MSK - Shoulder Flashcards
Prepare patient
Bare (only underwear) above waist
Check for pain
Procedure of exam
Inspection Palpation Move Rotator Cuff Power Special tests
From what positions do you inspect?
Anterior
Lateral
Posterior
Axillae
Anterior inspection
contour deltoid and trapezius muscle bulk Sterno-clavicular and acromio-clavicular joints Clavicle Scars
Lateral inspection
Contour
Sterno-clavicular and acromio-clavicular joints
Posterior inspection
Supraspinatous and infraspinatous fossae
Scapula for evidence of asymmetry
Axillae inspection
Swellings or scars
Palpation
Sterno-clavicular joint Clavicle Acromio-clavicular joint Long head of biceps Spine of scapula
Move
Forward flexion External rotation Abduction (from front and then view from behind) Internal rotation Scapula winging
Rotator Cuff Power
Supraspinatous
Infraspinatous
Teres minor
Subscapularis
How do you test supraspinatous power?
Arms out, thumb pointing to floor
press on patients arms as they try to push against you
How do you test infraspinatous and teres minor?
External rotation test, but with resistance
How do you test subscapularis?
Hands in middle of back
Push against examiners hands
Special tests for impingement or rotator cuff pathology?
Painful arc on abduction
Hawkins-Kennedy test
Scarf test
Jobes test
What does a painful arc suggest?
Impingement
What is the Hawkins-Kennedy test?
arm extended, bend at elbow so that hand is pointing towards other arm, and bend arm towards floor
What does +ve Hawkins-Kennedy test suggest?
Impingement
What is the scarf test?
Put arm round neck and push on elbow
What does a +ve scarf test suggest?
ACJ pathology
What is Jobes test?
Same as testing supraspinatous power
What does a +ve Jobes test suggest?
Supraspinatous tear
Special tests for instability
Sulcus signs
Anterior and posterior drawer tests
Anterior apprehension and relocation test
Posterior apprehension test
What is sulcus sign?
Hold patients shoulder
Pull down on arm
How do you perform anterior and posterior drawer test?
Patient lies on bed
Hold shoulder
Use other hand to displace the arm posteriorly and anteriorly feel for a strict end to the movement, if no strict end then it could be dislocated or ligaments loose or something… ?
How do you perform anterior apprehension and relocation test?
Arm at 90 degrees
Push arm back, then place hand on shoulder in an attempt to relocate it (this should relieve pain)
How do you perform posterior apprehension test?
Like scarf test, but with patient lying down
