OSCE: Shoulder

Question 1

What are some important landmarks of the shoulder?

Answer 1

• Level of T3: Spine of Scapula
• Level of T7: Inferior Border of Scapula
• Greater Tubercle of Humerus
• Bicipital Groove

Question 2

What is the normal ROM for shoulder flexion?

What muscles are involved?

Answer 2

180^o

Anterior Deltoid and Coracobrachialis

Question 3

What is the normal ROM for shoulder extension?

What muscles are involved?

Answer 3

60^o

Latissimus Dorsi and Teres Major

Question 4

What is the normal ROM for shoulder abduction?

What muscles are involved?

Answer 4

180^o

Deltoid and Supraspinatus (main)

0-15^o: Supraspinatus

15-100^o: Deltoid

>90^o: Trapezoid

>100^o: Serratus Anterior

Question 5

What is the normal ROM for shoulder horiztonal adduction?

What muscles are involved?

Answer 5

130-140^o

Pectoralis Major and Latissimus Dorsi

Question 6

What is the normal ROM for shoulder horizontal abduction?

What muscles are involved?

Answer 6

40-55^o
Supraspinatus and Mid-deltoid

Question 7

What is the normal ROM for shoulder external rotation?

What muscles are involved?

Answer 7

90^o

Infraspinatus and Teres Minor

Question 8

What is the normal ROM for shoulder internal rotation?

What muscles are involved?

Answer 8

90^o

Subscapularis and Pectoralis Minor

***I would say its Pec Major but I am just copying the OSCE

Question 9

What dermatome tests the top of the shoulder?

Answer 9

C4

Question 10

Apprehension Test

What does a positive test indicate?

How do you peform this test?

Answer 10

1. Patient is seated or supine.
2. Shoulder abducted to 90° and elbow flexed to 90°.
3. Stabilize shoulder with one hand (blocking linkage) and force arm into external rotation with the other hand.

Positive Test (apprehensive) indicaes Glenohumeral Instability

Question 11

Empty Can Test

What does a positive test indicate?

How do you peform this test?

Answer 11

1. Flex patient’s shoulders to 90° while horizontally abducting to 45°.
2. Internally rotate both arms so thumbs are pointing down.
3. Press down on forearms while patient resists.

Positive test (pain/weakness) indicates Rotator Cuff Pathology (specifically Supraspinatus)

Question 12

Drop Arm Test

What does a positive test indicate?

How do you peform this test?

Answer 12

1. Patient abducts arm to 90°
2. Slowly drops arm.

Positive test (arm drop upon tap) indicates full thickness tear of supraspinatus

Question 13

Painful Arc Test

What does a positive test indicate?

How do you peform this test?

Answer 13

1. Patient abducts arm starting at their side toward his head.

Positive Test: Pain is elicited within 60 and 120 degrees of shoulder abduction.

Indicates subacromial impingement and/or rotator cuff injury

Question 14

Neer Impingement

What does a positive test indicate?

How do you peform this test?

Answer 14

1. Stabilize patient’s shoulder.
2. With forearm pronated, passively flex shoulder to fully flexed position.

Postive test (pain) indicates subacromial bursa or rotator cuff impingement

Question 15

Hawkins Test

What does a positive test indicate?

How do you peform this test?

Answer 15

1. Flex shoulder to 90° and flex elbow to 90°
2. Passively rotate the humerus into internal rotation.This opposes rotator cuff against coracoacromial ligament and acromion.

Positve test (pain) indicates **rotator cuff or subacromial bursa
impingement**

Question 16

Cross Arm Test

Answer 16

1. Physician passively adducts patient’s arm across their chest
2. Rest patient’s hand on their opposite shoulder. (+) Test: Pain in AC joint with end range adduction

Positve test (pain) indicates AC joint pathology