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OSCEs > MSK - Shoulder > Flashcards

MSK - Shoulder Flashcards

1
Q

Prepare patient

A

Bare (only underwear) above waist

Check for pain

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2
Q

Procedure of exam

A 
Inspection
Palpation
Move
Rotator Cuff Power
Special tests
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3
Q

From what positions do you inspect?

A

Anterior
Lateral
Posterior
Axillae

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4
Q

Anterior inspection

A 
contour
deltoid and trapezius muscle bulk
Sterno-clavicular and acromio-clavicular joints
Clavicle
Scars
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5
Q

Lateral inspection

A

Contour

Sterno-clavicular and acromio-clavicular joints

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6
Q

Posterior inspection

A

Supraspinatous and infraspinatous fossae

Scapula for evidence of asymmetry

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7
Q

Axillae inspection

A

Swellings or scars

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8
Q

Palpation

A 
Sterno-clavicular joint
Clavicle
Acromio-clavicular joint
Long head of biceps
Spine of scapula
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9
Q

Move

A 
Forward flexion
External rotation
Abduction (from front and then view from behind)
Internal rotation
Scapula winging
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10
Q

Rotator Cuff Power

A

Supraspinatous
Infraspinatous
Teres minor
Subscapularis

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11
Q

How do you test supraspinatous power?

A

Arms out, thumb pointing to floor

press on patients arms as they try to push against you

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12
Q

How do you test infraspinatous and teres minor?

A

External rotation test, but with resistance

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13
Q

How do you test subscapularis?

A

Hands in middle of back

Push against examiners hands

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14
Q

Special tests for impingement or rotator cuff pathology?

A

Painful arc on abduction
Hawkins-Kennedy test
Scarf test
Jobes test

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15
Q

What does a painful arc suggest?

A

Impingement

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16
Q

What is the Hawkins-Kennedy test?

A

arm extended, bend at elbow so that hand is pointing towards other arm, and bend arm towards floor

17
Q

What does +ve Hawkins-Kennedy test suggest?

A

Impingement

18
Q

What is the scarf test?

A

Put arm round neck and push on elbow

19
Q

What does a +ve scarf test suggest?

A

ACJ pathology

20
Q

What is Jobes test?

A

Same as testing supraspinatous power

21
Q

What does a +ve Jobes test suggest?

A

Supraspinatous tear

22
Q

Special tests for instability

A

Sulcus signs
Anterior and posterior drawer tests
Anterior apprehension and relocation test
Posterior apprehension test

23
Q

What is sulcus sign?

A

Hold patients shoulder

Pull down on arm

24
Q

How do you perform anterior and posterior drawer test?

A

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… ?

25
Q

How do you perform anterior apprehension and relocation test?

A

Arm at 90 degrees

Push arm back, then place hand on shoulder in an attempt to relocate it (this should relieve pain)

26
Q

How do you perform posterior apprehension test?

A

Like scarf test, but with patient lying down

OSCEs (26 decks)

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