assessment of the shoulder Flashcards
GH flexion
180
GH abd
180
GH ext
60
GH ext rot
90
GH int rot
70
GH loose pack
55 abd and 33 horizontal add
sling position
AC loose pack
arm resting at side
SC loose pack
arm resting at side
GH close pack
full abd and external rotation
AC close pack
90 arm abd
SC close pack
max shoulder elevation
GH capsular
ex rot > abd > int rot
AC capsular
pain at end ranges
sc capsular
pain at end ranges
spine of scapula
ridge along upper lateral back
T3 level
medial border of scap
follow medial spine inferiorly
inferior angle of scap
terminal aspect of medial border
T7 level
posterior angle of acromion
most lateral aspect of spine of scap
sternal notch
midline v shape above sternum
SC joint and clavicle
1 cm inferior from sternal notch
s shaped bone that runs to shoulder
lateral edge of acromion and v notches
most lateral aspect of spine of scap
coracoid process
inferior to clavicle
hold arm in extension
lesser tubercle
laterally from coracoid until you reach a bony ridge
subscapularis
between coracoid and lesser tub
biceps
lateral to lesser tub in intertubercular groove
supraspinatus
superior to biceps on greater tub
easier to palpate in extension and IR
infraspinatus
under spine and attaches to posterior greater tub
teres minor
mediolateral
2 cm inferior to spine of scap
olecranon-manubrium percussion test
stethoscope over manubrium
taps olecranon
+ lack of symmetrical crisp sound
scapular active ROM observation
neutral
in elevation - up rot and ex rot
arms on hips - post tilt
shoulder flexion ROM
stationary: mid axillary line
fulcrum: greater tub
movement: lateral epicondyle
shoulder extension ROM
stationary: mid axillary line
fulcrum: greater tub
movement: lateral epicondyle
shoulder abduction ROM
stationary: parallel to sternum
fulcrum: anterior to acromion
movement: epicondyle that give more ROM
shoulder internal rotation ROM
stationary: perpendicular to floor
fulcrum: olecranon process
movement: ulnar styloid process
shoulder external rotation ROM
stationary: perpendicular to floor
fulcrum: olecranon process
movement: ulnar styloid process
scapular elevation 3-5
sitting
stabilize side of head
push down on shoulder
scapular elevation 3-5
prone
can elevate?
scapular protraction 0-5
seated
stabilize superior aspect of same shoulder
push back
scapular retraction 0-5
prone
pressure over contralateral thorax
push down
arm straight out for middle trap
arm up for lower trap
arm behind back for rhomboids
shoulder flexion 3-5
seated
stabilize superior shoulder
push down proximal to elbow
shoulder flexion 0-2
side lying
stabilize ipsilat shoulder
support test side in neutral position
shoulder extension 3-5
prone
stabilize ipsi thorax
push down
shoulder extension 0-2
side lying
stabilize ipsilat shoulder
support test side in neutral position
shoulder abduction 3-5
seated
stabilize superior border of scap
push down
shoulder abduction 0-2
supine
towel under arm
shoulder horizontal abduction 3-5
prone
stabilize scapula
push into table proximal to elbow
shoulder horizontal abduction 0-2
seated in chair
towel under arm
guard trunk
shoulder horizontal adduction 3-5
supine
stabilize clavicle
push into table
shoulder horizontal abduction 0-2
seated in chair
towel under arm
guard trunk
shoulder internal rotation 3-5
prone
arm at 90/90
rotate toward ears
shoulder internal rotation 0-2
prone, shoulder hanging off table
shoulder external rotation 3-5
prone
arm at 90/90
rotate toward toes
shoulder external rotation 0-2
prone, shoulder hanging off table
sulcus sign
distract shoulder
+ see a sulcus at GH
ST joint glides
side lying
glide scapula in different directions
GH joint anterior glide
prone
push down and stabilize proximal to elbow
GH joint posterior glide
supine push down and stabilize proximal to elbow
GH joint inferior glide
supine
push inferior
stabilize proximal to elbow
ST anterior glide
supine
ST inferior glide
use thumbs to push clavicle down
AC posterior glide
supine
both thumbs push down on ac
anterior apprehension test
supine with elbow in 90/90
move into 90 deg abd and full external rotation
+ if pain or apprehension present
shoulder shrug sign
upright
raise arm into maximal shoulder flexion
+ shoulder girdle shrugs prior to 90 deg of active flexion
coracoid pain test
arms at sides
palpate each coracoid
+ pain in one side 3 points greater than other
lateral jobe test
sitting with arm abd to 90 deg and full internal rot
inferior force while pt resists
+ pain or weakness
hornblower’s sign
sitting upright
90 deg of ER and abd
resistance at wrist into IR and maintain against resistance
+ fails to maintain
internal rotation lag test
upright with hand behind back
maintain position of wist off of back
+ cannot maintain, wrist falls back into spine
