Shoulder Exam

Question 1

ROM

Answer 1

Flexion: 180 degrees (anterior deltoid and coracobrachilais)
Extension: 60 degrees (latissimus dorsi and teres major)
Abduction: 180 degrees (supraspinatus and mid-deltoid) horizontal abduction = 40-55 or 130-145 degrees
Adduction: horizontal = 40-50 or 130-140 degrees (pectoralis major and latissimus dorsi)
External rotation: 90 degrees (infraspinatus and teres minor)
Internal rotation: 90 degrees (subscapularis and pectoralis minor)

AC joint- axial rotation: 10 degrees

Question 2

SC Joint ROM

Answer 2

Abduction: distal end of clavicle moves superiorly and proximal end moves inferiorly
Adduction: distal end of clavicle move inferiorly and proximal end move superiorly
Horizontal flexion: distal end of clavicle moves anteriorly and proximal end moves posteriorly on the sternum
Horizontal extension: distal end of clavicle moves posteriorly and proximal end moves anteriorly on the sternum

Rotation: multidirectional

Question 3

Scapula ROM

Answer 3

Retraction: rhomboid major and minor; move closer to spine
Protraction: serratus anterior; move away from spine
Elevation: upper trapezius and lavator scapulae; upward and parallel to spine (shoulder shrug)
Depression: lower trapezius and lower rhomboids; return from elevation
Upward/Downward Rotation: combined motions of the scapula

Question 4

Muscle Strength Testing Scale

Answer 4

5 = normal - complete ROM against gravity and full resistance
4 = good - complete ROM against gravity and some resistance
3 = fair - compete ROM against gravity
2 = poor - complete ROM with gravity eliminated
1 = trace - evidence of contraction with no joint movement
0 = zero - no evidence of muscle contraction

Question 5

Rotator Cuff (Supraspinatus-specific)

Answer 5

Empty Can Test (pain or weakness) - rotator cuff pathology (supraspinatus)

Drop-Arm Test (arm will drop or gentle tap on wrist will cause arm to drop) - full thickness of tear of supraspinatus

Question 6

Glenohumeral Instability

Answer 6

Apprehension Test (apprehensive of repeat dislocation) - glenohumeral instability

Sulcus Sign (intention appears in area beneath the acromion) - glenohumeral instability

Question 7

Long Head of Bicep

Answer 7

Yergason Test (pain and/or tendon subluxation out of groove) - unstable bicipital tendon/subluxation, bicipital tendonitis

Speed’s Test (pain in bicipital groove) - bicipital tendonitis of long head biceps

Question 8

Rotator Cuff Impingement

Answer 8

Neer Impingement (pain) - subacromial bursa or rotator cuff impingement

Hawkins Test (pain) - rotator cuff or subacromial bursa impingement

Question 9

ROM Test

Answer 9

Apley Scratch Test

Question 10

Subscapularis Test

Answer 10

Lift Off Test (weakness - inability to resist) - subscapularis weakness

Question 11

Palpate/Landmarks

Answer 11

Sternoclavicular joint
Clavicle
Acromioclavicular joint
Acromion process
Coracoid process
Spine of scapula (T3)
Inferior angle of scapula (T7)
Greater tubercle of humerus
Bicipital groove
Axillary lymph nodes
Latissimus dorsi
Pectoralis major
Supraspinatus
Infraspinatus
Teres minor
Subscapularis