Shoulder Complex Examination

Question 1

How is the DASH scored?

Answer 1

-30 functional task
-0-4 Lickert scale
-max score 80
-lower score= greater disability

Question 2

How is the SPADI scored?

Answer 2

-13 time scored on VAS
-8 item physical function
-5 item pain
-max score 100
-higher score = greater disability

Question 3

How is ASES scored

Answer 3

• American Shoulder Elbow Surgeon
  -10 item scored on VAS
  -Max score 100
  -Lower score = greater disability

Question 4

What are some movement patterns that a patient can present with?

Answer 4

-Total neglect
-“elbow down” movement only
-Substitution
(Scapular, Trunk, Head)

Question 5

What is Bakody’s Sign?

Answer 5

indicative of nerve root irritation C4-C6

Question 6

What are some trigger symptoms complaints about the quality?

Answer 6

-Shifting or popping out
-Clicking, snapping, or grinding
-Ache
-Sharp pain
-Stiffness
-Numbness
-Burning
-Dead arm

Question 7

What is Ehlers- Danlos?

Answer 7

-Rare genetic disorder that causes a defect In collagen fibers synethesis
- mild to life threatening with no cure

Question 8

What is Marfan’s Syndrome?

Answer 8

-autosomal dominant genetic disorder of connective tissue
-disproportionate limbs

Question 9

When evaluating the elevation painful arc what are the degrees that indicate glenohumeral pain?

Answer 9

60-120 degrees

Question 10

When evaluating the elevation painful arc what are the degrees that indicate acromioclavicular pain?

Answer 10

170-180 degrees

Question 11

What may be some neuromuscular issues causing extrinsic shoulder pain?

Answer 11

-Cervical radiculopathy
-upper trunk brachial plexopathy
-Neurologic amyotrophy
-Focal Mononeuropathy
-Muscular Dystrophy

Question 12

What may be some Cardiovascular issues causing extrinsic shoulder pain?

Answer 12

-Cardiac ischemia
-Thoracic Outlet Syndrome
-Aortic disease
-Axillary thrombosis

Question 13

What may be some causes of Pulmonary issues causing extrinsic shoulder pain?

Answer 13

-Upper lobe pneumonia
-Pulmonary embolism
-Pneumothorax
-Pneumoperitoneum

Question 14

What may be some Malignacy issues causing extrinsic shoulder pain?

Answer 14

-Pancoast tumor
-metastatic cancer

Question 15

What may be some Abdominal issues causing extrinsic shoulder pain?

Answer 15

-Biliary disease’s
-Hepatic disease
-Pancreatitis
-Splenic injury
-Perforated viscus

Question 16

What is the Popeye defect?

Answer 16

-Proximal portion of long head of bicep tears which causes bulging
-will still have function but not as strong

Question 17

Axillary nerve issues will cause atrophy to what muscles?

Answer 17

-Teres Minor
-Deltoid

Question 18

Accessory nerve issues will cause atrophy to what muscles?

Answer 18

SCM & Trapezius

Question 19

Suprascapular nerve issues will cause atrophy to what muscles?

Answer 19

-Supraspinatus
-Infraspinatus

Question 20

Lower sub scapular nerve issues will cause atrophy to what muscle?

Answer 20

Teres Major

Question 21

Long thoracic nerve issues will cause atrophy to what muscle?

Answer 21

Serratus Anterior

Question 22

Upper & Lower Subscapular nerve issues will cause atrophy to what muscle?

Answer 22

Subscapularis

Question 23

What is the normal value of flexion for the shoulder complex?

Answer 23

0-180 degrees

Question 24

What is the normal value of abduction for the shoulder complex?

Answer 24

0-180

Question 25

What is the normal value of extension for the shoulder complex?

Answer 25

0-60

Question 26

What is the normal value of external rotation for the shoulder complex?

Answer 26

0-90

Question 27

What is the normal value of internal rotation for the shoulder complex?

Answer 27

0-70

Question 28

What glides are used to assess flexion osteokinematic motion?

