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NBME 23 Answers

nbme23/Block 2/Question#47 (33.8 difficulty score)
A 65-year-old man is scheduled for physical ...
Medial (internal) rotation🔍
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 +10 
submitted by guillo12(47),
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arcanumm  I got this wrong too, but I think the exercise of internal rotation makes sense because it will isolate the muscle (without assistance by teres minor for adduction). +5  
tiredofstudying  The subscapularis assists in medial (internal) rotation and adduction, but the teres minor also assists in adduction, so the best choice to isolate the subscapularis would be internal (medial) rotation. Choice E +2  
thotcandy  @tiredofstudying teres major also internally rotates so it wouldn't really be isolated either. I guess Tmajor isn't relevant cuz it's not a SITS muscle? Still a stupid question. +1  



 +1 
submitted by nicsar(1),

a)abduction: supraspinatus-deltoid-triceps-serratus anterior

b)adduction: subscapularis-pectoralis major-lattisimus dorsi- teres major

c)extension=horizontal abduction; post. deltoid, infraspinatus, teres minor

d)internal rotation: subscapularis

for isolated work out, d is better.

TEN REPS.

thotcandy  teres major also internally rotates? It's attached to the medial lip of the humerus +3  
neovanilla  teres minor externally rotates (+ad-duction) +  



 +1 
submitted by syoung07(30),

SITS: supraspinatus- ABduction Infraspinatus- Ext rotation Teres minor- Ext rotation Subscapularis- Int rotation.




 +0 
submitted by fenestrated(29),
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thaW stup nrlineta nittoroa rveo idnoatdcu? uaprsiSbulacs slumce oesd ohbt

smc213  probably because the subscapularis m. is the only SITS muscle that does internal rotation & adduction along with the teres minor m. action being adduction & external rotation. +1  



 +0 
submitted by abhishek021196(61),

Shoulder muscles that form the rotator cuff: Supraspinatus (suprascapular nerve)— abducts arm initially (before the action of the deltoid); most common rotator cuff injury (trauma or degeneration and impingement; tendinopathy or tear [arrow in A ]), assessed by “empty/full can” test

Infraspinatus (suprascapular nerve)—externally rotates arm; pitching injury

teres minor (axillary nerve)—adducts and externally rotates arm

Subscapularis (upper and lower subscapular nerves)—internally rotates and adducts arm