of Triquetral.

This aspect of the GHJ allows for maximal range of movement, even though it usually is a stabilizing structure:

Inferior GH ( axillary pouch)

What are the 6 things the radial nerve does as it approaches the radial groove?

Innervates triceps, anconeus, posterior arm skin, posterior forearm skin

What nerve innervates the floor of the axilla?

Intercostal Brachial Nerve

What attaches to the supraglenoid tubercle

Lateral head Biceps, Superior GH Ligament, Glenoid Labrum, Joint Capsule

What are the only muscles that perform internal rotation at the GHJ?

Latissimus dorsi, Teres Major, Pectoralis major and subscapularis

Like the action of the Serratus Anterior at the SCJ, which other muscles produce the same movement at this location?

Lower Trap., Middle Trap., Rhomboids. (External Rotation at the ACJ)

What muscle allows for Abduction over 90 degrees?

Lower Trapezius (pulls the superior angle of the scapula downward)

What muscles cause Sternoclavicular joint depression?

Lower trap., Lat. Dorsi, Pec Major/Minor, Subclavius

If you have weakness in MPJ flexion, what nerves are damaged?

Median and Deep Ulnar

How many metacarpals articulate with the capitate?

Metacarpals 2, 3 , & 4

How many muscles are involved in the six tunnels of the extensor retinaculum?

Nine (Abductor Pollicis Longus/Extensor Pollicis Brevis, Extensor Carpi Radialis Longus/Extensor Carpi Radialis Brevis, Extensor Pollicis Longus, Extensor Digitorum/Extensor Indicis, Extensor Digitorum Minimi, Extensor Carpi Ulnaris)

The median nerve branches just before the carpal tunnel. If this branch is cut, what muscles and what skin will lose innervations?

No skin. Radial ½ FDP, FPL, Pronator quadrates

Which of these act on the IPJ? APB, FPB, OP, Adductor Pollicis?

None, they only act on the MPJ and CMPJ of the Thumb

Annie, a 5 year old, was playing with her bros when one pulled her arm hard. She cried but stopped when a bro attempted to find the injury by pronating and supinating her hand. What condition did she have?

Nursemaid's elbow

Once the radial nerve passes through the radial groove, where does it go?

Passes through the intermuscular septum between the lateral head of the triceps and brachialis

Which muscles could be worked in order to compensate for a weakened serratus due to peripheral neuropathy of the long thoracic nerve?

Pec Major/Minor (both do protraction, the muscle action lost)

What muscle sin the UE are innervated by 2 nerves?

Pectoralis Major, Pec. Minor, Subscapularis, FDP, FPB, Opponens Pollicis

What muscles/tendons can be palpated through the deltopectoral triangle?

Pectoralis Minor and Subscapularis

Deep palmar arch is made up of what artery (predominantly)

Radial

What are the 3 signs of Colles' Fracture?

Radial bone becomes shorter (more proximal), Wrist drifts to the radial side, "Dinner Fork" deformity

What separates the Lateral and Medial heads of the triceps?

Radial groove, Radial nerve and Profunda ( Deep) Brachial artery

What nerve surrounds the lateral and medial head of the triceps brachii?

Radial nerve

What structures travel between the lateral and medial heads of the triceps?

Radial nerve, Profundus Brachial artery, radial groove

What 7 things attach to the coricoid?

SH Biceps, Pec.Minor, Coricoclavicular Lig., Coricobrachialis, Coricoacromial Lig., Coricohumeral Lig., Tranverse Scapular ligament

Which part of a synovial joint is highly vascularized? Why?

Stratum Synovium (mobilization via synovial fluid production and filtration)

Damage to what peripheral nerve(s) would impair external rotation at the GHJ?

Suprascapular and Axillary nerves

A person complains of shoulder pain that arises while Abducting his arm at the GHJ. The pain is not there until his arm passes 90 degrees. What could be the 4 possibilities that could be causing this pain?

Supraspinatus, GHJ capsule, LH Biceps (Tendonitis), Subacromial/Deltoid Bursa

Headache from the back of the neck, up over the back of the head, is due to "strangulation" of the greater occipital nerve by what muscle?

The Trapezius (Via origin from greater occipital protuberance)

What is the profound atrophy of Median Nerve damage in the carpal tunnel? What is the Hallmark posture?

Thenar Compartment = Ape Hands (No opposable thumb? Anything but that!!!)

Which is more lateral? The Conoid Tubercle or Trapezoid Line? (Think Clavicle!)

Trapezoid line

T/F: Loss of the articular cartilage in a joint will increase its stabilization?

True

T/F: The Supraspinatus is always torn with a rotator cuff tear?

True

T/F: The supraglenoid tubercle has more attachments than the infraglenoid tubercle?

True

T/F: (#Supinators + #Pronators)/2 = # External Rotators

True (2)

T/F: If Sober Sally is diagnosed with a median neuropathy, she would experience the same location of cutaneous sensory alteration (radiating pain), regardless of the specific location of nerve damage?

True (carpal tunnel & pronator syndromes have same cutaneous alterations)

T/F: Damage to the Suprascapular Nerve will cause weakness in Abduction of GHJ?

True (supraspinatus. While Infraspinatus only creates horizontal AB)

What is the function of Listers' Tubercle?

Used as a pulley for the Ext. Pollicis Longus

Destruction of the Deep Radial nerve would leave which functions the UE intact?

Wrist Ext. and Radial Deviation (via Ext.Carpi and radial Longus), all elbow flexion (via brachioradialis)

If median nerve is cut after it passes through PT, would you experience weakness in Pronation?

Yes, the Pronator Quadratus (innervated by the Ant. Interosseous Nerve) is damaged.

A35-year-old man is admitted to the emergency department after a severe car crash. After examining the patient the emergency medicine physician con-cludes that the serratus anterior muscle is damaged. Which of the following nerves innervates the serratus anterior muscle? a.long thoracic b. Axillary c. Spinal accessory d. Dorsal scapular e. Thoracodorsal

a. ( long thoracic is the only nerve innervating serratus anterior. Axillary --> deltoid Spinal Accessory --> trapezius and SCM Dorsal scapular --> rhomboids + levator scapulae Thoracodorsal --> latissimus dorsi

T/F: The 1st MC articulates with the 2nd metacarpal creating an intermetacarpal joint?

a. False

T/F: The number of muscles which originate from the medial epicondyle equal the number of muscles which original from the lateral epicondyle?

a. False (5 from M.E., 6 from L.E.)

A35-year-old man is admitted to the emergency department after a severe car crash. After examining the patient the emergency medicine physician con-cludes that the serratus anterior muscle is damaged. Which of the following functions does the serratus anterior muscle serve? a.Adducts scapula b. Depresses ribs c. Protraction and rotation of scapula d. Elevation of scapul e. Adducts, extends and medially rotates arm

c. (Rhomboids --> adducts scapula Serratus posterior inferior --> depresses lower ribs Levator scapulae --> elevate scapula Latissimus dorsi --> adducts, extends + medially rotates arm)

What passes through the supraglenoid notch?

suprascapular artery and nerve