Download Chapter 004 The Shoulder Girdle

Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
True / False Questions
1. The bones of the shoulder girdle include the scapula and the clavicle.
True False
2. The two synovial joints in the shoulder girdle include the acromioclavicular joint and the
glenohumeral joint.
True False
3. The scapulothoracic joint is not a true synovial joint.
True False
4. This synergistic movement of the scapulothoracic joint with the shoulder joint is known as
the scapulohumeral rhythm.
True False
5. The origin of the upper trapezius is the root of the spine of the scapula.
True False
6. The upper trapezius and lower trapezius function as agonist and antagonist muscles.
True False
7. The shoulder girdle muscles are innervated primarily from the nerves of the cervical plexus
and lumbar plexus.
True False
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
8. Osteoarthritis can be a cause of nerve compression.
True False
9. Active Isolated Stretching (AIS) involves the use of body's natural movements (flexion,
extension, rotation, etc.) and physiology to achieve greater range of motion.
True False
10. In the Active Isolate Stretching (AIS) protocol, the antagonist muscles help to stretch the
agonist muscles.
True False
Multiple Choice Questions
11. Some bony landmarks on the scapula include the coracoids process,
A. greater tubercle, and lesser tubercle.
B. spine, and superior angle.
C. spine, and lesser tubercle.
D. spine, and greater tubercle.
12. Abduction of the scapulae is provided by _______ muscles.
A. lower trapezius and pectoralis minor
B. levator scapula and serratus anterior
C. pectoralis minor and serratus anterior
D. rhomboids and pectoralis minor
13. The muscles _____ and the ________ work together to perform elevation of the scapulae.
A. pectoralis minor; serratus anterior
B. upper and middle trapezius; levator scapulae
C. levator scapulae; lower trapezius
D. lower trapezius; pectoralis minor
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
14. The subclavius is a(n) _________ of the sternoclavicular joint.
A. synergist
B. agonist
C. antagonist
D. stabilizer
15. The trapezius is innervated by the ___________ nerve.
A. accessory
B. medial pectoral
C. long thoracic
D. sciatic
16. The muscles of the shoulder girdle that perform adduction of the scapulae are the
A. pectoralis minor and rhomboids.
B. rhomboids and levator scapulae.
C. middle and lower trapezius and rhomboids.
D. serratus anterior and rhomboids.
17. The muscles of shoulder girdle that perform depression of the scapulae are the
A. levator scapulae and pectoralis minor.
B. serratus Anterior and rhomboids.
C. lower trapezius, pectoralis minor and subclavius.
D. pectoralis minor and serratus anterior.
18. The muscles of the shoulder girdle that perform upward rotation of the scapulae are the
A. serratus anterior and middle and lower trapezius.
B. rhomboids and upper trapezius.
C. lower trapezius and pectoralis minor.
D. rhomboids and pectoralis minor.
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
19. The muscles of the shoulder girdle that perform downward rotation of the scapulae are
the
A. levator scapulae and pectoralis minor.
B. rhomboids and pectoralis minor.
C. lower trapezius and rhomboids.
D. serratus anterior and pectoralis minor.
20. The muscles that insert on the clavicle and or scapula and have action on the shoulder
girdle are the
A. trapezius, deltoids, pectoralis minor, serratus anterior, and rhomboids.
B. trapezius, levator scapulae, rhomboids, serratus anterior, and deltoids.
C. trapezius, levator scapulae, rhomboids, serratus anterior, pectoralis minor, and subclavius.
D. trapezius, supraspinatus, pectoralis minor, serratus anterior, and rhomboids.
21. The upper trapezius inserts on the
A. spine of the scapula.
B. inferior angle of the scapula.
