Prepared by Dr Kavitha Raja JSS College of Physiotherapy Mysore

Upper extremity quiz

A 50 y/o woman presents with complaints of pain the shoulder since 3 months. She does not
remember an inciting incident. The pain is described as a dull ache more during the evening or
after working, relieved by supporting the arm. Pain is restricted to shoulder and there is no
radiation.
On observation, there is flattening of the supra and infraspinous regions of the scapula, acromion
is prominent and the lateral epicondyle of the humerus is visible in the anterior view.
1. The pain onset is of
a. Sudden onset
b. Likely traumatic in origin
c. Insidious in onset
d. Likely muscular in origin
e. b & d
f. c& d
2. The observational findings indicate the following possibilities
a. Suprascapualr nerve injury
b. Axillary nerve injury
c. a & b
d. Teres major dysfunction
e. C5,6 root avulsion
f. c or e
3. The follow up examination should consist of the following
a. Sensory assessment of the lateral arm around the deltoid tuberosity
b. Strength testing of teres minor, triceps, supraspinatus and deltoid
c. Strength testing of supraspinatus and deltoid
d. a and b
e. a and c
f. b and c
4. Specific questions you will ask this patient would be
a. Does she travel by bus over bad roads?
b. Does she play tennis?
c. Does she do a lot of housework?
d. a and b
e. a and c
f. b and c
5. Information you would like form her chart would be
a. Does she have severe degenerative changes over her cervical spine?
b. Does she have shoulder arthritis?
c. Does she have diabetes ?
d. Does she have hypertension?
e. Is she on NSAIDS?
Prepared by Dr Kavitha Raja JSS College of Physiotherapy Mysore

f. All of the above
6. While observing the patient you would pay particular attention to
a. Whether she is using alternating rotations while abducting the shoulder
b. If she is strongly flexing the elbow while flexing the shoulder
c. If extension of elbow appears sudden rather than controlled
d. a and b
e. a,b, and c
f. a and c
7. When doing a functional evaluation on this patient, you will specifically observe the
following
a. Quality of movement during lifting an object in the sagittal plane
b. Quality of movement of replacing a heavy object lifted from shoulder height to
waist level
c. Quality of movement while taking the arm behind the head without weight
d. Quality of movement while bringing both hands together
e. None of the above
f. All of the above
8. In this patient you would expect the scapula to be
a. Medially rotated
b. Laterally rotated
c. Normal
d. Any of the above
e. None of the above
f. Winged
9. On observation you would not be surprised to find the following
a. Asymmetrical axillary creases
b. Erythema/ scar near the deltoid tuberosity
c. Dry skin along the upper arm
d. Redness of the elbow
e. a and b
f. a and c
10. you would rate this patients irritability as
a. No irritability
b. Mild
c. Moderate
d. Severe
e. Extreme
f. Fluctuating
11. The first thing you would do when you examine this patient is
a. Sensory evaluation of the superior lateal cutaneous nerve of arm distribution
b. MMT of deltoid
c. MMT of teres minor
d. MMT of supraspinatus
Prepared by Dr Kavitha Raja JSS College of Physiotherapy Mysore

e. Triceps jerk
f. Gleno humeral rhythm
12. Special tests you would employ in this patient are
a. Lateral Jobe test
b. Painful arc
c. Shoulder shrug
d. Labral shear
e. a and c
f. a and b
13. Identify this muscle

14. This muscle is inserted on the lesser tuberosity of humerus
a. Supraspinatus
b. Infraspinatus
c. Teres minor
d. Biceps brachii
e. Subscapularis
f. Pronator teres
15. The ----- nerve winds round the neck of humerus and is at risk for injury in shoulder
fracture and dislocation
a. Radial nerve
b. Circumflex nerve
c. Median nerve
d. Ulnar nerve
e. Posterior circumflex nerve
f. Subclavian nerve
16. The glenoid labrum is
a. Attached to the rim of the glenoid fossa
b. Gives attachment to biceps tendon
c. It is deficient inferiorly
d. a, b, but not c
e. a,b,,c
f. b,c,but not a
Prepared by Dr Kavitha Raja JSS College of Physiotherapy Mysore

