Shoulder Clinical Exam

Question 1

what are the four joints that are part of the shoulder?

Answer 1

acromioclavicular, sternoclavicular, scapulothoracic, glenohumeral

Question 2

the shoulder joins sacrifices ____________ for _______________

Answer 2

stability; mobility

Question 3

what is the static stabilizer of the shoulder?

Answer 3

glenoid labrum

Question 4

what is the dynamic stabilizer of the shoulder?

Answer 4

rotator cuff muscles

Question 5

what are the rotator cuff muscles?

Answer 5

supraspinatus, infraspinatous, subscapularis, teres minor

Question 6

what kind of force do the big should muscles exert?

Answer 6

net upward force

Question 7

what kind of force do the RC muscles exert to counteract the big shoulder muscles?

Answer 7

infermedial force

Question 8

what is impingement syndrome?

Answer 8

if RC muscles dont oppose the big shoulder muscles, the supraspinatus, subacromial bursa, and other structures can get pinched between humeral head and acromion

Question 9

what can cause an AC joint disruption?

Answer 9

an inferiorly directed overload force

Question 10

what can cause a clavicular fracture in the middle of curve of clavicle?

Answer 10

a medially directed overload force

Question 11

what ROM is the AC joint responsible for?

Answer 11

last 10-20 degrees of shoulder abduction

forward flexion

Question 12

in what planes does the SC joint withstand lots of force?

Answer 12

transverse and saggital

Question 13

in what plane does the SC joint allow almost limitless motion?

Answer 13

coronal

Question 14

what are the ROMs that you will test?

Answer 14

F&E (hitler), ABD&ADD (ymca), horizontal ABD, ADD (izzard), INT and EXT rotation (wave dancer)

Question 15

how do you test supraspinatus strength?

Answer 15

empty can/abduction - you stick pt’s arm out in front, turn thumb down, and passively flex arm up

Question 16

how do you test infraspinatus and teres minor strength?

Answer 16

external rotation; arm bent at elbow and adjacent to ribs; doc pushes in as pt tries to push out/externally rotate

Question 17

how do you test subscapularis?

Answer 17

lift off test - parade rest - pt tries to push out as you push in

Question 18

what are the special tests for impingment?

Answer 18

Neer’s and Hawkin’s

Question 19

what is the Neer’s special test?

Answer 19

like empty can but passively lift

positive test is pain with flexion

Question 20

what is Hawkin’s special test?

Answer 20

arm and elbow at 90 degrees (like a genie) and then push hand down
positive test is pain with roration

Question 21

how do impingement tests work?

Answer 21

you are pushing the greater tuberosity of the humerus under the acromion more, narrowing the subacromial space

Question 22

what are the instability tests?

Answer 22

apprehension test, relocation test, AC cross chest adduction

Question 23

what are the apprehension and relocation tests?

Answer 23

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

Question 24

what is the AC cross chest adduction test?

Answer 24

make a scarf with your hand, keep elbow at shoulder level, can push down on elbow as pt pushes up