S1_L4: Examination of the Shoulder Joint

Question 1

Shoulder pain could be the result
of different shoulder conditions. What are they?

A. Bursitis, labral tear, ad caps

B. Muscle rupture, Joint sprains

C. Dislocation, Impingement syndromes

D. Rotator Cuff, bicipital, supraspinatus Tendinitis

E. All of the above

Answer 1

E

Question 2

modified T/F. There are a lot of shoulder conditions, how to know which one is the true cause of shoulder pain

(1) conduct a thorough interview

(2) run a comprehensive PT examination

Answer 2

TT

Question 3

T/F

A good history is the cornerstone of proper diagnosis especially in shoulder pain as there are a lot of possible causes

Answer 3

T

Question 4

T/F
the ff are the correct age on which the condition may occur

Condition (age)

Rotator Cuff Syndrome (40-50)
Adhesive Capsulitis (45-60)
Shoulder Tendinitis (35-50)
Bicipital Tendinitis (40)
Rupture of SITS muscle (40)
Calcific deposits (20-40)

Answer 4

T

Question 5

identify the gender bias of each condition

1. Supraspinatus Tendinitis
2. Bicipital Tendinitis
3. Adhesive Capsulitis

Answer 5

All F > M

Question 6

match the Condition to its Medical condition

1.Diabetes
2. ischemic heart disease
3. Inflammatory disease
(due to intake of steroids)

A. Adhesive capuslitis
B. Tendon rupture

Answer 6

1. A
2. A
3. B

Question 7

match the Chief complaint to its Associated conditions

1. Labral disorder, rotator cuf tears, snapping scapula, subacromial bursitis, biceps tendon disorders
2. Dislocation
3. Labral tear
4. Bursitis
5. Adhesive capsulitis, calcific tendinitis
6. Subluxation, dislocation
7. Almost all shoulder conditions

A. Pain
B. Instability
C. Stiffness
D. Deformity
E. Locking
F. Swelling
G. Catching

Answer 7

1. G
2. D
3. E
4. F
5. C
6. B
7. A

Question 8

match the Quality of pain to its Associated conditions

1. Radicular pain (sharp, burning, radiating)
2. Deep, boring, localized
3. Hot and burning
4. Diffused, aching, poorly localized

A. Nerve
B. Bone
C. Tendon
D. Vascular

Answer 8

1. A
2. B
3. C
4. D

Question 9

match the Intensity of pain to its Associated conditions

1. Difficulty tucking in shirts
2. Pain with movement above 90 degrees of abduction with horizontal abduction
3. Difficulty with arm elevation in abduction, ER, and IR
4. Constant pain and worst at night

A. Adhesive Capsulitis
B. Posterior capsular stiffness
C. Vascular

Answer 9

1. B
2. C
3. A
4. A

Question 10

match the Weakness to its Associated conditions

1. Muscle strain
2. inflammation
3. Neurologic problems
4. myopathies
5. Delayed onset muscle soreness DOMS

A. Painful weakness
B. Painless weakness

Answer 10

1. A
2. A
3. B
4. B
5. A

Question 11

match the Occupation/
Activities to its Common musculoskeletal conditions

1. Triceps/ Biceps rupture
2. Carpal Tunnel Syndrome
3. Thoracic Outlet Syndrome
4. Labral tears, dislocation
5. Impingement

A. Pitchers
B. Swimmers
C. Lifters
D. Secretary/ Clerical work
E. Painters

Answer 11

1. C
2. D
3. E
4. A
5. B

Question 12

match the Occupation/
Activities to its Common musculoskeletal conditions

1. Median or Ulnar nerve pathology
2. Ulnar nerve palsy
3. Raynaud’s disease
4. Spondylolisthesis
5. Lateral Epicondylalgia

A. Musicians
B. Bikers
C. Construction workers (jackhammer)
D. Gymnasts
E. Tennis player

Answer 12

1. A
2. B
3. C
4. D
5. E

Question 13

Why do we have to ask a
lot of questions?? Does the pt. need to
answer all of them???

