shoulder

Question 1

Muscle tests for shoulder

Answer 1

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

Question 2

Adhesive Capsulitis ….. Frozen Shoulder Contracture
Syndrome (FCS)

Diagnostic crit

Answer 2

1. Equal restriction of active and passive shoulder movements
   (especially external rotation)
2. Essentially normal shoulder radiograph.
   • rule out … dislocations, arthritis, fractures, avascular necrosis, osteosarcomas.

Question 3

adhesive capsulitis capsular pattern of movement

Answer 3

Restricted shoulder motion occurs in this order ….

1. External rotation (most restricted) 2. Abduction 3. Flexion 4. Internal rotation (least restricted)

Question 4

speeds test

Answer 4

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

Question 5

Codmans drop arm

Answer 5

• rotator cuff

Passively abduct arm to 150°. Ask patient to slowly lower it to the sid

Question 6

empty can test

Answer 6

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

Question 7

Gerber lift-off test

Answer 7

rotator cuff test

arm placed in mid-lumbar • patient attempts to lift off • examiner may resist

Question 8

Painful acr

Answer 8

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.

Question 9

test cluster for rotator cuff

Answer 9

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)

Question 10

impingement syndrome

Answer 10

compression between humerus and acromion
•  subacomial bursitis
•  rotator cuff tendonitis
•  biceps tendonitis
•  inflammation

Question 11

empty can test

Answer 11

Scapular plane …
• shoulder abducted 90°
• internally rotated (thumb down).
• 30° horizontal abduction Apply downward pressure.

Question 12

Hawkins- kennedy test

Answer 12

shoulder flexed 90° • elbow flexed 90° • stabilize elbow • hold wrist • quickly move arm into
internal rotation

Question 13

neer impingement test

Answer 13

passively and forcibly flex shoulder with internal rotation and then with external rotation

Question 14

test cluster for subacromial impingement

Answer 14

A combination of a

+ Hawkin’s-Kennedy Test + Painful Arc + Infraspinatus Strength Test

Question 15

Acromioclavicular Crossbody Adduction + Resisted Extension Test

Answer 15

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

Question 16

interpretation of acromioclavicular crossbody adduction test

Answer 16

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.

Question 17

Acromioclavicular Compression Test

Answer 17

shoulder …..
•  flexed 90°
•  horizontal adduction 10°-15°
•  internal rotation elbow
•  extended examiner …..
•  places downward pressure    on distal arm (hand) as    patient resists

Question 18

test cluster for acromioclavicular pathology

Answer 18

A combination of a …..
(+) AC Cross Body Adduction Test
(+) AC Resisted Extension Test
(+) AC Compression Test

Question 19

shoulder apprehension test

Answer 19

Standing
•Gently externally rotate the shoulder … while pushing the humeral head forward

Supine
•Gently externally rotate the shoulder.

Question 20

shoulder relocation test

Answer 20

Gently externally rotate the arm … while pushing the humeral head posteriorly

Question 21

Diagnostic Cluster for Shoulder Apprehension and Relocation Tests

Answer 21

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.

Question 22

Sulcus sign

Answer 22

indent in shoulder

Question 23

bucket-handle tear

Answer 23

.Bucket-handle Tear ….. Also known as SLAP Lesion….. Superior Labrum Anterior Posterior

Question 24

o’briens part 1

Answer 24

Part 1 (Thumb Down)
•shoulder flexed 90°
•   horizontal adduction     10-15°
•   internal rotation     (thumb down)
•elbow extended
•place downward     pressure on arm

Question 25

O’brien part 2

Answer 25

Part 2 (Palm Up)
•shoulder flexed 90°
•   horizontal adduction     10-15°
•   external rotation      (Palm Up)
•   elbow extended
•place downward      pressure on arm