1. Shoulder

Question 1

Look

Answer 1

Both shoulders exposed
Look from the front, side and back
- Loss of symmetry
- Loss of shoulder contour could suggest dislocation
- Level of shoulders and winging of scapula
- muscle wasting (deltoid, infraspinatous, supraspinatous)
- Scars, wounds, sinuses, skin discolouration (bruising), swelling

Question 2

Feel

Answer 2

• Temperature at joint and adjacent areas
• Palpate bony landmarks for tenderness (Start sternoclavicular joint, along clavicle to acromioclavicular joint)
• Palpate acromion process, scapula, spine of scapula and greater tuberosity of humerus
• Palpate the anterior and posterior joint lines
• Palpate muscles (supraspinatous, deltoid, infraspinatous)
• Check axillary nerve sensation (badge patch area)

Question 3

Move - Active (1st)

Answer 3

• Hands behind head (abduction, external rotation)
• Hands behind back and give measure (addiction, internal rotation)
• Full extension and full flexion
• External and internal rotation of shoulder (elbows flexed 90 degrees, tucked into body) frozen shoulder

Question 4

Move - Passive (2nd)

Answer 4

Repeat all movements passively

• Hand on top of shoulder for crepitus
• Assess extension, flexion, abduction
• Assess external rotation with elbows at 90 degrees
• Abduction (painful arc?)
• Assessment of scapula movement (from behind, thumb and finger, note angle)

Question 5

Function

Answer 5

• Already assessed with hands behind head/back

- Examination of cervical spine and elbow (joint above and below)