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Ortho tests > Shoulder > Flashcards

Shoulder Flashcards

1
Q

What does Speeds test

A

Bicep tendinopathy, impingement syndrome, labral lesion, bursitis, SLAP lesion

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2
Q

Speeds technique

A

Pt seated
Forearm ext + sup, arm at side
Stabilise shoulder + wrist
Pt flexes arm to 120 (swing forward)
Resist
Whilst palpating bicipital groove (deltoid contraction will hide bicipital tendon)

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3
Q

+ve Speeds

A

P

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4
Q

Specificity of Speeds

A

11-100

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5
Q

Sensitivity of Speeds

A

4-100

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6
Q

What does Yergasons test

A

Bicep tendinopathy, glenoid labrum pathology, torn trans humeral lig

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7
Q

Yergasons test

A

Palpation over bicipital groove
Pt seated, elbow flex to 90
Forearm pronated + gripped
Door handle + open
Resist movement

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8
Q

+ve Yergasons

A

P in bicipital groove- bicep tendinopathy
P in shoulder- glenoid labrum pathology
Tendon slipping out of groove- torn transverse humeral ligament

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9
Q

Specificity of Yergasons

A

Bicep- 88

SLAP- 87

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10
Q

Sensitivity of Yergasons

A

Bicep- 32

SLAP- 12

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11
Q

What does Hawkins-Kennedy test

A

Supraspinatous impingement/lesion

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12
Q

Hawkins-Kennedy techniques

A

Pt seated
Put hand on hip, move hand off hip
Apply force through elbow, move forward + back

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13
Q

+ve Hawkins-Kennedy

A

Increased local P- ant-lat GH
Crepitus may be OA

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14
Q

Specificity of HK

A

59

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15
Q

Sensitivity of HK

A

79

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16
Q

What does empty can test

A

Injury/lesion to supraspinatous

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17
Q

Empty can technique

A

Pt standing or seated
Actively raises straight arm (palm up) to 120 in scapula plane
At the top- PT IR arm (thumb down= empty can)
Then lowers arm IR slwoly to body

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18
Q

+ve Empty can

A

Irritation + P- may be injury to muscle which produces IR (pec major, ant delt, lats)

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19
Q

Empty can spens/sens

A

Sens- 44-89
Spec- 50-90

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20
Q

What does painful arc test

A

Sub-acromion impingement
Rotator cuff or AC patio

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21
Q

Painful arc technqiue

A

Normal active abduction

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22
Q

+ve Painful arc

A

60-120 local P to subacromial/rotator cuff
170-180 pathology to AC

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23
Q

Painful arc sens/spec

A

Sens- 33-98
Spec- 10-81

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24
Q

What does Nears test

A

ER- bicep long head impingement
IR- supraspinatous impingement, subacromial bursitis

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25
Q

Nears technique

A

Depress scapula
ER arm, bring to maximal flex
Repeat for IR

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26
Q

+ve Nears

A

ER- P
IR- P

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27
Q

Specificity of Nears

A

60

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28
Q

Sensitivity of Nears

A

72

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29
Q

What does Cranks test

A

Labral tears

30
Q

Cranks test technique

A

Pt seated
Abd + ER elbow at 90
Apply pressure into elbow
‘Brush hair’
Rotate humerus int/ext

31
Q

+ve Cranks

A

If P is over AC test is
-ve
Shoulder P and crepitus- labral

32
Q

Specificity of Cranks

A

93

33
Q

Sensitivity of Cranks

A

46-91

34
Q

What does Obriens test

A

Labral tears, SLAP lesions, Ac pathology, bicep long head tendinopathy

35
Q

Obriens technique

A

Pt seated
Shoulder flexed to 90, arm add (10-20)
Pt attempts to maintain position whilst you apply force on forearm
1. Arm IR, thumb down
2. Arm ER, thumb up
Apply downward pressure ask Pt to resist

36
Q

+ve Obriens

A

IR- P- labral or SLAP lesion, AC pathology

ER- bicep long head tendinopathy

37
Q

Specificity of Obriens

A

98

38
Q

Sensitivity of Obriens

A

90

39
Q

What does Clunks test for

A

Labral lesion

40
Q

Clunks techniques

A

Pt supine
One hand under GH, other supporting above elbow
Shoulder abducted to 150
Apply translation under GH, other hand ER humerus

