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Anatomy
Upper Limb
Question 64 of 180
You have been asked to review a 65 year old woman who presents with a 2 week history of pain and weakness of the left shoulder. On examination you note weakness of lateral rotation at the glenohumeral joint, you suspect infraspinatus pathology. The infraspinatus muscle is innervated by which of the following nerves:
Answer:
The infraspinatus muscle is innervated by the suprascapular nerve.Infraspinatus Muscle
Anatomy / Upper Limb / Shoulder
Last Updated: 8th April 2019
The infraspinatus is part of the rotator cuff group.
Table: Function and Innervation of the Infraspinatus Muscle
| Muscle | Infraspinatus |
|---|---|
| Function | Lateral rotation of arm at glenohumeral joint |
| Innervation | Suprascapular nerve |
| Examination | Infraspinatus Test: Position the patient with the arm fully adducted, with the elbow flexed to 90 degrees. Ask the patient to resist the medially directed force to the arm. Test is positive if patient has pain or weakness. |
Function
It acts to laterally rotate the arm at the glenohumeral joint, together with the teres minor muscle.
Innervation
It is innervated by the suprascapular nerve.
Examination
Infraspinatus Test: Position the patient with the arm fully adducted, with the elbow flexed to 90 degrees. Ask the patient to resist the medially directed force to the arm. The test is positive if the patient has pain or weakness.
![Modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons](https://mrcemsuccess.com/wp-content/uploads/2016/12/Infraspinatus-1.png)
Infraspinatus Muscle. (Image modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons)
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- 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 |
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