Approach to Pt w/ joint pain and Shoulder Pain Flashcards
What is a normal reflex?
+2/4
What does Speed’s Test evaluate?
feel bicipital groove while having pt flex elbow against resistance
+ test = pain in bicipital groove
indicates: bicipital tendonitis of longhead biceps
What is a landmark for C4 dermatome?
top of shoulder
What vertebrae is at the inferior border of the scapula?
T7
What does OLDCAAARTS stand for?
onset location duration character alleviating factors aggravating factors associated factors radiation timing severity
What is the specificity of a joint test?
portion of pts without the diagnosis who lack the physical sign (true negative)
What is a landmark for T4 dermatome?
nipple line
What happens in a dislocation?
complete lack of contact btw two articular surfaces
What does migratory mean?
moves from one joint to another
What is tenosynovitis?
inflammation of the tendon sheath
What does the sulcus sign evaluate?
+ test = indentation appears beneath acromion
Indicates: glenohumeral instability
When do muscle strains often happen?
when muscle is stretched and contracted simultaneously
“grabbing sensation”
How do you document examination of edema?
press for 5 seconds
0 = absent
1+ = barely detectable, 2 mm, disappears rapidly
2+ = slight indentation (4 mm); 10-15 sec
3+ = deeper indentation (6mm); >1 min
4+ very marked indentation (8 mm); 2-5 min
What does the apley scratch test evaluate?
Range of motion of shoulder; test both sides
Upper arm: abduction and external rotation
Lower arm: internal rotation and adduction
What does the Empty Can test indicate?
Flex shoulder to 90 degrees while horizontally abducting to 45 degrees; internally rotated
press down on forearms while pt resists
+ test = pain or weakness
Indicates: rotator cuff pathology (spec supraspinatus m)
What is a landmark for C5 dermatome?
lateral part of upper arm
What does arthralgia mean?
joint pain
What does Neer Impingement evaluate?
Stabilize shoulder; w/ forearm pronated, passively flex shoulder to fully flexed pos
+ test = pain
Indicates: subacromial bursa or rotator cuff impingement
What does the lift off test evaluate?
pt’s arm in internal rotation and extension (arm behind back); pt pushes arm into further internal rotation against physician
+ test = weakness
Indicates: subscapularis weakness
What is a sprain?
ligament stretching and tearing
bleeding outside of ligament is proportional to how bad the tear is
What is a normal pulse?
+2/4
What does the drop-arm test evaluate?
Pt abducts to 90 degrees –> slowly drops arm
+ test: arm will drop or gentle tap on wrist will cause arm to drop
indicates: full thickness tear of supraspinatus
What vertebrae is at the spine of scapula?
T3
What is subluxation?
abnormal joint movement, but there is still residual contact btw articular surfaces
What is a normal muscle strength?
+5/5
What does the painful arc test evaluate?
+ test = pain within 60 and 120 degrees of abduction
indicates: subacromial impingement or rotator cuff injury
What is a landmark for C8 dermatome?
5th digit
What does the apprehension test evaluate?
put pt into external rotation
+ test = apprehensive of repeat dislocation
indicates: glenohumeral instability
What is LR in relation to a joint test?
probability of a disease or diagnosis
0 to infinity
higher the number, the more likely the disease
What does the cross arm test evaluate?
Passively adduct pt’s arm across chest
+ test = pain in aC joint w/ end range adduction
Indicates: AC joint pathology
What is a landmark for T10 dermatome?
umbilicus
What does Hawkins Test evaluate?
flex shoulder and elbow to 90 degrees; passively rotate into internal rotation
+ test = pain
indicates: rotator cuff or subacromial bursa impingement
What does extra-articular refer to?
bones, muscles, tendons, bursa, skin
What is the sensitivity of a joint test?
proportion of pts with the diagnosis that also have the physical sign (true positive)
What is a landmark for C7 dermatome?
posterior aspect of arm and forearm
middle 3 fingers
What is an effusion?
fluid escaped from blood vessels or lymphatics into tissues or cavity
What is a landmark for T1 dermatome?
medial aspect of arm and forearm
What does Yergason’s Test evaluale?
have pt supinate and externally rotate against resistance
+ test = pain and/or tendon sublaxation out of groove
Indicates: unstable long head bicipital tendon
What are landmarks for C6 dermatome?
radial aspect of forearm
thumb
