Upper Extremity

Question 1

ribs […] are true ribs, meaning that they […]

ribs […] are false ribs, meaning thaty they […]

ribs […] are floating ribs, meaning that they […]

Answer 1

• 1-7, connects directly to the sternum
• 8-10, connect indirectly to the sternum (via cc of rib 7)
• 11-12, do not connect to the sternum at all

Question 2

which ribs are “typical” ribs”?

what does this mean?

Answer 2

3-10

contain one of each of the following landmarks: head, neck, tubercle, angle, shaft

Question 3

which ribs are “atypical”?

what makes each rib atypical?

Answer 3

• 1 - no rib angle
• 2 - has 2 tubercles (an extra tubercle)
• 11, 12 - no tubercle, no neck

all atypical have a 1 and/or 2

Question 4

all ribs move […] during inhalation and […] during exhalation

Answer 4

superior, inferior

Question 5

ribs […] have pump handle motion mechanics, meaning that […]

Answer 5

ribs 1-5

their anterior portion moves superiorly during inhalation & inferiorly during exhalation, while the posterior portion remains stable

Question 6

ribs […] have bucket handle motion, meaning that […]

Answer 6

6-10

their anterior & posterior portions remain stead, but medial portion swings up and down

Question 7

ribs […] have caliper motion, meaning that […]

Answer 7

11-12

they move laterally during respiration, except for the posterior portion which remains fixed

Question 8

primary respiratory muscles are used during […] and include the […]

Answer 8

relaxed respiration

diaphragm, intercostals

Question 9

secondary respiratory muscles are used during […] and include the […]

Answer 9

times when pt needs more air - exercise, sports

latissimus dorsi, serratus anterior, pectoralis minor, scalenes

Question 10

exhalation dysfunction of rib 1 can be treated with ME to the […]

Answer 10

anterior scalene, middle scalene

Question 11

exhalation dysfunction of rib […] can be treated with ME to the posterior scalene

Answer 11

posterior scalene

Question 12

exhalation dysfunction of rib […] can be treated with ME to the pec minor

Answer 12

3-5

Question 13

exhalation dysfunction of rib […] can be treated with ME to the serratus anterior

Answer 13

6-8

Question 14

exhalation dysfunction of rib […] can be treated with ME to the latissmus dorsi

Answer 14

9-10

Question 15

inhalation dysfunctions should be treated with […] and exhalation dysfunctions should be treated with […]

Answer 15

direct pressure to the rib

ME to secondary muscles of respiration

Question 16

for a group of inhaled ribs, treat the […] rib first, and for a group of exhaled ribs, treat the […] rib first

Answer 16

bottom

top

BITE - bottom inhaled, top exhaled

Question 17

what four muscles comprise the rotator cuff?

Answer 17

• supraspinatous
• infraspinatous
• teres minor
• subscapularis

Question 18

supraspinatous

• location
• innervation
• action

Answer 18

• posterior scapula, superior to scapular spine
• suprascapular nerve (C5 - C6)
• aBduction

Question 19

infraspinatous

• location
• innervation
• action

Answer 19

• posterior scapula, inferior to scapular spine
• suprascapular nerve (C5-C6)
• EXternal rotation

Question 20

teres minor

• location
• innervation
• action

Answer 20

• posterior scapula, inferior to teres minor
• axillary nerve (C5-C6)
• EXternal rotation

Question 21

what rotator cuff muscles are on the posterior scapula and what origin / insertion do they all share?

Answer 21

supraspinatous, infraspinatous, teres minor

medial border of scapula → greater tubercle of humerus

Question 22

subscapularis

• location
• innervation
• action

Answer 22

• anterior scapula
• C5, C6, C7
• INternal rotation

Question 23

posterior rotator cuff muscle tenderpoints - counterstrain position

Answer 23

supraspinatous, infraspinatous, teres minor

• ABduction
• EXternal rotation
• Flexion

(their collective actions)

Question 24

subscapularis tenderpoint - counterstrain position

Answer 24

internal rotation + extension

Question 25

cubitus valgus * has a carrying angle of [...] * distal ulna is [adducted / abducted] * wrist is [adducted / abducted]

Answer 25

* \> 15 degrees * distal ulna abducted * wrist adducted

Question 26

cubitus varus * has a carrying angle of [...] * distal ulna is [adducted / abducted] * wrist is [adducted / abducted]

Answer 26

* \< 3 degrees * distal ulna adducted * wrist abducted

Question 27

when the forearm is supinated, the radial head is [anterior / posterior] and when the forearm is pronated, the radial head is [anterior / posterior]

Answer 27

anterior posterior

Question 28

if a patient falls backwards, they will catch themselves with a [...] arm, leading to a [...] radial head

Answer 28

supinated anterior

Question 29

if a patient falls forward, they will catch themselves with a [...] arm, leading to a [...] radial head

Answer 29

pronated posterior

Question 30

long head of the biceps tenderpoint - counterstrain position

Answer 30

flex + IR + ABduct "fire signs have abs"

Question 31

medial epicondyle tenderpoint - counterstrain position

Answer 31

* flex * pronate * adduct ## Footnote *opposite of lateral epicondyle*

Question 32

lateral epicondyle tenderpoint - counterstrain position

Answer 32

* extend * supinate * abduct *opposite of medial epicondyle\**