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When treating the Deltoid muscle, what other muscles might you treat in order to alleviate pain in the deltoids due to their location and referral patterns?
Subscapulatis, Teres Minor, Teres Major
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Your client comes into your office complaining of pain every time he raises his arm above his shoulder. Two muscles that you might consider treating are:
A.Subscapularis
B. Deltoids
C. Infraspinatus
D. B & C
E. A & C
F. None of the above
Answer D - Deltoids and Infraspinatus
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What muscles make up the S.I.T.S. group?
Suptraspinatus, Infraspinatus, Teres Minor, Subscapularis
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4.When treating the upper arm, what muscles (in particular) must be given special caution during treatment because of its proximity to the brachial plexus?
Coracobrachialis
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Where do you place your thumb pad to get ready to work the belly of the anterior scalene?
A. Directly behind the ear
B. At the angle of the mandible
C. Between the 2 heads of the SCM
D. Just medial to the sternal head of the SCM
C - Between the 2 heads of the SCM
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When is the side-lying position best for working the scalene muscles?
When working the MEDIAL and POSTERIOR scalene.
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When is the supine positiong best for working the scalene muscles?
When working the ANTERIOR scalenes.
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What muscles would you most suspect contributing to REtraction of the scapula?
Rhomboids
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What muscles would you most suspect contributing to PROtraction of the scapula?
Serratus Anterior
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Susan is a computer programmer. She comes to you with complaints of numbness and tingling in her right hand. Your treat her forearm and wrist but the problem is getting worse. Name 3 possible muscles that could be contributing to the problem.
Give your reasons for the previous answers.
- Scalenes - if hypertonic they can cause nerve entrapment between anterior and medial scalenes
- Pectoralis Minor - if hypertonic, can cause entrapment of neurovascular structures, also be responsible for the closing of the thoracic outlet by raising the clavicle
- Subclavius - if hypertonic, can close the thoracic outlet between clavicle and 1st rib by lowering of the clavicle
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List 3 NMT protocols during which it is important to keep the client awake and communicating with you.
Any NMT protocols
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Which muscle is NOT part of the rotator cuff?
A. Supraspinatus
B.Infraspinatus
C.Teres Major
D.Teres Minor
C - Teres Major
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What three insertions are treated between the tendons of the long and the short head of the biceps?
A. Levator Scapula, Latissimus Dorsi & SCM
B. Latissimus Dorsi, Pectoralis Major & Subscapularis
C. Gastrocnemius, Plantaris & Popliteus
B - Latissimus Dorsi, Pectoralis Major & Subscapularis
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A client comes intor your office and can't raise her arm to shoulder level. The best muscle to work in this situation would be to work the .................. muscle.
A. Deltoid
B. Supraspinatus
C. Subscapularis
D. Infraspinatus
E. None of the above
- B - Supraspinatus (Phil's 1st choice) or
- A - Deltoid
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A female client states that she can't reach behind her back to unlcok her bra. The two best muscles to work in order to alleviate this situation would be _____________ and ______________ .
Infraspinatus and Teres Minor
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True or False?
"Bi-lateral weakness of the Transverse Abdominus muscle can contribute to lordosis."
True
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Kwan reports a history of scoliosis. Describe how you assess her to find out if her scoliosis is functional or idiopathic.
- Take her out of weight bearing position.
- If it goes away, it is functional, if it stays, it is idiopathic.
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Name 2 muscles that are addressed in treating an anteriorly rotated pelvis.
A. Hamstrings
B. Quadriceps
C. TFL/IT band
D. A&C
E. B&C
E - Quadriceps and TFL/IT band.
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Depending on position of the pelvis, the Psoas can perform seemingly opposite actions. This ability of the Psoas is known as the
A. Psoas Paradox
B. Psoas Confusion
C. Psoas Distortion
A. - Psoas Paradox
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True or False?
80 % of shoulder injuries involve Subscapularis tendonitis.
