Practical skills of the shoulder region

Question 1

what are the limiting factors for elevation of the shoulder girdle?

Answer 1

SCJ joints- tension in costoclavicular ligs and subclavius

ACJ- Coracoclavicular ligs (both bands)

Question 2

what are the limiting factors of depression at the SCJ?

Answer 2

Interclavicular lig and intra-articular disc

Question 3

what are the limiting factors for protraction at the shoulder girdle

Answer 3

SCJ- sternoclavicular and costoclavicular ligaments

ACJ- coracoclavicular ligament and fibrous capsule

Question 4

what are the limiting factors for retraction at the shoulder girdle

Answer 4

SCJ- sternoclavicular and costoclavicular ligaments

ACJ- Coracoclavicular lig and fibrous capsule

Question 5

what is normal ROM for flexion at the glenohumeral joint

Answer 5

0- 110 degrees (180 degrees)

Question 6

what is normal ROM for extension at the glenohumeral joint

Answer 6

0-70 degrees

Question 7

what is normal ROM for ABduction at the glenohumeral joint

Answer 7

0-120 degrees

Question 8

what is normal ROM for medial rotation at glenohumeral joint

Answer 8

0-80 degrees

Question 9

what is normal ROM for lateral rotation at glenohumeral joint

Answer 9

0-90 degrees

Question 10

limiting factors flexion glenohumeral joint

Answer 10

tension in capsular structures and surrounding opposing musculature

Question 11

limiting factors extension glenohumeral joint

Answer 11

tension in capsular structures and opposing musculature

Question 12

limiting factors abduction glenohumeral joint

Answer 12

glenohumeral ligs (middle and inferior bands) and inferior part fibrous capsule

Question 13

what 3 tests can be used to test for sub acromial pain syndrome (SAPS)

Answer 13

-hawkins kennedy test
-infraspinatus muscle test
- painful arc test

Question 14

How many positive test results would indicate SAPS

Answer 14

If all 3 tests are positive, high likelihood SAPS is present,, 2 positive results indicates moderate likelihood of SAPS

Question 15

how would you conduct hawkins kennedy test

Answer 15

patient’s shoulder and elbow both flexed to 90 degrees
arm is medially rotated (pushed downwards)

Question 16

what is a positive test of hawkins kennedy test

Answer 16

model experiences familiar pain

Question 17

how to conduct infraspinatus muscle test

Answer 17

patients elbows flexed at 90 degrees, while keeping them to their side
therapist applies pressure on outer surface of forearm, pushing inwards, patient should resist this

Question 18

positive test for infraspinatus muscle test

Answer 18

model experiences familiar pain or weakness

Question 19

how to conduct painful arc test

Answer 19

model asked to abduct shoulder through full available range of motion, and then lower back down in controlled manner bck to their side
model asked to speak of any pain as soon as it is felt

Question 20

positive test for painful arc test

Answer 20

model experiences pain between 40-120 degrees of abduction, which eases below 40 degrees or higher than 120 degrees

Question 21

how to conduct drop arm test

Answer 21

model is asked to abduct arm to 90 degrees
they then slowly lower arm back to side

Question 22

positive test of drop arm test

Answer 22

pain or weakness experienced, which causes arm to drop

Question 23

what 3 tests, when combined are all positive indicate a very likely full tear of the rotator cuff

Answer 23

painful arc test
infraspinatus test
drop arm test

Question 24

which specific rotator cuff muscle does the drop arm test target

Answer 24

supraspinatus

Question 25

which specific rotator cuff muscle does the bear hug test target

Answer 25

subscapularis

Question 26

how to conduct bear hug test

Answer 26

model places hand of affected arm on opposite shoulder
physio tries to pull hand up off of the shoulder

Question 27

positive test for bear hug test

Answer 27

patient not able to resist external rotation force applied by physio- due to pain or weakness
if affected arm displays weakness compared to other arm

Question 28

which rotator cuff muscle does the hornblowers test target

Answer 28

teres minor

Question 29

how to conduct hornblowers test

Answer 29

patient’s shoulder and elbow both at 90 degrees
they maintain position, and instructed to say as soon as any pain is felt

Question 30

positive hornblowers test

Answer 30

unable to hold position due to pain or weakness

Question 31

what does the scarf test, test for

Answer 31

ACJ dysfunction

Question 32

how to conduct scarf test

Answer 32

patient reaches over to other hsoulder
physio applies pressure with one hand, holds on to the shoulder with the other

Question 33

what is a positive scarf test, and why does it demonstrate ACJ dysfuction

Answer 33

pain produced in the region of the ACJ
the test compresses the joint surfaces of the ACJ together