PTMMD Exam 2 QUESTIONS WITH
COMPLETE ANSWERS.
External impingement - ANSWER: Subacrominal impingement: Compression of supraspinatus,
infraspinatus, and/or biceps tendon
-Most common form of impingement
Internal impingement - ANSWER: Entrapment of articular side of supraspinatus or infraspinatus
tendons
-rare, seen in overhead activities
Actions of supraspinatus - ANSWER: Abduction, ER, IR
If there is no displacement or neurovascular damage then a supracondylar fracture would be: -
ANSWER: Immobilized with elbow flexed
If there is supracondylar fx with displacement then: - ANSWER: Closed reduction
If there is a supracondylar fx and there is neurovascular damage what should be done? -
ANSWER: ORIF needed
Radial head fx - ANSWER: compression of radial head in capitulum due to FOOSH
If non-displaced or minimally displaced avulsion fx of olecrandon - ANSWER: Immobilization
with elbow flexed 90 deg
What neurovascular structures could be damaged with dislocation of the elbow? - ANSWER:
Brachial artery damage and median nerve injury
Actions of infraspinatus - ANSWER: ER and extension
Supraspinatus innervation - ANSWER: Suprascapular nerve (c5, c6)
Infraspinatus innervation - ANSWER: Suprascapular nerve (c5, c6)
Test item cluster for Impingement syndrome - ANSWER: -(+) Hawkins-Kennedy test
, -(+) painful arc
-Infraspinatus MMT weakness and/or painful
Special tests for impingement syndrome - ANSWER: Neer impingement test
Hawkins Kennedy impingement
Subscapularis actions - ANSWER: IR
Subscapularis innervation - ANSWER: Upper and lower scapular nerve (c5, c6, c7)
What muscle/tendon is most often related rotator cuff pathology? - ANSWER: Supraspinatus
Test item cluster for rotator cuff pathology (tear) - ANSWER: -(+) Hawkins-Kennedy
-(+) drop-arm sign
-Infraspinatus MMT weakness and/or pain
Rotator cuff pathology special tests - ANSWER: -Empty can test
-Drop arm
-Lift off sign
The empty can test indicates what pathology? - ANSWER: Supraspinatus pathology
The lift off sing indicates what pathology? - ANSWER: Subscapularis
The drop arm sign indicates what pathology? - ANSWER: Rotator cuff rupture
Strong and painful MSTT - ANSWER: Tendon pathology
-tendinitis/tendinosis
Strong and pain free MSTT - ANSWER: No contractile dysfunction
Weak and painful MSTT - ANSWER: Partial tear
Weak and painless MSTT - ANSWER: Complete tear
Shoulder IR Arthrokinematics - ANSWER: anterior roll, posterior glide
-Tight posterior capsule --> anterior roll superior glide (impingement)
Radial nerve actions - ANSWER: Elbow extension; wrist extension and radial deviation; forearm
supination; finger and thumb extension; thumb abduction
Ulnar nerve actions - ANSWER: Finger flexion, thumb flexion, thumb adduction, pinky
opposition abduction and flexion; PAD; DAB, wrist ulnar deviation
COMPLETE ANSWERS.
External impingement - ANSWER: Subacrominal impingement: Compression of supraspinatus,
infraspinatus, and/or biceps tendon
-Most common form of impingement
Internal impingement - ANSWER: Entrapment of articular side of supraspinatus or infraspinatus
tendons
-rare, seen in overhead activities
Actions of supraspinatus - ANSWER: Abduction, ER, IR
If there is no displacement or neurovascular damage then a supracondylar fracture would be: -
ANSWER: Immobilized with elbow flexed
If there is supracondylar fx with displacement then: - ANSWER: Closed reduction
If there is a supracondylar fx and there is neurovascular damage what should be done? -
ANSWER: ORIF needed
Radial head fx - ANSWER: compression of radial head in capitulum due to FOOSH
If non-displaced or minimally displaced avulsion fx of olecrandon - ANSWER: Immobilization
with elbow flexed 90 deg
What neurovascular structures could be damaged with dislocation of the elbow? - ANSWER:
Brachial artery damage and median nerve injury
Actions of infraspinatus - ANSWER: ER and extension
Supraspinatus innervation - ANSWER: Suprascapular nerve (c5, c6)
Infraspinatus innervation - ANSWER: Suprascapular nerve (c5, c6)
Test item cluster for Impingement syndrome - ANSWER: -(+) Hawkins-Kennedy test
, -(+) painful arc
-Infraspinatus MMT weakness and/or painful
Special tests for impingement syndrome - ANSWER: Neer impingement test
Hawkins Kennedy impingement
Subscapularis actions - ANSWER: IR
Subscapularis innervation - ANSWER: Upper and lower scapular nerve (c5, c6, c7)
What muscle/tendon is most often related rotator cuff pathology? - ANSWER: Supraspinatus
Test item cluster for rotator cuff pathology (tear) - ANSWER: -(+) Hawkins-Kennedy
-(+) drop-arm sign
-Infraspinatus MMT weakness and/or pain
Rotator cuff pathology special tests - ANSWER: -Empty can test
-Drop arm
-Lift off sign
The empty can test indicates what pathology? - ANSWER: Supraspinatus pathology
The lift off sing indicates what pathology? - ANSWER: Subscapularis
The drop arm sign indicates what pathology? - ANSWER: Rotator cuff rupture
Strong and painful MSTT - ANSWER: Tendon pathology
-tendinitis/tendinosis
Strong and pain free MSTT - ANSWER: No contractile dysfunction
Weak and painful MSTT - ANSWER: Partial tear
Weak and painless MSTT - ANSWER: Complete tear
Shoulder IR Arthrokinematics - ANSWER: anterior roll, posterior glide
-Tight posterior capsule --> anterior roll superior glide (impingement)
Radial nerve actions - ANSWER: Elbow extension; wrist extension and radial deviation; forearm
supination; finger and thumb extension; thumb abduction
Ulnar nerve actions - ANSWER: Finger flexion, thumb flexion, thumb adduction, pinky
opposition abduction and flexion; PAD; DAB, wrist ulnar deviation