17. The musculoskeletal nerve supplies the following muscles
a. Coracobrachialis
b. Brachialis
c. Biceps brachii
d. Pronator teres
e. None of the above
f. All of the above
18. The lateral cord of brachial plexus is composed of
a. C5, 6, 7,8
b. C5, 6,7
c. C4,5,6,7,8
d. C6,7,8, t1
e. C5- T1
f. C5
19. The musculoskeletal nerve arises from
a. Lateral cord
b. Medial nerve
c. Posterior nerve
d. Superior root
e. Inferior root
f. Anterior division
20. A patient comes with tenderness over the anterior aspect of shoulder. You would suspect
a. Supraspinatus tendinitis
b. Infraspinatus tendinitis
c. Subscapularis tendinitis
d. Biceps tendinits
e. Anterior labral tear
f. Any of the above
21. If a patient is diagnosed with infraspinatus tendinitis , the position you would adopt to
give ultrasound is
a. Arm behind the back
b. Arm overhead
c. Prone on elbows with shoulder internally rotated and elbow lateral to shoulder
d. Prone on elbow with shoulder externally rotated and elbow medial to shoulder
e. Prone on elbow with shoulder externally rotated and elbow lateral to shoulder
f. Prone on elbow with shoulder internally rotated and elbow medial to shoulder
22. You identify a person who appears to have inflammation at the musculo tendinous
junction of supraspinatus. The position of the arm to give ultrasound is
a. Arm behind the back
b. Arm externally rotated
c. Arm internally rotated
d. Arm over the head
e. Arm in neutral
Prepared by Dr Kavitha Raja JSS College of Physiotherapy Mysore

f. Elbow flexed to 90 degrees
23. You ask your patient to lift her arm into abduction. She starts out by helping with the
opposite hand. Then completes the movement without use of the other hand. She may
have
a. Subscapularis tear
b. Anterior shoulder subluxation
c. Supraspinatus tear
d. Pectoralis major weakness
e. Teres major weakness
f. Deltoid weakness
24. A patient comes to you with external rotation grossly limited, abduction of 45 degrees,
internal rotation 15 degrees, adduction normal, flexion 100 degrees and extension 10
degrees. Your first priority of increasing ROM will be
a. Flexion
b. Extension
c. Horizontal abduction
d. Horizontal adduction
e. Internal rotation
f. External rotation
25. Codmans pivotal paradox is a
a. Normal finding
b. Abnormal finding in case of dislocation
c. Abnormal finding in case of rotator cuff tear
d. Abnormal finding in case of fracture of greater tuberosity
e. Abnormal finding in case of fracture neck of humerus
f. None of the above
26. A patient has range of motion restriction in external rotation. In which direction will you
perform glides?
a. Anterior
b. Posterior
c. Medical
d. Superior
e. Inferior
f. Lateral
27. A patient has range of motion restriction in abduction, in which direction will you
perform glides?
a. Anterior
b. Posterior
c. Medical
d. Superior
e. Inferior
f. Lateral
28. The capsular pattern of restriction of shoulder is as follows
Prepared by Dr Kavitha Raja JSS College of Physiotherapy Mysore

a. External rotn > abduction > internal rotation
b. Internal rotation> abduction> external rotation
c. External rotation>internal rotation>abduction
d. Abduction> Internal rotation>external rotation
e. Abduction>external rotation>internal rotation
f. Internal rotation>external rotation>abduction
29. The normal gleno humeral kinematics is as follows
a. The scapula moves inconsistently during the first 60 degrees of flexion
b. The scapula moves inconsistently during the first 30 degrees of abduction
c. During the initial 50 degrees of abduction, lateral rotation of the humeral head
occurs
d. Stressing the arm as with carrying weights can alter the scapula humeral rhythm
e. Of the maximum possible elevation of 150-180 degrees, the gleno humeral joint
f. All of the above
30. The shoulder shrug sign indicates
a. Reversal of scapulo humeral rhythm
b. Capsular tear
c. Rotator cuff tear
d. Anterior dislocation of shoulder
e. Sub scapularis tendinits
f. Bicipital tendinitis