Shoulder

Question 1

NOTE

Answer 1

Can be asked alongside cervical spine:
Look
Feel
Range of movements in the neck
(up, down, side to side, ear to shoulders)
special test - i dont think there is one for cervical

Can be asked in isolation

Question 2

1!!!
screen is the first thing you do in a shoulder exam

SCREEN QUESTIONS
Ask the patient if they
o can dress themselves without difficulty
o can wash their own hair

Answer 2

I’ve been asked to examine your shoulder, this will involve

• inspecting shoulder
• feeling shoulder joint
• assessing the range of movements in the

take shirt off for the examination and we can get started

Question 3

2

Answer 3

Inspect:

Front
Side
Back

Question 4

3

Answer 4

Assess temp

over the shoulder with back of hand. go along the clavicle up to tip of shoulder

Question 5

4

Answer 5

palpate
sterno-clavicular joint and then move along to
clavicle
clavicle-shoulder joint
head of humerus and work your way down the humerus

then start from the back of the shoulder and move to the front of the shoulder

Question 6

5

Answer 6

turn and face the wall behind you

palpate borders of scapula

Question 7

6

Answer 7

Palpate the muscle bulk

delts, traps, supraspinatus

Question 8

8

Answer 8

Active range of movement:

FLEXION AND EXTENTION - all way back!!!

Question 9

9

Answer 9

Abduction and Adduction (SNOW ANGEL)

“Arms out to the side, and all the way to the top

“Bring your arms back down and across your body”

Question 10

10

Answer 10

internal/external rotation

Dalek!!
Tuck elbows in, bend arm to 90 degrees and move arms out

Question 11

11

Answer 11

2 extra movements:

• sunbathe
• both hands reach up your back as far as you can

Question 12

12

Answer 12

PASSIVE ROM:

-flexion and extention
-abduction and adduction (move across body as well
-internal rotation
assess for crepitus)

Question 13

13

NEXT STEP IS HALF PASSIVE!!!!

Its semi painful!!!!

Answer 13

The painful arc (kinda still passive)

“im going to move your arm to the ceiling and then youre gonna bring it back down to the resting position yourself”

lift arm up, slowly lift back down on their own, ask if was painful

Question 14

14

Answer 14

Specific tests
(To be used if indicated by the patient’s history – you be given instructions as to whether these
are to be included in an OSCE station)

Question 15

15

Answer 15

rotator cuff (ext/int/abduction) against resistance

external rotation - push against hand

Question 16

16

Answer 16

internal rotation

put hand against back, palm facing outwards. now push against my hand

Question 17

17

Answer 17

resistance against active abduction

Question 18

18

Answer 18

Summary

• on inspection no obvious deformities
• on palpation he had no pain or tenderness
• full range of active and passive ROM

Complete

• Examine the cervical spine and elbow
• Assess the neurological and vascular status of the limb

(Thank patient and ask to get dressed. Wash hands!!)