Units 1-5 Test 1 Review

​Exam 1 review

units 1-5​ (through shoulder)

Multiple Choice

What 2 structures run through the spinoglenoid notch?

• Suprascapular n & suprascapula a

• Axillary n & suprascapular a

• Suprascapular n & subscapular a

• Subscapular n & subscapular a

​Suprascapular n & suprascapula a

​Spinoglenoid notch = Greater scapular notch

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Wraps around to supply Infraspinatus

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Don't get it confused with the suprascapular notch

where only the suprascapular n runs through.​

Multiple Choice

Name three things that attach to the coracoid process 

• long head of biceps brachii, coracobrachialis, pec major 

• short head of the biceps brachii, coracoclavicular lig, pec minor

• short head of the biceps brachii, coracobrachialis, pec major 

• long head of the biceps brachii, coracoclavicular lig, pec minor

​short head of the biceps brachii, coracoclavicular lig, pec minor 

​6 attachments:

• Muscles: short head of biceps brachii, coracobrachialis, pectoralis minor

• Ligaments: Coracoclavicular, coracoacromial, coracohumeral

Multiple Choice

What ligament is responsible to limiting inferior translation of the clavicles

• Costoclavicular lig

• Posterior Sternoclavicular lig

• Interclavicular lig

• Intraclavicular lig

Interclavicular lig

Multiple Choice

Your pt was playing football, when he was tackled and fell on his arm. He presents with bruising and pain in the upper arm.  Xray reveals a posterior displaced fracture of the surgical neck of the humerus, what structures are likely involved? 

• Radial artery 

• axillary artery

• Anterior and posterior circumflex arteries

• scapular circumflex artery 

​Anterior and posterior circumflex arteries

​Surgical Neck of Humerus

​

• Proximal part of humerus and the narrower shaft

• Axillary n. & Posterior Humeral circumflex a. are directly posterior to surgical neck

Multiple Choice

After a fall while figure skating a patient is diagnosed with a fracture of the superior articular facet of rib 8. What vertebra is most likely to be injured as well?

• T9

• T8

• T6

• T7

​T7

​Superior facet on the head of the rib articulates with the inferior costal facet on the body of the vertebra above

Multiple Choice

A patient comes in after injuring his left shoulder. Upon exam, his left arm appears to be slightly longer than his right at rest. He has increased external rotation of the shoulder. What ligament is likely injured?

• coracohumeral 

• coracoclavicular

• glenohumeral ligament 

• transverse humeral ligament 

​ coracohumeral 

​Broad thickening of superior capsule region

​

Attachments: lateral coracoid process to anterior aspect of greater and lesser tubercles

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Functions: Limits inferior translation of humerus due to gravity. Limits ER of GH joint

Multiple Choice

The inferior angle of the scapula is at what level?

• T6

• Rib 8

• Rib 7

• Rib 6

​Rib 7

​Superior angle - rib 2

Root of spine of scapula - T3

Inferior angle - rib 3​

Multiple Choice

A patient presents to your busy PCP clinic with weakened scapular retraction. Impingement of what n would cause this?

• Dorsal scapular (C3,4)

• Dorsal scapular (C4,5)

• Branches from ventral

  rami (C3, C4)

• Ventral rami (C3,4)

​Dorsal scapular (C4,5)

​Make sure you look at the spinal levels

Multiple Choice

A 16 year old female presents for a sports physical. She is really excited to start swim again this year. She has been practicing a lot over the summer, and notes that sometimes when she does overhead motions, like diving into the pool or practicing the butterfly stroke, she has right shoulder pain. What structure is most likely being impinged and causing her pain? 

• Subacromial bursa 

• supraspinatus burse

• deltoid nerve

• coracoacromial bursae 

​Subacromial bursa 

Multiple Choice

The intervertebral joints containing the intervertebral discs is what type of joint?

• Synchondrosis

• Syndesmosis

• Symphysis

• Ginglymus

​Symphysis

Multiple Choice

A patient presents with shoulder pain, upon examination you believe they are likely to have a rotator cuff injury, but being a stellar PA student who rocked in anatomy, you perform additional testing and find that the patient has weakness with the first 15 degrees of shoulder abduction , which muscle is most likely injured?

• infraspinatus

• subscapularis

• teres minor

• supraspinatus 

​Supraspinatus

Muscle chart movements. 

KNOW THE MUSCLES OF THE ROTATOR CUFF!!! 

Multiple Choice

Which of the following is TRUE about the joint capsule?

• The fibrous capsule is highly vascularized

• The synovial membrane is poorly innervated

• The synovial membrane is poorly vascularized

• The fibrous capsule is poorly innervated

​The synovial membrane is poorly innervated

​Fibrous capsule - highly innervated, poorly vascularized

​

Synovial membrane - poorly innervated, highly vascularized​

Multiple Choice

Your patient was in a bar fight and stabbed just below the inferior margin of teres minor and just above the superior margin of the teres major, what structures are likely injured?

• Posterior circumflex and axillary n.

• anterior and posterior circumflex a.

•  radial n and deep brachial artery.

