shoulder Flashcards
Muscle tests for shoulder
Abduction
• Supraspinatus (Empty Can test)
External Rotation
• Infraspinatus – shoulder in neutral and arm at the side
Teres minor – external rotation at 90
Internal Rotation
• Subscapularis
-Internal rotation; elbow 90°; arm at side – specific
for superior Subscapularis function
- Lift-off - specific for inferior Subscapularis function
Adhesive Capsulitis ….. Frozen Shoulder Contracture
Syndrome (FCS)
Diagnostic crit
- Equal restriction of active and passive shoulder movements
(especially external rotation) - Essentially normal shoulder radiograph.
• rule out … dislocations, arthritis, fractures, avascular necrosis, osteosarcomas.
adhesive capsulitis capsular pattern of movement
Restricted shoulder motion occurs in this order ….
1. External rotation (most restricted) 2. Abduction 3. Flexion 4. Internal rotation (least restricted)
speeds test
biceps test elbow extended • forearm supinated • patient concentrically
flexes shoulder and then
eccentrically resists back
to starting position
• examiner resists flexion and palpates bicipital groove
Codmans drop arm
- rotator cuff
Passively abduct arm to 150°. Ask patient to slowly lower it to the sid
empty can test
Specific Supraspinatus Muscle Test ▪Empty Can Impingement Test may also be used as a specific supraspinatus muscle test ▪See…impingement tests Empty can test ….. • scapular plane … • shoulder abducted 90° • internally rotated (thumb down) • 30° horizontal abduction • apply downward pressure
Gerber lift-off test
rotator cuff test
arm placed in mid-lumbar • patient attempts to lift off • examiner may resist
Painful acr
rotator cuff tests
the patient actively abducts their shoulder in the scapular plane
• if they complain of pain between 60°-120° of shoulder abduction, this is called the painful arc.
test cluster for rotator cuff
Test Cluster for a Rotator Cuff Tear Patients ≥ 60 years old with a combination of:
+ Drop Arm Test + Painful Arc + Infraspinatus Strength Test (external rotation)
impingement syndrome
compression between humerus and acromion • subacomial bursitis • rotator cuff tendonitis • biceps tendonitis • inflammation
empty can test
Scapular plane …
• shoulder abducted 90°
• internally rotated (thumb down).
• 30° horizontal abduction Apply downward pressure.
Hawkins- kennedy test
shoulder flexed 90° • elbow flexed 90° • stabilize elbow • hold wrist • quickly move arm into
internal rotation
neer impingement test
passively and forcibly flex shoulder with internal rotation and then with external rotation
test cluster for subacromial impingement
A combination of a
+ Hawkin’s-Kennedy Test + Painful Arc + Infraspinatus Strength Test
Acromioclavicular Crossbody Adduction + Resisted Extension Test
Acromioclavicular Crossbody Adduction + Resisted Extension Test
Active test …..
• patient reaches hand across to opposite shoulder. Passive test …..
• examiner passively flexes shoulder to 90°, then horizontally adducts the the arm as far as possible. Resisted test …..
• examiner resists patient’s horizontal abduction as they return from the opposite shoulder
interpretation of acromioclavicular crossbody adduction test
Interpretation of a (+) Test
▪ (+) Positive test …..
• localized pain at the acromioclavicular joint (AC). • localized pain at sternoclavicular joint (SC).
▪ Positive findings may indicate …..
• local pain ….. AC joint dysfunction or ligament sprain. • local pain ….. SC joint dysfunction or ligament sprain.
Acromioclavicular Compression Test
shoulder ….. • flexed 90° • horizontal adduction 10°-15° • internal rotation elbow • extended examiner ….. • places downward pressure on distal arm (hand) as patient resists
test cluster for acromioclavicular pathology
A combination of a …..
(+) AC Cross Body Adduction Test
(+) AC Resisted Extension Test
(+) AC Compression Test
shoulder apprehension test
Standing
•Gently externally rotate the shoulder … while pushing the humeral head forward
Supine
•Gently externally rotate the shoulder.
shoulder relocation test
Gently externally rotate the arm … while pushing the humeral head posteriorly
Diagnostic Cluster for Shoulder Apprehension and Relocation Tests
A combination of a (+) 1st part: apprehension test
(+) 2nd part: doctor pushes head of humerus posteriorly
and patient’s symptoms should subside if there is true anterior instability.
Sulcus sign
indent in shoulder
bucket-handle tear
.Bucket-handle Tear ….. Also known as SLAP Lesion….. Superior Labrum Anterior Posterior
o’briens part 1
Part 1 (Thumb Down) •shoulder flexed 90° • horizontal adduction 10-15° • internal rotation (thumb down) •elbow extended •place downward pressure on arm