C. lateral clavicle.
D. root of the spine of the scapula.
22. The middle trapezius inserts on the
A. root of the spine of the scapula.
B. deltoid tuberosity.
C. lateral clavicle.
D. spine of the scapula, acromium.
23. The lower trapezius inserts on the
A. lateral clavicle.
B. supraspinous fossa.
C. root of the spine of the scapula.
D. spine of the scapula.
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
24. The origin of the levator scapulae is
A. spine of the scapula.
B. superior angle of the scapula.
C. C1-4 transverse processes.
D. C1 spinous process.
25. The insertion of the levator scapulae is the
A. vertebral border of the scapula (medial) from superior angle to root of the spine.
B. spine of the scapula.
C. root of the spine of the scapula.
D. inferior angle of the scapula.
26. The origin of the rhomboid major is on the
A. transverse processes of C 1-4.
B. spinous processes of T2-T5.
C. spinous processes of C7, T1.
D. transverse processes of C 1-3.
27. The origin of the rhomboid minor is on the
A. transverse processes of T2-T5.
B. spinous processes of T2-T5.
C. spinous processes of C7-T1.
D. root of the spine of the scapula.
28. The insertion of the rhomboid minor is on the
A. coracoid process.
B. humerus.
C. root of the spine of the scapula.
D. vertebral border of the scapula below the root of the spine.
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
29. The insertion of the rhomboid major is on the
A. vertebral border of the scapula below the root of the spine.
B. root of the spine of the scapula.
C. acromion.
D. spine of the scapula.
30. The origin of the serratus anterior is on the
A. coracoid process.
B. anterior surfaces of the third to fifth ribs.
C. superior aspect of the first rib.
D. surface of the upper nine ribs at the side of the chest.
31. The insertion of the serratus anterior is on the
A. anterior aspect of the whole length of the medial border of the scapula.
B. coracoid process.
C. inferior groove in the mid-portion of the clavicle.
D. humerus.
32. The origin of the pectoralis minor is on the
A. clavicle.
B. anterior surfaces of the third to fifth ribs.
C. surfaces of the upper nine ribs at the side of the chest.
D. first rib.
33. The insertion of the pectoralis minor is on the
A. superior angle of the scapula.
B. clavicle.
C. coracoid process.
D. acromion.
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
34. The origin of the subclavius is located on the
A. coracoid process.
B. clavicle.
C. superior angle of the scapula.
D. superior aspect of the first rib at its junction with its costal cartilage.
35. The insertion for the subclavius is located on the
A. spine of the scapula.
B. inferior groove in the mid-portion of the clavicle.
C. coracoid process.
D. first three ribs.
36. When strengthening the pectoralis major, what other muscle group should be strengthened
with it to help shoulder balance?
A. Biceps brachii, triceps
B. Subclavius, pectoralis minor
C. Rhomboids, trapezius
D. Subclavius, brachialis
37. Increasing flexibility in the body helps
A. reduce wear and tear on the joints.
B. improve sleep.
C. depression.
D. resting heart rate.
38. Flexibility is defined as
A. improvement in eccentric contractions.
B. angle of two points.
C. the end motion of a segment.
D. lengthening of a synergist muscle.
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
39. Ligaments, in their supportive roles as joint protectors
A. elongate to assist a stretch.
B. restrict range of motion and flexibility at the end movement.
C. heat up to allow stretching.
D. cause the golgi tendon organ to fire.
40. Two of the main influences on flexibility are
A. blood flow and oxygen.
B. Pacinian and Meissner's corpuscles.
C. physical length of the antagonist muscle and the neurologic innervation of the muscle
being stretched.
