Shoulder Flashcards
what is the cross arm test?
- Passively adduct patient’s arm across chest wall with humerus parallel
to the ground so free hand of the examined elbow rests on the opposite
shoulder - Patient pushes elbow superiorly against the clinician’s resistance
Positive => pain with end-range adduction or with pushing arm up
what are the findings for cross arm test?
acromioclavicular joint pathology
what is the active compression test
- Patient flexes arm to 90 and adducts 10-15 with internal rotation
(thumb down) - Patient resists examiners downward force – maneuver repeated with
arms supinated
Positive => pain in AC joint or shoulder during the first maneuver that
improves for resolves with the second maneuver
what are the findings for the active compression test?
If pain in AC joint -
acromioclavicular joint pathology
If pain in internal shoulder –labral
(slap lesion) pathology
what is the scapular wining
- Have patient do a push-up off the wall
Positive => scapula wings
what are the findings for scapular winging?
weakness of serratus anterior or long thoracic nerve
what is the Yergason’s test
- Patient seated with elbow at side and forearm flexed to 90 degrees
- Examiner palpates long head of biceps with one hand while holding the
wrist with other - Patient simultaneously flexes their elbow and supinates their forearm
against resistance
Positive => tendon will pop out of groove and cause significant pain
what is the findings for Yergason’s test
unstable bicipital tendon and subluxation
what is the speed’s test
- Shoulder in 90 of forward flexion, elbow extended, and hand
supinated, with resistance applied downward
Positive => pain in bicipital groove
what is the finding for speed’s test?
bicipital tendon pathology - usually tendinitis
what is the empty can or Jobe’s test
- Patient abducts both arms to 90 degrees and forward flexes 45 degrees with thumbs
pointing down to ground - Patient resists downward pressure
Positive => weakness, pain, or dropping of the arm
what are the finding for empty can/Jobe’s test
Dropping – significant tear of
supraspinatus muscle with even gentle tap
Supraspinatus tendon tear
what is the full can test
- Same as empty can but thumbs point to ceiling
- Patient resists downward pressure
Positive => weakness, pain, or dropping of arm
what are the findings for full can test?
Dropping – significant tear of
supraspinatus muscle with even gentle tap
Supraspinatus tendon tear
what is the neer impingement sign
- Examiner stabilizes patients’ shoulder on top with off hand
- Forward flex humerus in scapular plane to 180 with the arm medially
rotated
Positive => pain in shoulder
what are the findings of neer impingement sign
Impingement pathology – usually supraspinatus or biceps tendon
what is the painful arc test
- Patient abducts arm overhead as far as they can go
Positive => pain with shoulder abduction between 70-100
what is the findings for painful arc test
Rotator cuff impingement pathology
Pain after 100 degrees of abduction
suggests AC joint pathology
Pain immediately with abduction may indicate frozen shoulder
what is the drop-arm test
- Examiner abducts patient’s shoulder to 90 degrees and asks patient to slowly
lower arm to side in same arc movement
Positive => patient unable to return arm to side slowly or has severe pain
when attempting
what is the findings of the drop-arm test
Tear in rotator cuff complex – likely supraspinatus
what is the Napoleon sign
- Place patient’s hand on his or her stomach and have patient push palms
into stomach
Positive => elbow will drop backward
what is the findings for Napoleon sign
subscapularis weakness or injury
what is the Gerber’s test
- Patient puts hand behind lumbar spine and attempts to lift the hand
away from the back
Positive => if patient cannot accomplish lift off
what is the findings for Gerber’s test
subscapularis injury or weakness
what is the anterior apprehension sign
- Patient sitting or supine, arm is abducted to 90 degrees, elbow flexed to 90 degrees
- Forearm forced into external rotation past 90 degrees
Positive => patient will be apprehensive and ask to stop for fear of repeat
dislocation
what is the finding for anterior apprehension sign
anterior glenohumeral instability, previous dislocation
what is the posterior apprehension sign
- Patient lying or sitting
- Examiner moves patient’s arm into internal rotation, adduction, and
flexion - Examiner gently but firmly pushes posteriorly on elbow
Positive => pain, clunk, apprehension
what is the findings of the posterior apprehension sign
posterior instability due to labral pathology
what is the clunk test
- Patient is supine
- Examiner places hand behind the humeral head, opposite hand holds
the distal humerus and fully abducts the humerus over the patient’s
head - Examiner pushes anteriorly (towards ceiling) on the humeral head
- Hand on distal humerus then externally rotates shoulder
Positive => clunk or grinding in shoulder
what is the finding of the clunk test
labral pathology
what is the special tests for AC joint sprain
- cross arm test
- active compression test
- painful arc test
what are the special test for supraspinatus injury
- Full can
- Empty can (Jobe’s)
- Neer’s test (impingement
sign) - Painful arc (pain around 70-
100)
what are the special tests for subscapularis tendonitis/tear?
Gerber’s Lift Off Test – (+)
indicates inflammation injury
Napoleon sign – (+) indicates
weakness of subscapularis
what are the special tests for bicipital tendinopathy
- speed’s test
- Yergason’s
what are the special test for glenohumeral instability
- crank test - anterior apprehension sign
- posterior apprehension sign
- clunk test
what are the special tests for adhesive capsulitis (frozen shoulder)
all the rotator cuff tests
