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MSK > shoulder exam > Flashcards

shoulder exam Flashcards

1
Q

what to look for in anterior inspection in a shoulder exam

A

scars, brusing, asymmetry of the shoulder girdle, swelling, abnormal bony prominance and deltoid wasting

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2
Q

what can asymmetry of the shoulder girdle be caused by

A

scoliosis, arthritis, fractures or dislocation

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3
Q

what can cause swelling in the shoulder joints

A

effusion, inflammatory arthropathy, or dislocation

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4
Q

what can an abnormal bony prominence on the shoulder indicate

A

a clavicular fracture or anterior dislocation of the glenohumeral joint

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5
Q

what can deltoid wasting indicate

A

disuse atrphy or axillary nerve injury

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6
Q

what to look for on lateral inspection in a shoulder exam

A

scars and deltoid wasting

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7
Q

what to look for on posterior insepction in a shoulder exam

A

scars, trapezous muscle asymmetry, supraspinatus and infraspinatoid asymmetry, scoliosis, winged scapula

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8
Q

what is trapezius muscle asymmetry suggestive of

A

muscle wasting secondary to disuse atrophy spinal accessory nerve lesion

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9
Q

what is supraspinatoud and infraspinatous asymmetry suggestive of

A

muscle wasting secondary to chronic rotator cuff tear of a suprascapular nerve lesion

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10
Q

what is a winged scapula indicative of

A

ipsialtral serratus anterior muscle weakness secondary to long thoracic nerve injury

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11
Q

what to do in a shoulder exam after looking

A

feel the temperature of the shoulder joint

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12
Q

what to do after assessing joint temperature in a shoulder exam

A

palpate the sernoclavicular joint, the clavicle, the acromioclavicular joint, acromion, coracoid process, head of the humerus, greater tubercle of the humerus and the spine of the scapula

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13
Q

what to do after palpating in a shoulder exam

A

ask patient to place hands behind their head

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14
Q

what does asking the patients to place their hands behind their head asses

A

external rotation and abduction of the shoulder joint

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15
Q

what to do in a shoulder exam after asking patients to place their hands behind their head

A

ask the patient to place each hand nehind their back and reach as far up their spine as they can

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16
Q

what does asking the patient to put their hand behind their back asses in a shoulder exam

A

internal rotatoin and adduction of the shoulder joint

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17
Q

what to do after asking the patient to put their hand behind their back in a shoulder exam

A

ask the patient to raise their hands forwards until theyre pointing towards the ceiling (shoulder flexion)

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18
Q

what to do after asking the patient to put their hands forwards to the sky in a shoulder exam

A

ask the patient to stretch their arms out behind them (shoulder extension)

19
Q

what to do after asking the patient to put their arms out behind them in a shoulder exam

A

ask the patient to raise their arms out to the sides in an arc like motion until their hands touch above their head (abduction)

20
Q

what to do after the arc movemnet in a shoulder exam

A

ask the patient to keep their arms straight and move them across the front of their body to the opposite side (adduction)

21
Q

what to do after adduction in a shoulder exam

A

ask the pateint to keep their elbows by their sides flexed at 90 degrees they move their forearms out (external rotation)

22
Q

what to do after asking a patient to keep their elbows by their side flexed at 90 degrees and moce their forearms out in a shoulder exam

A

ask the patient to place each hand behind their back and reach up as far as they are able to (internal rotation)

23
Q

how far up their own spine should a patient to able to reach

A

T4-T8

24
Q

what to do in a shoulder exam after asking the patient to place each hand behind their back and reach up as far as they are able

A

wing scapular test (wall)

25
Q

what does jobes test assess

A

the function of the supraspinatous muscle

26
Q

how to perform jobes test

A

abduct the patients arm to 90 degrees and then angle the arm forwards by 30 degrees so the shoulder is the plane of the scapula, internally rotate the arm so the thumb points to the floor, now push down the arm whilst the patient resists

27
Q

how to interpret jobes test

A

weakness - tear in supraspinatous pain - impingement

28
Q

what to do after jobes test

A

painful arc test

29
Q

what does pain between 60-120 degrees suggest

A

impingemnet or supraspinatour tendonitis

30
Q

what to do after the painful arc test

A

assess the function of infraspinatour and teres minor muscles

31
Q

how to assess the function of infraspinatous and teres minor muslces

A

position the patients arm with the elbow flexed at 90 degrees on slight abduction then passively externally rotate the arm to its maximum

32
Q

pain on resisted external rotation suggets

A

infraspinatois tendonitis

33
Q

if the arm falls back to internal roation or their is loss of power in the external rotation against resistance test what does this indicate

A

a tear in the infraspinatus or teres minor tendon, muscle wasting or lower motor neurone lesion

34
Q

how test test the function of the teres minor muscle

A

external rotation in abduction

35
Q

how to peform external rotation in abduction

A

position the arm in 90 degree of abduction and bend the elbow to 90 degrees, passively externally rotate the shoulder to its maximum degree

36
Q

what is hornblowers sign

A

inability to keep the arm in a 90 degrees whilst passively rotating the shoulder

37
Q

what can hornblowers sign suggest

A

teres minor pathology or an axillary nerve lesion

38
Q

what test assesses internal rotation against resistance

A

gerbers lift off test

39
Q

how to perform gerbers lift off test

A

ask the patient to place the dorsu of their hand on their lower back and apply light resistance to the heand and ask the patient to move their hand off the bacl

40
Q

how to interprate gerbers lift off test

A

if the patient is unable to move their hand of their back it indicates pathology of the subscapularis muscle or subscapular nerve lesion

41
Q

what does the scarf test assess

A

the function of the acromioclavicular joint

42
Q

how to perform the scarf test

A

passively flex the shoulder to to degrees and ask the patient to place the hand on the side you are examining to the contrateral shoulder and apply resistance to the elbow in the direction of the contralateral shoulder

43
Q

interpratation of the scraf test

A

id the patient experiences pain in the test there is acromioclavicular joint pathology

MSK (19 decks)

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