COMLEX 2: OMM (COMBANK) EXAM
QUESTIONS AND ANSWERS
CC: R shoulder pain
volleyball player
full passive ROM
weakness in right arm flexion
loss of stabilization - Correct Answers -serratus anterior
winged scapula
*long thoracic nerve*
acute or recurrent trauma in sporting events
tests: PE and *EMG*
long thoracic nerve injury: what tests? - Correct Answers -physical exam: pt pushes
against wall and abduct arms over head
*EMG (electromyography)*
long thoracic nerve injury: treatment? - Correct Answers -most atraumatic lesions
spontaneously recover
brace scapula to rib cage: alleviates pain, stabilizes shoulder, protects from
overstretching of serratus anterior
avoid heavy lifting
last resort: surgical stabilization
primary mechanism of long thoracic nerve injury - Correct Answers -acute or recurrent
trauma during sporting events
,surgical neck of humerus fracture: nerve? - Correct Answers -axillary nerve
axillary nerve injury associated with? - Correct Answers -surgical neck of humerus fx
dislocated shoulder
axillary nerve injury results in paralysis of what muscle? - Correct Answers -deltoid
median nerve palsy: high vs low - Correct Answers -high palsy: lesions at elbow and
forearm
low palsy: lesions at wrist
median nerve receives fibers from what roots? - Correct Answers -C6-T1, sometimes
C5
branch of medial and lateral cords of brachial plexus
sternocleidomastoid function - Correct Answers -tilts and rotates head
trapezius muscle function - Correct Answers -shoulder elevation
adduction of scapula
lateral winging of scapula - Correct Answers -trapezius paralysis (spinal accessory
nerve)
long thoracic nerve: nerve roots? - Correct Answers -C5-C7
serratus anterior function - Correct Answers -holds scapula to chest wall
prevents inferior angle of scapula from migrating medially
C5-C6 nerve roots supply what muscles? - Correct Answers -arm and shoulder girdle
levator scapulae nerve roots - Correct Answers -C3-C5
C6-C8 nerve roots supply what muscles? - Correct Answers -arm, forearm, and
*latissimus dorsi*
C7-T1 nerve roots supply what muscles? - Correct Answers -forearm and hand
CC: L elbow pain
tenderness and edema over left *medial* epicondyle
, clawed hand - Correct Answers -ulnar nerve damage
claw hand - Correct Answers -4th and 5th digits:
- flexed PIP and DIP
- MCP extension
can be seen in ulnar n injury
ulnar nerve: nerve roots? actions? - Correct Answers -C8-T1
abduction/adduction of fingers
*thumb adduction (adductor pollicis muscle)*
arm abduction nerves - Correct Answers -up to 90 degrees:
- supraspinatus (suprascapular n.)
- deltoid (axillary n)
above 90 degrees:
- upper trapezius (CN XI)
- serratus anterior (long thoracic n.)
loss of arm abduction beyond 90 degrees seen in what injuries? - Correct Answers -
shoulder dislocations
axillary nerve injury of supraspinatus tears
forearm pronation: muscles and nerves? - Correct Answers -pronator teres
pronator quadratus
*median* n for both muscles
forearm supination: muscles and nerves? - Correct Answers -biceps brachii -
musculocutaneous n
supinator - posterior interosseus division of radial n
loss of wrist extension (wrist drop): nerve? what kind of fracture? where does it course?
- Correct Answers -radial nerve
*midshaft* humerus fraction
courses through radial groove with the deep artery of the arm
QUESTIONS AND ANSWERS
CC: R shoulder pain
volleyball player
full passive ROM
weakness in right arm flexion
loss of stabilization - Correct Answers -serratus anterior
winged scapula
*long thoracic nerve*
acute or recurrent trauma in sporting events
tests: PE and *EMG*
long thoracic nerve injury: what tests? - Correct Answers -physical exam: pt pushes
against wall and abduct arms over head
*EMG (electromyography)*
long thoracic nerve injury: treatment? - Correct Answers -most atraumatic lesions
spontaneously recover
brace scapula to rib cage: alleviates pain, stabilizes shoulder, protects from
overstretching of serratus anterior
avoid heavy lifting
last resort: surgical stabilization
primary mechanism of long thoracic nerve injury - Correct Answers -acute or recurrent
trauma during sporting events
,surgical neck of humerus fracture: nerve? - Correct Answers -axillary nerve
axillary nerve injury associated with? - Correct Answers -surgical neck of humerus fx
dislocated shoulder
axillary nerve injury results in paralysis of what muscle? - Correct Answers -deltoid
median nerve palsy: high vs low - Correct Answers -high palsy: lesions at elbow and
forearm
low palsy: lesions at wrist
median nerve receives fibers from what roots? - Correct Answers -C6-T1, sometimes
C5
branch of medial and lateral cords of brachial plexus
sternocleidomastoid function - Correct Answers -tilts and rotates head
trapezius muscle function - Correct Answers -shoulder elevation
adduction of scapula
lateral winging of scapula - Correct Answers -trapezius paralysis (spinal accessory
nerve)
long thoracic nerve: nerve roots? - Correct Answers -C5-C7
serratus anterior function - Correct Answers -holds scapula to chest wall
prevents inferior angle of scapula from migrating medially
C5-C6 nerve roots supply what muscles? - Correct Answers -arm and shoulder girdle
levator scapulae nerve roots - Correct Answers -C3-C5
C6-C8 nerve roots supply what muscles? - Correct Answers -arm, forearm, and
*latissimus dorsi*
C7-T1 nerve roots supply what muscles? - Correct Answers -forearm and hand
CC: L elbow pain
tenderness and edema over left *medial* epicondyle
, clawed hand - Correct Answers -ulnar nerve damage
claw hand - Correct Answers -4th and 5th digits:
- flexed PIP and DIP
- MCP extension
can be seen in ulnar n injury
ulnar nerve: nerve roots? actions? - Correct Answers -C8-T1
abduction/adduction of fingers
*thumb adduction (adductor pollicis muscle)*
arm abduction nerves - Correct Answers -up to 90 degrees:
- supraspinatus (suprascapular n.)
- deltoid (axillary n)
above 90 degrees:
- upper trapezius (CN XI)
- serratus anterior (long thoracic n.)
loss of arm abduction beyond 90 degrees seen in what injuries? - Correct Answers -
shoulder dislocations
axillary nerve injury of supraspinatus tears
forearm pronation: muscles and nerves? - Correct Answers -pronator teres
pronator quadratus
*median* n for both muscles
forearm supination: muscles and nerves? - Correct Answers -biceps brachii -
musculocutaneous n
supinator - posterior interosseus division of radial n
loss of wrist extension (wrist drop): nerve? what kind of fracture? where does it course?
- Correct Answers -radial nerve
*midshaft* humerus fraction
courses through radial groove with the deep artery of the arm
