Shoulder

Question 1

Dugas Test

Answer 1

Instruct: Patient seated, examiner instructs patient to place the hand of the affected side on the opposite shoulder and then bring the affected elbow to the chest.
Positive: Inability to touch the opposite shoulder and/or inability of the elbow to touch the chest.
Indicates: Acute dislocation of the shoulder

Question 2

Anterior Apprehension Test

Answer 2

Instruct: Patient seated, examiner abducts the patients shoulder, flexes the patients elbow and then gradually externally rotates to the patients shoulder
Positive: Patient will have a noticeable look of apprehension or alarm on their face with possible pain.
Indicates: Chronic anterior dislocation of the shoulder

Question 3

Posterior Apprehension Test

Answer 3

Instruct: Patient supine, examiner flexes patients shoulder, flexes patients elbow and internally rotates the patients shoulder. Examiner places his/her hand on the patients distal humerus and gradually applies increasing posterior pressure
Positive: Patient will have noticeable look of apprehension or alarm on their face with possible pain
Indicates: Chronic posterior dislocation of the glenohumeral jt

Question 4

Drop Arm Test (Codman Drop Arm Test)

Answer 4

Instruct: Patient seated, examiner passively abducts patient arm to slightly over 90 degrees and removes support, if patient can maintain arm, then instructs patient to slowly lower their arm.
Positive: Patient will not be able to lower the arm slowly or the arm drops suddenly
Indicates: Rotator cuff tear, usually supraspinatus

Question 5

Dawbarn Test

Answer 5

Instruct: Patient seated, examiner applies pressure below the affected acromial process with his/her fingertips. Note for pain or tenderness. Examiner continues to apply pressure while abducting the patients arm past 90 degrees.
Positive: Decrease in pain and/or tenderness
Indicates: Subacromial bursitis

Question 6

Yergason Test

Answer 6

Insturuct: Patiented seated, examiner flexes patient elbow to 90 degrees. Examiner uses their other hand and grasps slightly above pts wrist. Examiner offers resistance while pt is instructed to externally rotate their humerus and slightly supinate the forearm
Positive: 1) Localized pain and/or tenderness at the bicipital groove
2) Audible click or biceps tendon subluxes or dislocates
Indicates: 1) Tendinitis
2) Instability of the biceps tendon possibly associated with a torn transverse humoral ligament

Question 7

Abbott-Saunders

Answer 7

Insturuct: Pt seated, examiner fully abducts and externally rotates the patients affected arm. Examiner places their fingers on the pts bicipital groove and then slowly lowers the pts affected arm to their side.
Positvie: Palpable and/or audible click
Indicates: subluxation or dislocation of the biceps tendon (Rupture of transverse ligament or tendon subluxation beneath subscapularis muscle belly)

Question 8

Speed Test

Answer 8

Instruct: Patient seated with forearm supinated, and elbow flexes to 45 degrees. Examiner places their fingers on patients bicipital groove with their opposite hand on the completely extend the elbow as the doctor applies resistance
Positive: Pain and/or tenderness in bicipital groove
Indicates: Bicipital tendinitis

Question 9

Apley Test

Answer 9

Instruct: Patient seated. Have him/her place the affected hand behind the head and touch the opposite superior angle of the scapula= Apley Scratch superior. Then patient is instructed to place the hand behind the back to touch inferior angle of scapula= Apley scratch inferior
Positive: Exacerbation of pain
Indicates: Degenerative tendinitis of rotator cuff tendon (usually Supraspinatus)

Question 10

Impingement Sign

Answer 10

Instruct: Patient seated with arms at side, examiner slightly abducts patient’s arm (hand should be pronated) and moves it fully through flexion (will jam greater tuberosity and anterior/inferior surface of acromion)
Positive: Pain in the shoulder
Indicates: Overuse injury to the supraspinatus and possible biceps tendon.

Question 11

Bony Palpation

Answer 11

1) Sternoclavicular articulation
2) Clavicle
3) Coracoid process
4) Acromioclavicular articulation
5) Acromion
6) Greater tuberosity of the humerus
7) Bicipital groove
8) Lesser tuberosity of the humerus
9) Spine of the scapula
10) Body of the Scapula
11) Scapulothoracic articulation

Question 12

Soft Tissue Palpation

Answer 12

1) Rotator Cuff Muscles (SITS)
2) Subacromial bursa
3) Subdeltoid bursa
4) Axillary borders
- Pec Major, Serratus ant, Axillary lymph nodes, Lats, Bicipital tendon
5) SCM
6) Biceps
7) Deltoids
8) Rhomboids
9) Trapezius

Question 13

Range of motion

Answer 13

Flexion: 180
Extension: 60
Abduction: 180
Adduction: 50
External rotation: 90
Internal rotation: 70
Scapular retraction, protraction, and elevation