D. strength of agonist and temperature of muscle.
41. To protect a muscle from being overstretched, a primary afferent neuron initiates a(n)
A. myotactic reflex arc.
B. stretch organ.
C. eccentric contraction.
D. golgi tendon reflex.
42. When a muscle is in a stretch, and pressure is applied to the tendons, the golgi tendon
response occurs, also known as
A. myotactic reflex arc.
B. inverse stretch reflex.
C. golgi inversion response.
D. GTO.
43. Clinical flexibility is best defined as
A. stretching in a home gym.
B. stretching performed by a physician.
C. flexibility therapy after surgery.
D. flexibility in a clinical setting and when injuries might exist.
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
44. Active Isolated Stretching (AIS) is best suited for a clinic because
A. its number of safe components.
B. athletes recommend it.
C. it does not work in a home setting.
D. a nurse should always be present.
45. Stretching the upper and middle trapezius fibers are important because
A. it improves breathing.
B. it improves blood flow to the pectoralis major.
C. it improves cervical lesions.
D. of the antigravity functions of these muscles and history of inflicting chronic tension.
46. To stretch the rhomboids, the scapula must be
A. retracted.
B. protracted.
C. in downward rotation.
D. neutral.
47. Winging of the scapulae is usually caused by what two muscles?
A. Trapezius and pectoralis minor
B. Levator scapulae and latissimus
C. Serratus anterior and rhomboids
D. Subscapularis and teres major
48. One way to strengthen the upper trapezius is
A. shoulder shrugs with dumbbells.
B. biceps curls with cables.
C. front dumbbell raises.
D. latissimus dorsi pull downs.
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
49. Levator scapulae can be strengthened with shoulder shrugs and
A. serratus push ups.
B. wall push ups.
C. scapular retraction.
D. lateral neck flexion against gravity.
50. To isolate rhomboids more specifically for strengthening in a prone position, the head
should be
A. rotated.
B. extended.
C. at an oblique angle.
D. completely relaxed in a flexed position.
Fill in the Blank Questions
51. ______ is another name for the movement adduction of the scapulae.
________________________________________
52. ______ is another name for the movement abduction of the scapulae.
________________________________________
53. The brachial plexus is vulnerable to __________ or "pinched" nerves from several
perspectives.
________________________________________
54. Soft-tissue structures can apply pressure to nerves and cause ___________.
________________________________________
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
55. Osteoarthritis, a pathological condition causing abnormal bony growth, can press on the
nerves and cause ___________.
________________________________________
56. Clinical Flexibility and Therapeutic Exercise (CFTE) is a(n) __________ composed of
stretching and strengthening the muscles of the body.
________________________________________
57. Flexibility is defined as the end motion of a segment, and it can occur by _________
contraction of the agonist (active range of motion), or by motion of an external force (passive
range of motion).
________________________________________
58. Stretching is taking a muscle in its resting length and __________ it.
________________________________________
59. Proprioceptive Neuromuscular Facilitation (PNF) stretching utilizes the components of
muscle physiology to obtain a(n) ________ amount of flexibility in muscles.
________________________________________
60. Active Isolated Stretching (AIS) involves the use of body's natural movements (flexion,
extension, rotation, etc.) and physiology to achieve ________ range of motion.
________________________________________
61. Clinical flexibility is defined as stretching used in a(n) _______ setting, and it is usually
assisted by a therapist.
________________________________________
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
62. The middle trapezius can be palpated from C7 to T3 and laterally to acromion process and
scapula spine, particularly during _________.
________________________________________
63. The trapezius can act as its own agonist and __________.
________________________________________
64. The rhomboid major is palpable and superficial near the ________ angle of the scapula.
________________________________________
65. The serratus anterior is named for its _________.
________________________________________
66. Rhomboids are muscles that literally mean ___________.
________________________________________
67. Serratus anterior and pectoralis minor perform ________ of the scapulae and together are
________.
________________________________________
68. The upper and middle trapezius and levator scapulae perform ________ of the scapulae.
________________________________________
69. The lower trapezius and the upper and middle trapezius act as agonist and ________.
________________________________________
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder...
70. The trapezius is located mostly ___________ to the rhomboids.
________________________________________
71. The pectoralis minor and the serratus anterior both originate on _______.
________________________________________
72. When the rhomboids perform adduction of the scapulae __________ act as antagonist to
perform abduction of the scapulae.