Answer 28

-Posterior glide -Inferior glide

Question 29

What glides are used to assess extension osteokinematic motion?

Answer 29

-Anterior

Question 30

What glides are used to assess ABDuction osteokinematic motion?

Answer 30

-Inferior glide humeral head -Inferior glide clavicle on sternum

Question 31

What glides are used to assess Internal rotation osteokinematic motion?

Answer 31

posterior glide

Question 32

What glides are used to asses external rotation osteokinematic motion?

Answer 32

- Anterior glide (biomechanically) - Posterior glide (when patient has poor posture)

Question 33

What glides are used to assess horizontal ABDuction osteokinematic motion?

Answer 33

-Anterior glide

Question 34

What glides are used to assess Horizontal ADDuction osteokinematic motion?

Answer 34

posterior glide

Question 35

What is HHD Interrater Reliability?

Answer 35

Reliability of hand-held dynamometry in measuring isometric strength of the shoulder internal & external rotator musculature using a stabilizing device

Question 36

What muscles contribute to flexion of the shoulder?

Answer 36

-Anterior deltoid -Coracobrachialis -Long head bicep & short head bicep -Supraspinatus -Pec Major

Question 37

What muscles contribute to extension of the shoulder?

Answer 37

-Posterior Deltoid -Lattissiums Dorsi -Teres Major - Long head tricep

Question 38

What muscles contribute to abduction of the shoulder?

Answer 38

-Middle Deltoid -Supraspinatus

Question 39

What muscles contribute to External rotation of the shoulder?

Answer 39

-infraspinatus -teres major

Question 40

what muscles contribute to internal rotation of the shoulder?

Answer 40

Subscapularis

Question 41

What muscles contribute to horizontal abduction of the shoulder?

Answer 41

Posterior deltoid

Question 42

What muscles contribute to horizontal adduction of the shoulder?

Answer 42

Pec major -clavicular head (60) -Sternal head (120)

Question 43

What scapular muscles contribute to abduction & upward rotation?

Answer 43

Serratus Anterior

Question 44

What scapular muscles contribute to adduction & downward rotation?

Answer 44

Rhomboid major & minor

Question 45

What scapular muscles contribute to retraction?

Answer 45

-middle trap -rhomboid major/minor

Question 46

What scapular muscles contribute to depression & adduction?

Answer 46

Lower & middle trap

Question 47

What are some examples of RC Pathology?

Answer 47

-RC tear -RC Tendinopathy

Question 48

What are some examples of extra-articular pathology?

Answer 48

-AC Joint -Long head bicep tendinopathy -Long head bicep tendinitis -Long head bicep rupture -Bursitis

Question 49

What are some examples of Intra-articular pathology?

Answer 49

Anterior instability Posterior instability Bankart Lesion SLAP lesion GH OA

Question 50

What are some examples of other pathologies of the shoulder?

Answer 50

Adhesive Capsulitis C-spine Radicular Shoulder Referred (other body system)

Question 51

What is Litaker diagnostic cluster for RC tear?

Answer 51

Age >65= +LR 2.61 Night Pain= +LR 2.61 ER weakness = +LR 6.96 All 3: +LR=9.84

Question 52

what is park diagnostic cluster for RC tear?

Answer 52

Age > 60 +painful arc +drop arm test +infraspinatus test

Question 53

What combination of tests used to confirm RC tendinopathy of full thickness tear of supraspinaus?

Answer 53

Jobe/Empty Can (deltoid little less activated) + Full Can + External Rotation Lag Sign (have pt in full extension & ask them to stay there)

Question 54

What combination of tests used to confirm RC tendinopathy of full thickness tear of infraspinatus?

Answer 54

External rotation Lag sign

Question 55

What combination of tests used to confirm RC tendinopathy of full thickness tear of subscapularis?

Answer 55

Lift off + Belly press or Belly press + bear hug

Question 56

What does positive speed's test indicate?

Answer 56

long head biceps tendinopathy

Question 57

What does positive ludington's test indicate?

Answer 57

long head of biceps tendon rupture