Shoulder

Question 1

General inspection

Answer 1

Pain

Sling etc

Question 2

Inspection

Answer 2

Anterior: scars, asymmetry, swelling, wasting

Lateral: scars, wasting, alignment (UNDER AXILLA)

Posterior: scars, deformity, bulk of trapezius, para-vertebral muscles, wasting

Question 3

Function

Answer 3

Hands behind head

Hands behind back

Right hand to left shoulder (vice verca)

Question 4

Feel

Answer 4

Temperature

Structures: SCJ, clavicle, ACJ, acromion, borders of scapula, greater tubercle of humerus, coracoid, biceps tendon, supra and infraspinatus, deltoid

Question 5

Move

Answer 5

Flexion (150-180) forwards above head
Extension (40) arms straight and extend back 
Abduction  (180) arms straight out to sides 
          Lower arc pain: supraspinatus 
          High arc pain: ACJ pathology 
Adduction (30-40)
External rotation (80-90)
Internal rotation (T4-T8)

Question 6

Special tests - Rotator cuff

Answer 6

Supraspinatus: empty can test
Infraspinatus / teres minor: external rotation against resistance
Subscapularis: lift off test

Weakness: tear??
Pain: strain??

Question 7

Special tests - impingement

Answer 7

Hawkins-Kennedy

Scarf test: ACJ pathology

Question 8

Joint above / below

Answer 8

Neck

Spine

Elbow

Question 9

Neurovascular

Answer 9

Power: deltoid (axillary)

Sensation: regimental badge (axillary)

Vascular: radial, ulnar, cap refill

Question 10

To finish

Answer 10

Wash hands, thank patient

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