41
Q

+ve Clunks

A

Clunk or grinding sound- trapping of torn labrum between glenoid + humeral head

42
Q

Clunks spec/sens

A

Spec- 69
Sens- 44

43
Q

What does Kims test for

A

Labral lesion (posterior glenoid)
Ant instability

44
Q

Kims technique

A

Pt seated
Back support ]stand on injured side
Abd to 90
Apply force through shoulder
Other hand on deltoid
Elevate their arm upwards, whilst apply downward force

45
Q

+ve Kim

A

P (in post shoulder) + clicking

46
Q

Specificity of Kims

A

94

47
Q

Sensitivity of Kims

A

80

48
Q

AC Shear technique

A

Pt seated, examiner cups hands over clavicle and spine of scar
Apply compressive force

49
Q

+ve AC Shear

A

P or abnormal movement –> AC Jt patio, AC ligament sprain

50
Q

Ant Apprehension Test

A

Pt seated or supine
Shoulder abducted to 90, elbow flexed 90
Examiner applies P-A pressure over the humerus
Observe for signs of apprehension or discomfort

51
Q

Ant Apprehension test- for?

A

Ant GH instability

52
Q

Ant apprehnsion test +ve

A

Excessive ant translation, dislocation or Pt apprehension

53
Q

Ant drawer procedure

A

Pt supine
Examiner grasps the Pts arm with one hand and palpates with other hand over coracoid process and post scapula (trying to stabilise)
Examiner applies long axis distraction to humerus

54
Q

What does Ant drawer test

A

Ant GH instability - inc motion or apprehension
Rotator cuff ligament damage - local P

55
Q

Ant slide test procedure

A

Pt seated and supine
Hands on hips so thumb is posterior
Examiner stabilises shoulder
Applies an ant-sup force to ipsilateral olecranon + asks Pt to resist action

56
Q

What does ant slide test

A

SLAP lesion - ant shoulder P
GH OA - crepitus

57
Q

Ant slide sensitivity/specificity

A

8-78
84-93

58
Q

Apleys procedure

A

Pt seated or standing
Examiner instructs Pt to place hand behind back and touch mid back inferiorly then superiorly (over shoulder)

59
Q

What does Apleys test

A

Rot cuff patho (bicipital or supraspin tendonitis)- P and inability to perform motion
Ext GH rotator tightness or patho
Labral pathology
AC arthritis
Capsular/muscle contracture

60
Q

Bicep load test

A

Pt supine or seated
Shoulder abducted- 120 and flexed to 90
Examiner fully ER shoulder then asks Pt to flex elbow while resisting action

61
Q

What does bicep load test

A

SLAP lesion- if ant shoulder P

62
Q

Bicep load validity

A

High validity for testing SLAP
- bicep tendon attaches to superior labrum
- when resistive force to elbow flexion, biceps contracts and pulls on injured labrum

Specificity- 97
Sensitivity- 90

63
Q

Arm drop test procedure

A

Pt seated
Examiner passively abducts shoulders to 90
suddenly let go and ask Pt to catch themselves

64
Q

What does arm drop test

A

Bursitis, rotator cuff strain or tear, tendonitis/impingement- P/weakness or ‘racheting’ movement

Grade 3 cuff strain= unable tp catch themselves, less than 3/5 muscle strength

65
Q

Drop arm sens/spec

A

Sens- 8-27
Spec- 88-100

66
Q

Full can procedure

A

Pt seated
Actively raises straight arm (palm up) to 120 in scapular plane
At top examiner applies downward pressure and notes Pt strength

67
Q

Full can interpretation

A

P or weakness- injury or lesion of supraspinatus

68
Q

Full can spec/sens

A

Sen- 86
Spec- 57

69
Q

Post apprehension procedure

A

Pt supine
Shoulders flexed 90 + IR
Elbow flexed 90
Examiner applies A-P pressure voer elbow while palapting GH

70
Q

Post apprehension interpretation

A

Post GH instability- apprehension/inc motion
Rotator cuff ligament/tendon damage- local P

Ortho tests (15 decks)

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