________________________________________
73. The rhomboids perform downward rotation with its synergist _____________.
________________________________________
74. Upward rotation is performed by the synergists of the middle and lower trapezius and
_________.
________________________________________
75. The acromioclavicular joint is made up of the _______ and the ________.
________________________________________
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
True / False Questions
1. The bones of the shoulder girdle include the scapula and the clavicle.
TRUE
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-2
Learning Outcome: 4-3
Learning Outcome: 4-6
2. The two synovial joints in the shoulder girdle include the acromioclavicular joint and the
glenohumeral joint.
FALSE
The glenohumeral joint is the shoulder joint. The other synovial joint in the shoulder girdle is
the sternoclavicular joint.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-2
Learning Outcome: 4-3
Learning Outcome: 4-6
3. The scapulothoracic joint is not a true synovial joint.
TRUE
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-2
Learning Outcome: 4-3
Learning Outcome: 4-5
4-14
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
4. This synergistic movement of the scapulothoracic joint with the shoulder joint is known as
the scapulohumeral rhythm.
TRUE
Bloom's: Comprehension
Difficulty: Hard
Learning Outcome: 4-4
Learning Outcome: 4-5
5. The origin of the upper trapezius is the root of the spine of the scapula.
FALSE
The root of the spine of the scapula is the insertion for the lower trapezius.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
6. The upper trapezius and lower trapezius function as agonist and antagonist muscles.
TRUE
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-7
7. The shoulder girdle muscles are innervated primarily from the nerves of the cervical plexus
and lumbar plexus.
FALSE
The lumbar plexus does not innervate the shoulder girdle muscles.
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-1
4-15
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
8. Osteoarthritis can be a cause of nerve compression.
TRUE
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-1
9. Active Isolated Stretching (AIS) involves the use of body's natural movements (flexion,
extension, rotation, etc.) and physiology to achieve greater range of motion.
TRUE
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-10
Learning Outcome: 4-9
10. In the Active Isolate Stretching (AIS) protocol, the antagonist muscles help to stretch the
agonist muscles.
FALSE
In order to stretch the antagonist muscles, the agonist muscles must be used.
Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Hard
Difficulty: Medium
Learning Outcome: 4-10
Learning Outcome: 4-9
4-16
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
Multiple Choice Questions
11. Some bony landmarks on the scapula include the coracoids process,
A. greater tubercle, and lesser tubercle.
B. spine, and superior angle.
C. spine, and lesser tubercle.
D. spine, and greater tubercle.
The greater tubercle and lesser tubercle are on the head of the humerus not the scapula.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-2
Learning Outcome: 4-3
Learning Outcome: 4-6
12. Abduction of the scapulae is provided by _______ muscles.
A. lower trapezius and pectoralis minor
B. levator scapula and serratus anterior
C. pectoralis minor and serratus anterior
D. rhomboids and pectoralis minor
Only the serratus anterior and pectoralis minor work together to provide abduction of the
scapulae. Other muscles are not located in a position to perform abduction of the scapulae or
are not matched with the right synergist.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-5
Learning Outcome: 4-7
4-17
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
13. The muscles _____ and the ________ work together to perform elevation of the scapulae.
A. pectoralis minor; serratus anterior
B. upper and middle trapezius; levator scapulae
C. levator scapulae; lower trapezius
D. lower trapezius; pectoralis minor
Only the upper and middle trapezius and levator scapulae perform the function of elevation of
the scapulae and are synergists. Other muscles are not located in a position to perform
elevation of the scapulae or are not matched with the right synergist.
Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-5
Learning Outcome: 4-7
14. The subclavius is a(n) _________ of the sternoclavicular joint.
A. synergist
B. agonist
C. antagonist
D. stabilizer
The location of the muscles lends to its stabilizing function. It is not considered to be a prime
mover of the shoulder girdle.
Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-7
4-18
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
15. The trapezius is innervated by the ___________ nerve.
A. accessory
B. medial pectoral
C. long thoracic
D. sciatic
Only the accessory nerve innervates the trapezius.