Answer 13

Yes, since we will assure them that all the information that they share
with us will be treated with utmost confidentiality

Question 14

match the ff ocular findings

1. Deltoid atrophy
2. Balled-up appearance
3. Prominent clavicle
4. Swelling of the anterior aspect of the shoulder
5. Atrophy of the serratus anterior

A. High-riding clavicle
B. Fountain sign
C. Popeye sign
D. Squared appearance of the shoulder
E. scapular winging

Answer 14

1. D
2. C
3. A
4. B
5. E

Question 15

modified T/F

muscle guarding is noted during no activity, passive (hypertonicity)

muscle spasm is noted during active movements

Answer 15

FF

muscle SPASM is noted during no activity, PASSIVE (hypertonicity)

muscle GUARDING is noted during ACTIVE movements

Question 16

which of the ff are NOT true on ROM

A. (+) capsular pattern means there’s capsular pathology

B. (-) capsular pattern means it’s non capsular & might be tendon, muscle, soft tissues pathology

C. capsular pattern of shoulder
follows Abd>ER>IR

D. None of the above

Answer 16

C. capsular pattern of shoulder
follows ER>ABD>IR

• ER is the most limited shoulder movement

Question 17

T/F the ff myotomes are correctly matched

C5: elbow flexors

C6: elbow extensors

C7: wrist extensors

C8: Finger flexors

T1: Finger abductors

Answer 17

F

C6: wrist extensors

C7: elbow extensors

Question 18

modified T/F

Masked weakness is painless weakness due to nerve problem

True weakness is painful weakness due to inflammation/muscle strain

Answer 18

FF

TRUE weakness is PAINLESS weakness due to nerve problem

MASKED weakness is PAINFUL weakness due to inflammation/muscle strain

Question 19

T/F
the ff are the correct dermatomal distribution

C3: Supraclavicular area
C4: AC joint
C5: Lateral shoulder/ arm

Answer 19

T

Question 20

match the ff special test
(can have multiple answers)

1.Anterior Instability
2. Multidirectional Instability

A. Load and shift test
B. Crank test
C.Anterior drawer test
D. Sulcus sign
E. Feagin test

Answer 20

1. A, B, C
2. D, E

Question 21

3. Impingement

Neer

Hawkins-Kennedy

Posterior Internal
Impingement

Labral tear

Clunk test

Anterior slide test

Active Compression test of

O’Brien

Answer 21

.

Question 22

match the ff special test
(can have multiple answers)

1. Muscle pathology
2. Scapular staility

A. Speed’s test
B. Lateral scapular slide test
C. Yergason’s test
D. Wall-floor push up
E. Drop arm test
F. Scapular protraction test
G. Lift-off sign
H. Spring back test

Answer 22

1. A, C, E, G, H
2. B, D, F

Question 23

which of the ff are true about special test

A. 2 confirmatory and 1 rule out tests

B. Usually done last (with palpation)

C. Exercise prudence in choosing from
among the many special test

D. All of the above

Answer 23

D

Question 24

modified T/F on postural assessment

When assessing, you should start from
the head down to the feet

When documenting, write the findings
from the feet up to the head

Answer 24

FF

When ASSESSING, you should start from
the FEET up to the HEAD

When DOCUMENTING, write the findings
from the HEAD down to the FEET

Question 25

which of the ff are part of the functional assessment

A. Level of dependence (indep or
dependent)

B. Degree of difficulty (Min, mod or
max difficulty)

C. Number of assistance (+1, +2, +3)

D. ADLs (combing, donning/ doffing
clothes, reaching overhead, wearing
undergarments, tucking shirts, reaching
for the back pocket, etc)

E. All of the above

Answer 25

E

Question 26

match the ff OMTs

1. 30 items, self-report questionnaire that measures physical function and symptoms
2. For pain level and extent of difficulty (13 item- questionnaire)
3. 12 questions related to ADLs For INSTABILITY

Scoring
4. Responses are added on Scores of 12 (best function) to 60(worst function)

5. (expressed as %) with Pain: 50 points, Disability: 80 points & 0= best result; 100= worst, Any question missed should be taken out of the total score of each subscale
6. Disability section (30 items; 1-5 points [(sum of n responses/n) - 1] x 25,
   n= number of completed responses, NOT CALCULATED if >3 missing items

A. Disabilities of the Arm, Shoulder and Hand (DASH)

B. Shoulder Pain and Disability Index (SPADI)

C. Oxford Shoulder Instability Score (OSIS)

Answer 26

1. A
2. B
3. C
4. C
5. B
6. A