• scapular circumflex a and v 

​scapular circumflex a and v 

​Triangular Space

• Borders:

• Medial margin of LH of triceps

• Superior margin of teres major

• Inferior margin of teres minor

• Contents:

• Scapular circumflex a. & v. 

​**know the borders of these spaces and what runs through them!

PAs in the QUAD, and triangular interVAL w/ radiAL and deep brachiAL 

Multiple Choice

What ligament resists the distraction of C1/C2?

• Apical

• Alar

• Transverse atlantal

• Tectorial membran

Multiple Choice

A fracture at the lesser tubercle of the humerus would result in weakness of what motions?

• weakness of external rotation of the humerus

• weakness of abduction of the humerus

• Weakness of internal rotation of the humerus

• weakness of adduction of the humerus 

​Weakness of internal rotation of the humerus

​Greater Tubercle: Large, lateral landmark with 3 facets for muscle attachment

• Superior facet – supraspinatus tendon

• Middle facet – infraspinatus tendon

• Inferior facet – teres minor tendon

Lesser Tubercle

• Anterior landmark; attachment for subscapularis tendon

​

​

SITS SMIL 

Multiple Choice

You get stabbed in the back lateral to the angle of the rib, after telling a friend the wrong answer to a questions that comes up on the CI exam. What nerve is most likely injured?

• Medial branch of the lateral branch of the ventral ramus

• Lateral branch of the posterior branch of the dorsal ramus

• Posterior branch of the lateral branch of the ventral ramus

• Posterior branch of the lateral branch of the dorsal ramus

​Posterior branch of the lateral branch of the ventral ramus

Multiple Choice

Which of the Longissimus muscles has partial blood supply from the Muscular branches of occipital a?

• Longissimus cervicis

• Longissimus capitus

• Longissimus thoracis

• Logissimus lumborum

​Longissimus capitus

Multiple Choice

After falling backwards in chair a patient is diagnosed with a fractured mamillary

processes. What action may be impaired?

• contralat rot

  of spine

• ipsilat rot of spine

• contralat SB

  of spine

• ipsilat SB of spine

​Contralat rot of spine

​

Mammillary process = ​Multifidus

Multiple Choice

After a shoulder injury, a patient presents with increased laxity in lateral rotation and finds his shoulder slides forward easily. What structure was likely injured? 

• Glenohumeral Ligament 

• "T" ligament 

• glenohumeral labrum 

• transverse humeral ligament 

​Glenohumeral “Z” Ligament - make sure you know both names 

​

•Intrinsic (inside capsule)

• PA: superior medial to glenoid margin

• DA: Superior portion- lesser tubercle of humerus

• Middle portion- inferior aspect of lesser tubercle

• Inferior portion- inferior aspect of the anatomical neck

​

​

• Functions: checks/resists anterior glide, lateral rotation of the GH joint

​

Multiple Choice

What artery supplies the spinal nerve roots?

• Prelaminar br

• Postlaminar br

• Radicular br

• Precentral br

​Radicular Br

Multiple Choice

You are playing darts with a friend, and you've had too much to drink. Your friend walks towards the board to grab their darts, right as you release your last one. Bullseye! you manage to impale your friend on the back of his arm. Upon further inspection, you can see that you hit him right below the inferior margin of the teres major, medial to the shaft of the humerus and lateral to the long head of the triceps brachii.  What structures did you likely hit? 

• Posterior and anterior circumflex arteries 

• radial n and deep brachial a 

• radial a. and brachial n 

• scapular circumflex a and v 

​ radial n and deep brachial a 

​

InterVAL - radiAL n. and deep brachiAL artery.​

Multiple Choice

Which of the following is NOT a border of the suboccipital triangle?

• Rectus captious posterior major

• Obliquus capitus inferior

• Splenius capitus

• Rectus captius posterior minor

​Splenius capitus

Multiple Choice

You are performing a lumbar puncture, in order to reach the CSF, you will have to travel through which to get to the appropriate space? 

•  Supraspinous lig, interspinous lig, Ligamentum flavum

• ligamentum flavum, interspinous lig, supraspinous lig.

•  ALL, PLL, ligamentum flavum

• interspinous lig, PLL, supraspinous lig. 

​ Supraspinous lig, interspinous lig, Ligamentum flavum

Multiple Choice

The suboccipital nerve innervates all of the suboccipital muscles. From which nerve root does it arise?

• C1

• C2

• C1 & C2

• C2 & C3

​C1

Multiple Choice

When taking a lumbar puncture, you will look for what anatomical landmark to be sure you are in which area? 

•  the sacral crest, L4/L5

• the iliac crest, L4/L5

• the sacral crest L3/L4

• the iliac crest L3/L4 

​ the iliac crest, L4/L5

Multiple Choice

You have a pregnant patient coming in with complaints of lower back pain, you notice an exaggerated curve to her lower spine.  What is this condition called? 

• kyphosis

•  lordosis 

• Covexosis 

• concaveosis 

​lordosis 

​Questions???

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Don't forgot to do some practice questions on Texas tech & Michigan

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