Shoulder

Question 1

Look:

Answer 1

When palpating:
-use X2 fingers

Anterior, lateral, posterior and axillary

Anterior:
-Deltoid and trapezius muscle bulk
-Sterno-Clavicular joints
-Acromio-clavicular joints (acromion process go humerus and scapula)
-Scars etc

Lateral:
-Shoulder contour
-Sterno-Clavicular joints
-Acromio-clavicular joints

Posterior:
-Supraspinatus and Infraspinatus fosse for muscle wasting (Rotator Cuff) *above and below the SCAPULA

Axillary:
Swellings and scars

Question 2

Feel: (one side only)

Answer 2

Sterno-clavicular joint
Acromion-clavicular joint
-Scapula
-Spine

Question 3

Move: (compare BOTH Shoulders)

Answer 3

Carry out Active movement, ONLY perform Passive movement if movement range is limited.

Stand behind the patient- look at scapula when they are doing the movements

External Rotation:
Keep elbows by side flexed at 90 degrees and move forearms outwards.

Internal Rotation:!!
-Ask patient to place hand behind their back and reach for the spine. (waist level)

Abduction: (away)
Patient raise arms out by their sides in arc like motion until their hands are above their head.

Adduction: (towards)
Straight Arms to opposite sides

Scapula Winging:
Patient puts arms on the wall

Question 4

State where the sterna-clavicular joint is

Answer 4

located at point between where the sternal head and clavicle meets.

Question 5

Where and what are the Supraspinatus and Infraspinatus muscles?

Answer 5

These are Rotator Cuff muscles located posteriorly. Supraspinatus is located superiorly to the scapula and Infraspinatus is inferior to the scapula.

Question 6

What is the difference between Active and Passive Movement?

Answer 6

-Active- movement carried out by the patient themselves
-Passive- movement carried out by the examiner

Question 7

If patient can’t fully complete abduct one of their arms arms what condition does this indicate?

Answer 7

Impingement Syndrome (compression on the subacromial space)
*usually arms can’t abduct fiurther than 60-120 degrees

Question 8

Name the Special tests carried out

Answer 8

Scarf test, Hawkin’s Kennedy test, Jobe’s test, Apprehension test, Arc, Sulci Sign, Scapular winging
(SHAASS)

Impingement Syndrome:
Painful arc on abduction (60-120 degrees)
-try and passively move it for them to see if it still moves

Hawkin’s Kennedy test- Arm bent at 90 degrees AT SIDES and flatten down > impingement syndrome

Rotator Cuff Tear:
Jobe’s test- soup can
*(apply pressure!
-acromioncavoiclar joint

Scarf test- reach hand on back to opposite shoulder

Instability:
-Sulci sign- pull down on the shoulder

Scapular Winging

Apprehension test; (Shoulder Dislocation)
-lie on bed with arm bent and push down with force.

Question 9

What does an abnormal Jobe’s test indicate

Answer 9

Rotator Cuff tear
(soup can test)

Question 10

Suspected Conditions: Based on Age

Younger:
-instability
-impingement syndrome
-dislocation

Older:
-frozen shoulder
-rotator cuff tear

Answer 10

Painful arc
pain 60-120 degrees- impingement syndrome