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BMS 150 Practical Final > Shoulder > Flashcards

Shoulder Flashcards

1
Q

what is the cross arm test?

A
  1. 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
  2. Patient pushes elbow superiorly against the clinician’s resistance

Positive => pain with end-range adduction or with pushing arm up

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2
Q

what are the findings for cross arm test?

A

acromioclavicular joint pathology

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3
Q

what is the active compression test

A
  1. Patient flexes arm to 90 and adducts 10-15 with internal rotation
    (thumb down)
  2. 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

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4
Q

what are the findings for the active compression test?

A

If pain in AC joint -
acromioclavicular joint pathology

If pain in internal shoulder –labral
(slap lesion) pathology

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5
Q

what is the scapular wining

A
  1. Have patient do a push-up off the wall

Positive => scapula wings

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6
Q

what are the findings for scapular winging?

A

weakness of serratus anterior or long thoracic nerve

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7
Q

what is the Yergason’s test

A
  1. Patient seated with elbow at side and forearm flexed to 90 degrees
  2. Examiner palpates long head of biceps with one hand while holding the
    wrist with other
  3. Patient simultaneously flexes their elbow and supinates their forearm
    against resistance

Positive => tendon will pop out of groove and cause significant pain

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8
Q

what is the findings for Yergason’s test

A

unstable bicipital tendon and subluxation

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9
Q

what is the speed’s test

A
  1. Shoulder in 90 of forward flexion, elbow extended, and hand
    supinated, with resistance applied downward

Positive => pain in bicipital groove

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10
Q

what is the finding for speed’s test?

A

bicipital tendon pathology - usually tendinitis

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11
Q

what is the empty can or Jobe’s test

A
  1. Patient abducts both arms to 90 degrees and forward flexes 45 degrees with thumbs
    pointing down to ground
  2. Patient resists downward pressure

Positive => weakness, pain, or dropping of the arm

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12
Q

what are the finding for empty can/Jobe’s test

A

Dropping – significant tear of
supraspinatus muscle with even gentle tap
Supraspinatus tendon tear

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13
Q

what is the full can test

A
  1. Same as empty can but thumbs point to ceiling
  2. Patient resists downward pressure

Positive => weakness, pain, or dropping of arm

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14
Q

what are the findings for full can test?

A

Dropping – significant tear of
supraspinatus muscle with even gentle tap
Supraspinatus tendon tear

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15
Q

what is the neer impingement sign

A
  1. Examiner stabilizes patients’ shoulder on top with off hand
  2. Forward flex humerus in scapular plane to 180 with the arm medially
    rotated

Positive => pain in shoulder

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16
Q

what are the findings of neer impingement sign

A

Impingement pathology – usually supraspinatus or biceps tendon

17
Q

what is the painful arc test

A
  1. Patient abducts arm overhead as far as they can go

Positive => pain with shoulder abduction between 70-100

18
Q

what is the findings for painful arc test

A

Rotator cuff impingement pathology

Pain after 100 degrees of abduction
suggests AC joint pathology

Pain immediately with abduction may indicate frozen shoulder

19
Q

what is the drop-arm test

A
  1. 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

20
Q

what is the findings of the drop-arm test

A

Tear in rotator cuff complex – likely supraspinatus

21
Q

what is the Napoleon sign

A
  1. Place patient’s hand on his or her stomach and have patient push palms
    into stomach

Positive => elbow will drop backward

22
Q

what is the findings for Napoleon sign

A

subscapularis weakness or injury

23
Q

what is the Gerber’s test

A
  1. Patient puts hand behind lumbar spine and attempts to lift the hand
    away from the back

Positive => if patient cannot accomplish lift off

24
Q

what is the findings for Gerber’s test

A

subscapularis injury or weakness

25
Q

what is the anterior apprehension sign

A
  1. Patient sitting or supine, arm is abducted to 90 degrees, elbow flexed to 90 degrees
  2. Forearm forced into external rotation past 90 degrees

Positive => patient will be apprehensive and ask to stop for fear of repeat
dislocation

26
Q

what is the finding for anterior apprehension sign

A

anterior glenohumeral instability, previous dislocation

27
Q

what is the posterior apprehension sign

A
  1. Patient lying or sitting
  2. Examiner moves patient’s arm into internal rotation, adduction, and
    flexion
  3. Examiner gently but firmly pushes posteriorly on elbow

Positive => pain, clunk, apprehension

28
Q

what is the findings of the posterior apprehension sign

A

posterior instability due to labral pathology

29
Q

what is the clunk test

A
  1. Patient is supine
  2. Examiner places hand behind the humeral head, opposite hand holds
    the distal humerus and fully abducts the humerus over the patient’s
    head
  3. Examiner pushes anteriorly (towards ceiling) on the humeral head
  4. Hand on distal humerus then externally rotates shoulder

Positive => clunk or grinding in shoulder

30
Q

what is the finding of the clunk test

A

labral pathology

31
Q

what is the special tests for AC joint sprain

A
  • cross arm test
  • active compression test
  • painful arc test
32
Q

what are the special test for supraspinatus injury

A
  • Full can
  • Empty can (Jobe’s)
  • Neer’s test (impingement
    sign)
  • Painful arc (pain around 70-
    100)
33
Q

what are the special tests for subscapularis tendonitis/tear?

A

Gerber’s Lift Off Test – (+)
indicates inflammation injury

Napoleon sign – (+) indicates
weakness of subscapularis

34
Q

what are the special tests for bicipital tendinopathy

A
  • speed’s test
  • Yergason’s
35
Q

what are the special test for glenohumeral instability

A
  • crank test - anterior apprehension sign
  • posterior apprehension sign
  • clunk test
36
Q

what are the special tests for adhesive capsulitis (frozen shoulder)

A

all the rotator cuff tests

BMS 150 Practical Final (17 decks)

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