Shoulder

Question 1

winging of the scapula suggest?

Answer 1

injury to the long thoracic nerve. this supplies the serratus anterior muscle. this can be a consequence of surgery, such as radical mastectomy, or rarely viral disease. as a consequence the arm is not able to be lifted more than 90° from the side.

Question 2

order of palpation

Answer 2

start at Sternoclavicular joint, moving down the clavicle to the acromioclavicular joint, acromion process, spine of scapula, medial border, humeral head.

Question 3

what is suggested by tenderness at the acromioclavicular joint?

Answer 3

May indicate osteoarthritis

Question 4

what is suggested by tenderness over the greater tuberosity?

Answer 4

impingement or rotator cuff injury

Question 5

what is the typical finding in impingement syndrome?

Answer 5

painful arc of adduction between 60 and 120

Question 6

which movement is usually most affected in frozen shoulder?

Answer 6

external rotation, this is also first to go in glenohumeral arthritis

Question 7

special test for supraspinatous?

Answer 7

List of test, ask patient to abduct shoulder from neutral against resistance. Loss of power suggests a supraspinatous tear, pain may suggest tendinitis.

Question 8

clinical test for infraspinatus and teres minor.

Answer 8

external rotation against resistance. Position patient on with elbow flexed at 90° and ask patient to externally rotate while you apply resistance. Pain may suggest tendonitis, loss of power suggests torn ligament

Question 9

clinical test for subscapularis

Answer 9

internal rotation against resistance, Gerber lift of the test. Ask patient to please the dorsum of the hand on the lower back. Apply light resistance to the hand and ask patient to move the hand of the back.

Question 10

completing his shoulder examination

Answer 10

Full neurovascular examination of the upper limbs, examine the spine and elbow joint, perform further imaging if indicated