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-1
16. The muscles of the shoulder girdle that perform adduction of the scapulae are the
A. pectoralis minor and rhomboids.
B. rhomboids and levator scapulae.
C. middle and lower trapezius and rhomboids.
D. serratus anterior and rhomboids.
Middle and lower trapezius and rhomboids are located positively to perform adduction of the
scapulae and are synergists. The other muscles cannot perform adduction of the scapulae as
they are not located in a direct line of pull for adduction to occur or are not matched with the
right synergist.
Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-5
Learning Outcome: 4-7
4-19
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
17. The muscles of shoulder girdle that perform depression of the scapulae are the
A. levator scapulae and pectoralis minor.
B. serratus Anterior and rhomboids.
C. lower trapezius, pectoralis minor and subclavius.
D. pectoralis minor and serratus anterior.
Lower trapezius, pectoralis minor, and subclavius are located positively to perform depression
of the scapulae and are synergists. The other muscles cannot perform depression of the
scapulae as they're not located in a direct line of pull for depression to occur or are not
matched with the right synergist.
Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-5
Learning Outcome: 4-7
18. The muscles of the shoulder girdle that perform upward rotation of the scapulae are the
A. serratus anterior and middle and lower trapezius.
B. rhomboids and upper trapezius.
C. lower trapezius and pectoralis minor.
D. rhomboids and pectoralis minor.
The serratus anterior and the middle and lower trapezius are located positively to perform
upward rotation of the scapulae and are synergists. The other muscles cannot perform upward
rotation of the scapulae as they are not located in a direct line of pull for upward rotation to
occur or are not matched with the right synergist.
Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-5
Learning Outcome: 4-7
4-20
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
19. The muscles of the shoulder girdle that perform downward rotation of the scapulae are
the
A. levator scapulae and pectoralis minor.
B. rhomboids and pectoralis minor.
C. lower trapezius and rhomboids.
D. serratus anterior and pectoralis minor.
The rhomboids and pectoralis minor are located positively to perform downward rotation of
the scapulae and are synergists. The other muscles are not either located in a direct line of pull
for downward rotation to occur or are not matched with the right synergist.
Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-5
Learning Outcome: 4-7
20. The muscles that insert on the clavicle and or scapula and have action on the shoulder
girdle are the
A. trapezius, deltoids, pectoralis minor, serratus anterior, and rhomboids.
B. trapezius, levator scapulae, rhomboids, serratus anterior, and deltoids.
C. trapezius, levator scapulae, rhomboids, serratus anterior, pectoralis minor, and subclavius.
D. trapezius, supraspinatus, pectoralis minor, serratus anterior, and rhomboids.
Deltoids and supraspinatus insert on the humerus and are not shoulder girdle muscles.
Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-7
Learning Outcome: 4-8
4-21
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
21. The upper trapezius inserts on the
A. spine of the scapula.
B. inferior angle of the scapula.
C. lateral clavicle.
D. root of the spine of the scapula.
The inferior angle of the scapula is not a part of the attachment sites of the trapezius. The
other attachment sites are for the middle and lower trapezius.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
22. The middle trapezius inserts on the
A. root of the spine of the scapula.
B. deltoid tuberosity.
C. lateral clavicle.
D. spine of the scapula, acromium.
The deltoid tuberosity is the insertion for the deltoids. The other attachment sites are for the
upper and lower trapezius.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
4-22
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
23. The lower trapezius inserts on the
A. lateral clavicle.
B. supraspinous fossa.
C. root of the spine of the scapula.
D. spine of the scapula.
The supraspinous fossa is the origin of the supraspinatus. The other attachment sites are for
the upper and middle trapezius.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
24. The origin of the levator scapulae is
A. spine of the scapula.
B. superior angle of the scapula.
C. C1-4 transverse processes.
D. C1 spinous process.
In order to lift the scapula, the levator scapulae must come from the neck for the appropriate
line of pull. Only C1-4 transverse processes work in this arrangement.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
