Shoulder Clinical Exam Flashcards
what are the four joints that are part of the shoulder?
acromioclavicular, sternoclavicular, scapulothoracic, glenohumeral
the shoulder joins sacrifices ____________ for _______________
stability; mobility
what is the static stabilizer of the shoulder?
glenoid labrum
what is the dynamic stabilizer of the shoulder?
rotator cuff muscles
what are the rotator cuff muscles?
supraspinatus, infraspinatous, subscapularis, teres minor
what kind of force do the big should muscles exert?
net upward force
what kind of force do the RC muscles exert to counteract the big shoulder muscles?
infermedial force
what is impingement syndrome?
if RC muscles dont oppose the big shoulder muscles, the supraspinatus, subacromial bursa, and other structures can get pinched between humeral head and acromion
what can cause an AC joint disruption?
an inferiorly directed overload force
what can cause a clavicular fracture in the middle of curve of clavicle?
a medially directed overload force
what ROM is the AC joint responsible for?
last 10-20 degrees of shoulder abduction
forward flexion
in what planes does the SC joint withstand lots of force?
transverse and saggital
in what plane does the SC joint allow almost limitless motion?
coronal
what are the ROMs that you will test?
F&E (hitler), ABD&ADD (ymca), horizontal ABD, ADD (izzard), INT and EXT rotation (wave dancer)
how do you test supraspinatus strength?
empty can/abduction - you stick pt’s arm out in front, turn thumb down, and passively flex arm up
how do you test infraspinatus and teres minor strength?
external rotation; arm bent at elbow and adjacent to ribs; doc pushes in as pt tries to push out/externally rotate
how do you test subscapularis?
lift off test - parade rest - pt tries to push out as you push in
what are the special tests for impingment?
Neer’s and Hawkin’s
what is the Neer’s special test?
like empty can but passively lift
positive test is pain with flexion
what is Hawkin’s special test?
arm and elbow at 90 degrees (like a genie) and then push hand down
positive test is pain with roration
how do impingement tests work?
you are pushing the greater tuberosity of the humerus under the acromion more, narrowing the subacromial space
what are the instability tests?
apprehension test, relocation test, AC cross chest adduction
what are the apprehension and relocation tests?
pt lies down with arm sticking straight out, bend at elbow and push the hand towards the face; positive test means pain with external rotation
if apprehension test is positive, do relocation; push posteriorly into humerus, if less painful - then that’s a positive test
what is the AC cross chest adduction test?
make a scarf with your hand, keep elbow at shoulder level, can push down on elbow as pt pushes up
