← Back to Session

Questions Answered: 238

Final Score 84%

200
38

Questions

  • Q1. ✓ Correct
  • Q2. ✓ Correct
  • Q3. X Incorrect
  • Q4. ✓ Correct
  • Q5. ✓ Correct
  • Q6. ✓ Correct
  • Q7. ✓ Correct
  • Q8. ✓ Correct
  • Q9. ✓ Correct
  • Q10. ✓ Correct
  • Q11. ✓ Correct
  • Q12. ✓ Correct
  • Q13. ✓ Correct
  • Q14. ✓ Correct
  • Q15. ✓ Correct
  • Q16. ✓ Correct
  • Q17. ✓ Correct
  • Q18. ✓ Correct
  • Q19. ✓ Correct
  • Q20. ✓ Correct
  • Q21. ✓ Correct
  • Q22. ✓ Correct
  • Q23. ✓ Correct
  • Q24. ✓ Correct
  • Q25. ✓ Correct
  • Q26. ✓ Correct
  • Q27. ✓ Correct
  • Q28. ✓ Correct
  • Q29. ✓ Correct
  • Q30. ✓ Correct
  • Q31. ✓ Correct
  • Q32. ✓ Correct
  • Q33. X Incorrect
  • Q34. ✓ Correct
  • Q35. ✓ Correct
  • Q36. ✓ Correct
  • Q37. X Incorrect
  • Q38. ✓ Correct
  • Q39. ✓ Correct
  • Q40. ✓ Correct
  • Q41. ✓ Correct
  • Q42. X Incorrect
  • Q43. ✓ Correct
  • Q44. ✓ Correct
  • Q45. ✓ Correct
  • Q46. ✓ Correct
  • Q47. ✓ Correct
  • Q48. ✓ Correct
  • Q49. ✓ Correct
  • Q50. ✓ Correct
  • Q51. ✓ Correct
  • Q52. ✓ Correct
  • Q53. ✓ Correct
  • Q54. X Incorrect
  • Q55. ✓ Correct
  • Q56. ✓ Correct
  • Q57. X Incorrect
  • Q58. ✓ Correct
  • Q59. ✓ Correct
  • Q60. X Incorrect
  • Q61. ✓ Correct
  • Q62. ✓ Correct
  • Q63. X Incorrect
  • Q64. ✓ Correct
  • Q65. X Incorrect
  • Q66. ✓ Correct
  • Q67. ✓ Correct
  • Q68. ✓ Correct
  • Q69. ✓ Correct
  • Q70. ✓ Correct
  • Q71. ✓ Correct
  • Q72. X Incorrect
  • Q73. ✓ Correct
  • Q74. ✓ Correct
  • Q75. ✓ Correct
  • Q76. ✓ Correct
  • Q77. ✓ Correct
  • Q78. ✓ Correct
  • Q79. ✓ Correct
  • Q80. ✓ Correct
  • Q81. ✓ Correct
  • Q82. ✓ Correct
  • Q83. X Incorrect
  • Q84. ✓ Correct
  • Q85. ✓ Correct
  • Q86. ✓ Correct
  • Q87. X Incorrect
  • Q88. ✓ Correct
  • Q89. X Incorrect
  • Q90. ✓ Correct
  • Q91. ✓ Correct
  • Q92. ✓ Correct
  • Q93. ✓ Correct
  • Q94. ✓ Correct
  • Q95. ✓ Correct
  • Q96. ✓ Correct
  • Q97. ✓ Correct
  • Q98. ✓ Correct
  • Q99. ✓ Correct
  • Q100. ✓ Correct
  • Q101. ✓ Correct
  • Q102. ✓ Correct
  • Q103. ✓ Correct
  • Q104. X Incorrect
  • Q105. ✓ Correct
  • Q106. ✓ Correct
  • Q107. ✓ Correct
  • Q108. ✓ Correct
  • Q109. ✓ Correct
  • Q110. ✓ Correct
  • Q111. ✓ Correct
  • Q112. ✓ Correct
  • Q113. ✓ Correct
  • Q114. X Incorrect
  • Q115. ✓ Correct
  • Q116. ✓ Correct
  • Q117. X Incorrect
  • Q118. ✓ Correct
  • Q119. ✓ Correct
  • Q120. ✓ Correct
  • Q121. ✓ Correct
  • Q122. ✓ Correct
  • Q123. ✓ Correct
  • Q124. ✓ Correct
  • Q125. ✓ Correct
  • Q126. ✓ Correct
  • Q127. ✓ Correct
  • Q128. ✓ Correct
  • Q129. ✓ Correct
  • Q130. ✓ Correct
  • Q131. ✓ Correct
  • Q132. ✓ Correct
  • Q133. ✓ Correct
  • Q134. ✓ Correct
  • Q135. ✓ Correct
  • Q136. ✓ Correct
  • Q137. ✓ Correct
  • Q138. ✓ Correct
  • Q139. ✓ Correct
  • Q140. ✓ Correct
  • Q141. ✓ Correct
  • Q142. X Incorrect
  • Q143. ✓ Correct
  • Q144. ✓ Correct
  • Q145. ✓ Correct
  • Q146. ✓ Correct
  • Q147. X Incorrect
  • Q148. ✓ Correct
  • Q149. ✓ Correct
  • Q150. X Incorrect
  • Q151. ✓ Correct
  • Q152. X Incorrect
  • Q153. ✓ Correct
  • Q154. ✓ Correct
  • Q155. ✓ Correct
  • Q156. ✓ Correct
  • Q157. ✓ Correct
  • Q158. X Incorrect
  • Q159. ✓ Correct
  • Q160. ✓ Correct
  • Q161. ✓ Correct
  • Q162. X Incorrect
  • Q163. ✓ Correct
  • Q164. X Incorrect
  • Q165. ✓ Correct
  • Q166. ✓ Correct
  • Q167. ✓ Correct
  • Q168. X Incorrect
  • Q169. ✓ Correct
  • Q170. ✓ Correct
  • Q171. ✓ Correct
  • Q172. ✓ Correct
  • Q173. ✓ Correct
  • Q174. ✓ Correct
  • Q175. X Incorrect
  • Q176. X Incorrect
  • Q177. X Incorrect
  • Q178. X Incorrect
  • Q179. ✓ Correct
  • Q180. ✓ Correct
  • Q181. ✓ Correct
  • Q182. X Incorrect
  • Q183. X Incorrect
  • Q184. ✓ Correct
  • Q185. ✓ Correct
  • Q186. X Incorrect
  • Q187. ✓ Correct
  • Q188. ✓ Correct
  • Q189. ✓ Correct
  • Q190. ✓ Correct
  • Q191. ✓ Correct
  • Q192. X Incorrect
  • Q193. ✓ Correct
  • Q194. ✓ Correct
  • Q195. ✓ Correct
  • Q196. ✓ Correct
  • Q197. ✓ Correct
  • Q198. ✓ Correct
  • Q199. ✓ Correct
  • Q200. ✓ Correct
  • Q201. ✓ Correct
  • Q202. ✓ Correct
  • Q203. ✓ Correct
  • Q204. ✓ Correct
  • Q205. ✓ Correct
  • Q206. ✓ Correct
  • Q207. ✓ Correct
  • Q208. X Incorrect
  • Q209. ✓ Correct
  • Q210. ✓ Correct
  • Q211. ✓ Correct
  • Q212. ✓ Correct
  • Q213. ✓ Correct
  • Q214. X Incorrect
  • Q215. ✓ Correct
  • Q216. X Incorrect
  • Q217. ✓ Correct
  • Q218. ✓ Correct
  • Q219. ✓ Correct
  • Q220. ✓ Correct
  • Q221. ✓ Correct
  • Q222. X Incorrect
  • Q223. X Incorrect
  • Q224. ✓ Correct
  • Q225. ✓ Correct
  • Q226. X Incorrect
  • Q227. ✓ Correct
  • Q228. ✓ Correct
  • Q229. ✓ Correct
  • Q230. ✓ Correct
  • Q231. ✓ Correct
  • Q232. ✓ Correct
  • Q233. ✓ Correct
  • Q234. ✓ Correct
  • Q235. ✓ Correct
  • Q236. ✓ Correct
  • Q237. ✓ Correct
  • Q238. ✓ Correct
  • Q239. Skipped

