NMS3 Shoulder Orthos

Question 1

Pt seated. Instruct patient to touch opposite shoulder and lower arm to chest. Perform bilaterally.

Answer 1

Dugas test

Question 2

What does the inability to perform the Dugas test mean?

Answer 2

Anterior shoulder dislocation

Question 3

Exacerbation of pain in the shoulder while performing Apley’s scratch test indicates?

Answer 3

Degenerative tendonitis of rotator cuff. Usually supraspinatus tendon

Question 4

Pt seated. Doctor standing behind, ask patient to look at you. Abduct arm to 90 degrees and externally rotate. Look for pain on the patient’s face.

Answer 4

Apprehension test

Question 5

Apprehension test - Pain over anterior capsule, the look of apprehension, or laxity compared to good side will indicate what?

Answer 5

Anterior dislocation trauma of humerus

Question 6

Follow up to apprehension test. Perform same test except stabilize the anterior capsule to prevent humerus from moving forward.

Answer 6

Relocation test

Question 7

Pt seated. Palpate anterolateral and inferior to acromion (area of subacromial bursa), abduct patient’s arm to 90 degrees and press on spot again noting pain.

Answer 7

Dawbarn’s Sign (Subacromial bursa test)

Question 8

If pain is decreased when performing Dawbarn’s sign it is indicative of?

Answer 8

Subacromial bursitis

Question 9

Pt seated with hand internally rotated (in lap). Doctor standing behind applies downward traction on the arm by grasping the distal humerus/elbow. Looking for dimpling below acromion and above humeral head.

Answer 9

Sulcus sign

Question 10

A positive sulcus sign indicates what?

Answer 10

Multidirectional instability of the shoulder

Question 11

Pt can be seated or supine. Stabilize superior shoulder with inside hand, grasp humeral head with contact hand. Apply inward pressure to humeral head and move it anterior and posterior. Check to see if the bad side has noticeably more movement than good side, or if there is any popping, grinding, slapping.

Answer 11

Load and shift test

Question 12

Positive load and shift test indicates?

Answer 12

Instability of glenohumeral joint, possible labrum damage

Question 13

Pt seated. Doctor passively abducts arm above 90 degrees and then removes support causing the patient to actively “catch” it from falling. Could also have patient slowly lower their arm.

Answer 13

Drop arm test (Codman’s)

Question 14

The drop arm test (Codman’s) is checking for?

Answer 14

Rotator cuff tear or rupture of supraspinatus tendon

Question 15

Pt seated or standing w/elbow extended, arm abducted to 90 degrees, arm in neutral rotation. Doctor pushes down on arm while patient resists. Arm is then moved to 30 degrees horizontal flexion and thumb pointed down and doctor pushes down again.

Answer 15

Empty can test (Supraspinatus test)

Question 16

Positive empty can test means?

Answer 16

Lesion of supraspinatus muscle or tendon

Question 17

Pt seated. Place hand behind back over lumbars. Patient pushes posteriorly while doctor tries to hold/push anteriorly.

Answer 17

Lift-off test (Gerber’s)

Question 18

Positive lift-off test means?

Answer 18

Lesion of the subscapularis muscle or tendon

Question 19

Pt seated, elbow flexed 90 degrees. Instruct patient to supinate hand against your resistance. Either extend the elbow or externally rotate arm against resistance.

Answer 19

Yergason’s test

Question 20

Pt supine. Doctor abducts arm 90 degrees and applies P-A pressure on humeral head w/inside hand. Then internally and externally rotate patient’s arm with outside hand.

Answer 20

Clunk test

Question 21

Clicking or clunking during the clunk test indicates?

Answer 21

Labrum tear

Question 22

Pt supine. Bring arm to 160 degrees flexion in the scapular plane. Bend the elbow and apply a compressive force on the elbow while internally and externally rotating the arm.

Answer 22

Crank test

Question 23

Clicking or clunking during crank test indicates?

Answer 23

Labrum tear

Question 24

Pt seated. Bring arm and elbow to 90 degrees flexion (patient’s forearm should be across their body), support elbow and push down on wrist (attempting to internally rotate).

Answer 24

Hawkins-Kennedy test

Question 25

Pain in anterior glenohumeral joint during the Hawkins-Kennedy test indicates?

Answer 25

Rotator cuff tendonitis (possible impingement of supraspinatus tendon)

Question 26

Pt standing w/elbow extended and arm in 90 degrees flexion and then 10-15 degrees internal horizontal flexion (in front of chest). Internally rotate arm and have patient resist as you press down. Then externally rotate their arm and repeat.

Answer 26

O’Brien Sign

Question 27

Finding for O’Brien sign?

Answer 27

Deep pain in shoulder while internally rotated that is reduced/eliminated on external rotation indicates TORN GLENOID LABRUM

Question 28

Pt seated, elbow extended. Doctor takes arm and quickly flexes it all the way above the head.

Answer 28

Neer’s test

Question 29

Pain in anterior glenohumeral joint on Neer’s test indicates?

Answer 29

Rotator cuff tendonitis

Question 30

Pt supine, arm in 90 degrees abduction. Doctor presses S-I over humeral head checking for relief of pain in shoulder.

Answer 30

Impingement relief test

Question 31

Pt supine. Flex humerus and elbow 90 degrees and internally rotate (forearm should be crossing chest). Place one hand under scapula for support and apply compressive pressure A-P on elbow.

Answer 31

Posterior dislocation apprehension test