Shoulder Complaint

Question 1

What is special about the shoulder joint? Why is it so susceptible to injury?

Answer 1

It is the only joint in the body where the tendons pass between the bones

This makes the joint flexible but very susceptible to injury

Question 2

What is the painful arc test testing for?

Answer 2

Subacromial impingement and rotator cuff tendon injuries

Question 3

Describe the painful arc test

Answer 3

You have the patient adduct their arm from 60 degrees to 120 degrees. If they have pain, then the test is positive and indicative of a subacromial impingement or rotator cuff injury

Question 4

Which population of upper extremity pathologies is the most common in the elderly?

Answer 4

Proximal humerus fractures

Question 5

Where do the most clavicular fractures occur?

Answer 5

69% happen in the middle third

Question 6

What is the most common glenohumeral dislocation? How would the patient present?

Answer 6

Anterior dislocation happens in about 95-97% of cases

Arm would be slightly abducted and externally rotated with resistance of all movement

Question 7

Describe acromioclavicular joint issues.

Answer 7

Occurs from direct trauma to the superior or lateral aspect of the shoulder with the arm adducted

Question 8

Describe impingement syndrome in the rotator cuff pathology

Answer 8

Compression of the rotator cuff tendons and the subacromial bursa between the humeral head and the acromion

Question 9

Describe a tendon injury of the shoulder. In which tendon do most of these occur?

Answer 9

Sprain or tear of the tendon from the result of a subacromial impingement

most injuries are in the supraspinous tendon

Question 10

Describe tendinopathy of the shoulder

Answer 10

Chronic injury to the supraspinatus/infraspinatus tendons

consequence of repetitive activity

Question 11

Describe the apprehension test

Answer 11

The patient is seated with the shoulder abducted and flexed to 90 degrees

Shoulder is stabilized and the other forces the arm into external rotation

IF THE PATIENT is apprehensive, then there is a sign that they have had a dislocation before

Question 12

What does a positive apprehension test insinuate?

Answer 12

Glenohumeral instability

Question 13

Describe the empty can test

Answer 13

Have the patient flex their arms to 90 degree s and horizontally abduct to 45 degrees. Internally rotate both arms so that the thumbs are pointing down. Press down on the forearms while the patient resists

Question 14

Describe the drop arm test

Answer 14

Patient abducts arms to 90 degrees then slowly drops arms

a positive test would be the arm dropping at about 20 degrees to the side OR the arm dropping with a gentle tap on the arm

Question 15

What does a positive empty can test indicate?

Answer 15

Rotator cuff pathology

Question 16

What does a positive drop arm test indicate?

Answer 16

full thickness tear of the supraspinatous

Question 17

Describe a Neer Impingement test

Answer 17

Stabilize the patients shoulder

With the forearm pronated, passively flex the shoulder to the fully flexed position

***basically you are grabbing the patients hand and keep taking it up into the flexed position

IF the patient experiences pain, then the test is positive

Question 18

What does a positive neer impingement test indicate?

Answer 18

Subacromial bursa or rotator cuff impingement

Question 19

Describe a Hawkins test

Answer 19

Flex the shoulder and the elbow to 90 degrees and rotate the humerus into internal rotation (like a wing flapping)

Pain is a positive test

Question 20

What does a positive Hawkins test indicate?

Answer 20

Rotator cuff or subacromial bursa impingement

The movement itself opposes the rotator cuff against the coracoacromial ligament and acromion

Question 21

Describe a cross arm test

Answer 21

Physician adducts the arm across their chest and holds the hand on the patients opposite shoulder

A positive test results in pain in the AC joint with end range adduction

Question 22

What does a positive cross arm test indicate?

Answer 22

AC joint pathology

Question 23

What are the tests for glenohumeral instability?

Answer 23

Apprehension test

Question 24

What are the tests for rotator cuff pathology?

Answer 24

Empty can test

Drop arm test

Question 25

What are the tests for the rotator cuff impingement?

Answer 25

Painful arc test

Neer Impingement

Hawkins test

Question 26

What are the tests for an acromioclavicular pathology?

Answer 26

Cross arm test