True
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A high Latissimus Dorsi
A. Will medially rotate the humerus
B. Can depress humerus on that side
C. Both A&B
C - both A&B
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When working the Ilio-Psoas mucle it is important to work the _________ muscle due to its tendon insertion that is in close proximity to the origin of psoas major.
Diaphragm
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When a patient is told that she has "frozen shoulder" it might serve the client well if the therapist examined the________ muscle.
Subscapularis
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The ___________ muscle is often the cause of "tennis elbow".
A. Triceps
B. Biceps Femoris
C. Anconeus
D. Brachialis
C - Anconeus
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Name the five causes of TOS.
- 1. Nerve entrapment between anterior and medial scalenes due to hypertonicity or facial adhesions
- 2. Closing of the thoracic outlent between clavicle and 1st rib toward the scapula due to hypertonicity of the scalenes
- 3. Closing of the thoracic outlet between the clavicle and 1st rib by the lowering of the clavicle due to hypertonicity of the subclavius
- 4. Entrapment of the neurovascular structures by the pectoralis minor
- 5. Deformed osseous structures such as the clvaicle or first rib
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Suppose someone comes into your office complaining of neck and arm pain. Upon examination you notice that they have very shallow breathing. Besides treating the diaphragm, what other muscle(s) might you look at?
State your reasons for the muscle(s) listed above.
Scalenes
When the scalenes are hypertonic, the person breathes with the scalenes instead of the diaphragm which causes pain in the neck and arm due to nerve entrapment of the brachial plexus.
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The "stitch in the side" muscle is also known as the ___________.
Serratus Anterior
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If someone complains of discomfort in the rhomboids it might be a good idea to work the ____________ muscles.
State the reasons for the previous answer.
- Pectoralis Muscles, because there are antagonists to the rhomboids.
- Traps or Levator Scapula because they have trigger point referral to the rhomboid muscles.
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True or False?
The deltoid muscle's referral pattern tends to be found in other muscles outside of the deltoid region.
False
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True or False?
A hypertonic rhomboid muscle can cause digestive disfunction.
False
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Dr. Janet Travell calls the ___________ muscle the "Amazingly complex muscle".
SCM
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The ___________ muscle has been described as a respiratory muscle with a postural function.
- Diaphragm because its primary function is respiration but is has a postural function due to its interdigitation with Psoas.
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The ___________ muscle has been described as a postural muscle with a respiratory function.
Psoas or Scalenes because they assist during inhalation.
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List three muscles that might treat if someone comes in with a severe kyphosis at C7 (aka "Dowager's hump")
State the reasons for each of the three muscles.
- Hamstrings - hypertonic Hamstrings can cause a posterior tuck of the pelvis and pull the head forward
- Iliopsoas - when tight can cause anterior rotation of the pelvis
- Pecs - hypertonic pecs will pull the shoulders forward and cause the pelvis to compensate
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Someone comes into your office complaining of pain in the deltoid region. After working the deltoids, you realize that the pain is still present. According to Phil, the ___________ muscle is the next best muscle to work due to its tendon insertion in the deltoid region.
Subscapularis
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True or False?
Someone with chronic bursitis or chronic arthritis should never have their SITS tendons worked on.
False
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Chronic tightness of the following tissues can contribute to the formation of bone spurs on the plantar surface of the Calcaneus.
A. Peroneus Longus
B. Tibialis Anterior
C. Achilles Tendon
C - Achilles Tendon
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Chronic rigidity of the vertebral column is relieved by using a small T-bar, which is applied in the lamina groove at what angle?
A. 90 degrees
B. 45 degrees
C. 60 degrees
B - 45 degrees
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Someone walks into your office and their toes are pointed outward while they are walking. A muscle or muscles that you could treat to relieve are:
A. Peroneus Longus
B. Piriformis
C. Obturator Internus
D. Both B and C
Piriformis and Obturator Internus
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