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Erin is learning to bowl from her own private bowling instructor. The instructor is demonstrating in slow motion the proper technique via extending his shoulder and elbow simultaneously. However, he is unable to hold the heavy ball up in the air behind himself.  Why did he have such difficulty holding the ball with his shoulder and elbow both in the extended position?

A patient sustained multiple deep lacerations on the palm of his hand and anterior surface of his wrist. During examination, the physician put a piece of paper between adjacent surfaces of the patient’s index (digit 2) and middle (digit 3) fingers and found him unable to squeeze them together with sufficient force to hold the paper. What muscles are being tested?

BONUS QUESTION: Michael is receiving outpatient OT services due to an ulnar nerve lesion and paralysis of most of the intrinsic muscles of the fingers. He presents with “claw” position of the hand and is unable to extend the IPs, especially in digits 4 and 5. How should you position Michael’s hand allow the extensor digitorum to extend the IP joints?

Cindy is attending out-patient OT due to a hand injury. She is squeezing a small foam ball in effort to improve her hand strength.  Which of Cindy’s distal muscles is being used to flex all of the joints in her fingers?

Which of the following structures prevents bow stringing of the digital flexors as they travel along the anterior aspects of the DIGITS?

Which of the following muscles does NOT flex the hip joint?

Little Nicholas is using a three-jaw chuck to pick up blocks from the floor. Which muscle(s) are being used to simultaneously flex the MCPs and extend the IPs?

Which of the following nerves has contribution from the posterior division of inferior trunk of the brachial plexus?  

As Gregg abducts his shoulder to reach overhead, which muscle(s) synergistically contract with the middle deltoid and supraspinatus to form a force couple around the head of the humerus resulting in an almost perfect spinning of the humeral head in the glenoid fossa?

A 31-year-old woman with reported history of major depressive disorder and attention-deficit/hyperactivity disorder presents as a new patient. She is currently 10 weeks pregnant by last menstrual period and confides in you that she has been using intravenous heroin daily for 2 years. She has been going to Narcotics Anonymous meetings intermittently, says she asked someone to be her sponsor, and has been “trying to give it my all.” She says she last used heroin 2 days ago and says she “really wants to stay off the stuff for the baby” but feels “the worst I have ever felt in my life.” She endorses diarrhea, irritability, and achiness. On physical exam, she is noted to be flushed, she frequently shifts in her seat, she is yawning frequently, and she uses several tissues to blow her nose. What of the following is the most appropriate next step in management?