4-23
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
25. The insertion of the levator scapulae is the
A. vertebral border of the scapula (medial) from superior angle to root of the spine.
B. spine of the scapula.
C. root of the spine of the scapula.
D. inferior angle of the scapula.
In order for the levator scapulae to lift the scapula in elevation, it must have a line of pull
from the neck to the superior angle of the scapula. Other attachments might affect a different
action.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
26. The origin of the rhomboid major is on the
A. transverse processes of C 1-4.
B. spinous processes of T2-T5.
C. spinous processes of C7, T1.
D. transverse processes of C 1-3.
Transverse processes of C 1-4 is the origin of levator scapulae, spinous processes of C7; T1 is
the origin for rhomboid minor; D is outside the line of pull for the muscle to perform.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
4-24
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
27. The origin of the rhomboid minor is on the
A. transverse processes of T2-T5.
B. spinous processes of T2-T5.
C. spinous processes of C7-T1.
D. root of the spine of the scapula.
Since the rhomboid minor is smaller than the major and it is superior to the major, it is logical
from the angle of pull that is come from the spinous processes of C7-T1. The root of the spine
could not be an origin or fixed attachment as it moves the scapula.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
28. The insertion of the rhomboid minor is on the
A. coracoid process.
B. humerus.
C. root of the spine of the scapula.
D. vertebral border of the scapula below the root of the spine.
The coracoid process is in the wrong location for the angle of pull; the humerus is not a
shoulder girdle bone; and the vertebral border of the scapula below the root of the spine is the
insertion for rhomboid major.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
4-25
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
29. The insertion of the rhomboid major is on the
A. vertebral border of the scapula below the root of the spine.
B. root of the spine of the scapula.
C. acromion.
D. spine of the scapula.
In order for the larger rhomboid major to have its correct actions, it must have a broad
attachment on the vertebral border of the scapula below the insertion of rhomboid minor. The
other attachments would not work from a perspective of line of pull.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
30. The origin of the serratus anterior is on the
A. coracoid process.
B. anterior surfaces of the third to fifth ribs.
C. superior aspect of the first rib.
D. surface of the upper nine ribs at the side of the chest.
Anterior surface of the third to fifth ribs is the origin of the pectoralis minor; coracoid process
is the insertion of pectoralis minor; superior aspect of the first rib is impossible from a line of
pull; only the surface of the upper nine ribs at the side of the chest works from a line of pull.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
31. The insertion of the serratus anterior is on the
A. anterior aspect of the whole length of the medial border of the scapula.
B. coracoid process.
C. inferior groove in the mid-portion of the clavicle.
D. humerus.
Only the anterior aspect of the medial border of the scapula makes sense according to these
muscles actions.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
32. The origin of the pectoralis minor is on the
A. clavicle.
B. anterior surfaces of the third to fifth ribs.
C. surfaces of the upper nine ribs at the side of the chest.
D. first rib.
In order to have action on the scapula, the pectoralis minor must originate on the ribs.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
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Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
33. The insertion of the pectoralis minor is on the
A. superior angle of the scapula.
B. clavicle.
C. coracoid process.
D. acromion.
Line of pull requires the coracoid process as a logical choice. It is located on the anterior
chest, so the superior angle of the scapula is impossible.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
34. The origin of the subclavius is located on the
A. coracoid process.
B. clavicle.
C. superior angle of the scapula.
D. superior aspect of the first rib at its junction with its costal cartilage.
Only the superior aspect of the first rib at its junction with its costal cartilage fits the actions
and line of pull for the muscle.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
4-28
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
35. The insertion for the subclavius is located on the
A. spine of the scapula.
B. inferior groove in the mid-portion of the clavicle.
C. coracoid process.
D. first three ribs.
The location of the muscle and the muscle's name give away the insertion on the clavicle.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
36. When strengthening the pectoralis major, what other muscle group should be strengthened
with it to help shoulder balance?