Anatomy

Upper Limb

Question 38 of 239

A 28 year old man presents to ED having injured his right shoulder playing basketball. You position the patient as shown in the image below. He is unable to maintain this position with his right arm as you push downwards on both arms. Which of the following muscles is most likely to be injured:

Image by FRCEM Success.

Answer:

This is the Empty Can Test, used to assess the supraspinatus muscle. The test is positive if the patient has pain or weakness.

Supraspinatus Muscle

Anatomy / Upper Limb / Shoulder

Last Updated: 14th July 2019

The supraspinatus is part of the rotator cuff group of muscles.

Table: Function and Innervation of the Supraspinatus Muscle

Muscle Supraspinatus
Function Initiation of abduction of shoulder to 15 degrees (and then assistance of deltoid with continued abduction)
Innervation Suprascapular nerve
Examination Empty Can Test: Position the patient with arms elevated to 90 degrees in the scapular plane, with the elbow extended, and full medial rotation and pronation of the forearm with thumbs pointing downwards. Ask the patient to resist the downward force being applied to the forearm.  Test is positive is patient has pain or weakness.

Function

The supraspinatus acts to initiate abduction of the arm to 15 degrees and then assists the deltoid with continued abduction to 90 degrees.

Innervation

The supraspinatus is innervated by the suprascapular nerve.

Examination

The supraspinatus muscle can be assessed using the 'empty can' test. The 'empty can' test can be performed by positioning the patient with the arm in 90 degrees of forward flexion, in the plane of the scapula (approximately 30 degrees of abduction) and in full internal rotation with the thumb pointing down (as if emptying a can). The patient is asked to forward flex their arm against resistance, and the test is considered positive if there is significant pain and/or weakness.

Modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons

Supraspinatus Muscle. (Image modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

Report A Problem

Is there something wrong with this question? Let us know and we’ll fix it as soon as possible.

Loading Form...

Close
  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

Join our Newsletter

Stay updated with free revision resources and exclusive discounts

©2017 - 2024 MRCEM Success