Shoulder Exam

Question 1

look

Answer 1

anterior- contour, delt + trap muscles, clavicle + joints,
lateral- contour, clavicle + joints
posterior- infra + supraspinatus muscle bulk, scapula (asymmetry)

Question 2

feel

Answer 2

clavicle + joints
long head of biceps
scapular (spine + body)

Question 3

move

Answer 3

flexion
abduction
external rotation
internal rotation (hand up back)

Question 4

special tests for rotator cuff/ACJ pathology

Answer 4

-POWER TESTS (supraspinatus- JOBE’S, infraspinatus, subscapularis) (rotator cuff tear)
-HAWKIN’S KENNEDY TEST (impingement)
-SCARF TEST (ACJ pathology)
- (+ painful arc)

Question 5

how to perform ROTATOR CUFF MUSCLES POWER TESTS

Answer 5

-supraspinatus (JOBE’S)- arms extended out in front + pronated, resist downward force
-infraspinatus- elbows flexed to 90 + external rotation of shoulder, resist internal rotational force
-subscapularis- shoulder internally rotated + hands behind bum, resist anterior force

Question 6

how to perform HAWKINS-KENNEDY TEST

Answer 6

elbow flexed to 90, internally rotate shoulder forward, apply downward force to wrist whilst pushing up on elbow

Question 7

how to perform SCARF TEST

Answer 7

abduct arm across patient’s body

Question 8

special tests for shoulder instability

Answer 8

-SUCULUS SIGN (shoulder laxity)
- ANTEIROR + POSTEIROR DRAWER TESTS
- ANTERIRO + POSTERIOR APPREHENSION TESTS

Question 9

how to perform SUCULUS SIGN TEST

Answer 9

w/ patient standing, secure ACJ + apply downward force at wrist, observe for gap between humeral head + ACJ

Question 10

how to perform ANTEIROR + POSTEIROR DRAWER TESTS

Answer 10

w/ patient lying on bed, secure ACJ and push/pull humerus posteriorly/anteriorly, observing for displacement of humeral head

Question 11

how to perform ANTERIOR + POSTERIOR APPREHENSION TESTS

Answer 11

w/ patient lying on bed,
anterior- flex elbow + externally rotate shoulder out (observing for anterior dislocation- push humeral head posteriorly to relocated if necessary)
posterior- flex elbow + abduct arm across chest, push posteriorly down through elbow, observe for posterior dislocation

Question 12

how to perform SCAPULAR WINGING TEST

Answer 12

w/ patient standing, put palms against wall at shoulder height + ask them to draw chest into wall whilst keeping their arms straight, then repeat with hands at waist height