A. Biceps brachii, triceps
B. Subclavius, pectoralis minor
C. Rhomboids, trapezius
D. Subclavius, brachialis
Since the pectoralis major is an anterior muscle, it pulls the shoulders forward. Strengthening
the posterior upper shoulders helps keep the shoulders back.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
4-29
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
37. Increasing flexibility in the body helps
A. reduce wear and tear on the joints.
B. improve sleep.
C. depression.
D. resting heart rate.
Improving flexibility means a better range of motion in joint, which overall helps improve
body movement.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
38. Flexibility is defined as
A. improvement in eccentric contractions.
B. angle of two points.
C. the end motion of a segment.
D. lengthening of a synergist muscle.
Stretching is defined as taking a muscle in its resting length and expanding it.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-1
Learning Outcome: 4-4
Learning Outcome: 4-8
4-30
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
39. Ligaments, in their supportive roles as joint protectors
A. elongate to assist a stretch.
B. restrict range of motion and flexibility at the end movement.
C. heat up to allow stretching.
D. cause the golgi tendon organ to fire.
Ligaments help provide overall stability to the joints.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
40. Two of the main influences on flexibility are
A. blood flow and oxygen.
B. Pacinian and Meissner's corpuscles.
C. physical length of the antagonist muscle and the neurologic innervation of the muscle
being stretched.
D. strength of agonist and temperature of muscle.
Without neurological innervation, stretching cannot take place.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
41. To protect a muscle from being overstretched, a primary afferent neuron initiates a(n)
A. myotactic reflex arc.
B. stretch organ.
C. eccentric contraction.
D. golgi tendon reflex.
The myotactic reflex arc is also known as a stretch reflex.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
4-31
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
42. When a muscle is in a stretch, and pressure is applied to the tendons, the golgi tendon
response occurs, also known as
A. myotactic reflex arc.
B. inverse stretch reflex.
C. golgi inversion response.
D. GTO.
The inverse stretch reflex helps protect a muscle from overstretching by relaxing the muscle
being stretched.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
43. Clinical flexibility is best defined as
A. stretching in a home gym.
B. stretching performed by a physician.
C. flexibility therapy after surgery.
D. flexibility in a clinical setting and when injuries might exist.
Clinical flexibility is usually performed as a set of exercises to one that has existing injuries.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-1
Learning Outcome: 4-4
Learning Outcome: 4-8
4-32
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
44. Active Isolated Stretching (AIS) is best suited for a clinic because
A. its number of safe components.
B. athletes recommend it.
C. it does not work in a home setting.
D. a nurse should always be present.
AIS used short holds, full range of motion, and is easy to teach patients.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
45. Stretching the upper and middle trapezius fibers are important because
A. it improves breathing.
B. it improves blood flow to the pectoralis major.
C. it improves cervical lesions.
D. of the antigravity functions of these muscles and history of inflicting chronic tension.
Stretching the antigravity muscles helps forward shoulder postures.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
46. To stretch the rhomboids, the scapula must be
A. retracted.
B. protracted.
C. in downward rotation.
D. neutral.
Protraction of the scapula causes tension on the medial attachments of the rhomboids.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
4-33
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
47. Winging of the scapulae is usually caused by what two muscles?
A. Trapezius and pectoralis minor
B. Levator scapulae and latissimus
C. Serratus anterior and rhomboids
D. Subscapularis and teres major
Serratus anterior weakness may result from an injury to the long thoracic nerve.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
48. One way to strengthen the upper trapezius is
A. shoulder shrugs with dumbbells.
B. biceps curls with cables.
C. front dumbbell raises.
D. latissimus dorsi pull downs.
Shrugs that move forward, up, and back help strengthen the anti-gravity muscles of the
shoulder.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
49. Levator scapulae can be strengthened with shoulder shrugs and
A. serratus push ups.
B. wall push ups.
C. scapular retraction.
D. lateral neck flexion against gravity.
Neck extensions against gravity also help strengthen this muscle.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
4-34
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
50. To isolate rhomboids more specifically for strengthening in a prone position, the head
should be
A. rotated.
B. extended.
C. at an oblique angle.
D. completely relaxed in a flexed position.
Keeping the head relaxed and down during this exercise keeps the upper trapezius from
helping.
