Shoulder Exam Flashcards
What are the key components of a shoulder physical exam?
Inspection, palpation, range of motion (ROM), strength testing, special tests.
What should be assessed during inspection of the shoulder?
Symmetry, atrophy, swelling, deformities, skin changes.
What are the key landmarks to palpate in a shoulder exam?
Sternoclavicular joint, clavicle, acromioclavicular joint, coracoid process, bicipital groove, scapula.
What are the normal active range of motion (ROM) movements of the shoulder?
Flexion (180°), extension (60°), abduction (180°), adduction (30°), external rotation (90°), internal rotation (70°).
What test is used to assess for shoulder impingement?
Neer test and Hawkins-Kennedy test.
What is a positive Neer impingement test?
Pain when the examiner passively flexes the patient’s internally rotated arm to 180°.
What is a positive Hawkins-Kennedy test?
Pain with passive internal rotation of the arm while the shoulder is flexed to 90°.
What special test assesses for supraspinatus tendon pathology?
Empty Can (Jobe) test.
What indicates a positive Empty Can test?
Weakness or pain when resisting downward pressure with the arms in 90° abduction and 30° forward flexion.
What test evaluates for infraspinatus or teres minor weakness?
External rotation resistance test.
What is the significance of a positive external rotation resistance test?
Weakness suggests infraspinatus or teres minor pathology, commonly seen in rotator cuff tears.
What special test is used for subscapularis function?
Lift-off test and Belly Press test.
What indicates a positive Lift-off test?
Inability to lift the hand off the lower back against resistance suggests subscapularis weakness or tear.
What does a positive Belly Press test indicate?
Inability to maintain pressure against the abdomen suggests subscapularis pathology.
What test is used to assess the integrity of the biceps tendon?
Speed’s test and Yergason’s test.
What is a positive Speed’s test?
Pain in the bicipital groove when resisting forward flexion of the arm with the palm up.
What is a positive Yergason’s test?
Pain or snapping in the bicipital groove when the patient resists supination and external rotation.
What special test is used for acromioclavicular (AC) joint pathology?
Cross-body adduction test.
What indicates a positive cross-body adduction test?
Pain at the AC joint when the arm is passively adducted across the chest.
What test assesses for shoulder instability?
Apprehension test and Relocation test.
What is a positive Apprehension test?
Patient expresses fear or discomfort when the arm is placed in 90° abduction and external rotation.
What does a positive Relocation test indicate?
Relief of apprehension or pain when applying posterior pressure on the humeral head, suggesting anterior instability.
What test evaluates for labral tears or SLAP lesions?
O’Brien’s test.
What indicates a positive O’Brien’s test?
Pain with resisted downward pressure when the arm is in 90° flexion, internal rotation, and adduction, which improves in external rotation.
What is the role of the scapular assist test?
Determines if scapular dysfunction contributes to shoulder pain by manually assisting scapular motion.
What test helps differentiate cervical radiculopathy from shoulder pathology?
Spurling’s test (pain radiating down the arm with cervical compression suggests cervical nerve root involvement).