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
Fill in the Blank Questions
51. ______ is another name for the movement adduction of the scapulae.
Retraction
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-5
52. ______ is another name for the movement abduction of the scapulae.
Protraction
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-5
4-35
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
53. The brachial plexus is vulnerable to __________ or "pinched" nerves from several
perspectives.
nerve impingements
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-1
54. Soft-tissue structures can apply pressure to nerves and cause ___________.
nerve entrapment
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-1
55. Osteoarthritis, a pathological condition causing abnormal bony growth, can press on the
nerves and cause ___________.
nerve compression
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-1
56. Clinical Flexibility and Therapeutic Exercise (CFTE) is a(n) __________ composed of
stretching and strengthening the muscles of the body.
modality
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-1
Learning Outcome: 4-9
4-36
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
57. Flexibility is defined as the end motion of a segment, and it can occur by _________
contraction of the agonist (active range of motion), or by motion of an external force (passive
range of motion).
active
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-1
Learning Outcome: 4-9
58. Stretching is taking a muscle in its resting length and __________ it.
expanding
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-1
Learning Outcome: 4-9
59. Proprioceptive Neuromuscular Facilitation (PNF) stretching utilizes the components of
muscle physiology to obtain a(n) ________ amount of flexibility in muscles.
increased
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-1
Learning Outcome: 4-9
60. Active Isolated Stretching (AIS) involves the use of body's natural movements (flexion,
extension, rotation, etc.) and physiology to achieve ________ range of motion.
greater
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-1
Learning Outcome: 4-9
4-37
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
61. Clinical flexibility is defined as stretching used in a(n) _______ setting, and it is usually
assisted by a therapist.
clinical
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-1
Learning Outcome: 4-9
62. The middle trapezius can be palpated from C7 to T3 and laterally to acromion process and
scapula spine, particularly during _________.
adduction
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-6
Learning Outcome: 4-8
63. The trapezius can act as its own agonist and __________.
antagonist
Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-7
64. The rhomboid major is palpable and superficial near the ________ angle of the scapula.
inferior
Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-6
Learning Outcome: 4-8
4-38
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
65. The serratus anterior is named for its _________.
shape
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-1
Learning Outcome: 4-8
66. Rhomboids are muscles that literally mean ___________.
diamond-shaped
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-1
Learning Outcome: 4-8
67. Serratus anterior and pectoralis minor perform ________ of the scapulae and together are
________.
abduction; synergists
Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-5
Learning Outcome: 4-7
68. The upper and middle trapezius and levator scapulae perform ________ of the scapulae.
elevation
Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-5
Learning Outcome: 4-7
4-39
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
69. The lower trapezius and the upper and middle trapezius act as agonist and ________.
antagonist
Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 4-5
Learning Outcome: 4-7
70. The trapezius is located mostly ___________ to the rhomboids.
superficial
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
71. The pectoralis minor and the serratus anterior both originate on _______.
ribs
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-8
72. When the rhomboids perform adduction of the scapulae __________ act as antagonist to
perform abduction of the scapulae.
pectoralis minor and serratus anterior
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-7
Learning Outcome: 4-8
4-40
Chapter 004 The Shoulder Girdle – Dynamic Stability for the Shoulder... Key
73. The rhomboids perform downward rotation with its synergist _____________.
pectoralis minor
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-7
Learning Outcome: 4-8
74. Upward rotation is performed by the synergists of the middle and lower trapezius and
_________.
serratus anterior
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Difficulty: Medium
Learning Outcome: 4-4
Learning Outcome: 4-7
Learning Outcome: 4-8
75. The acromioclavicular joint is made up of the _______ and the ________.
clavicle; scapula
Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 4-2
Learning Outcome: 4-3
Learning Outcome: 4-6
4-41