Shoulder Exam Flashcards
Arm Flexion
Anterior deltoid and coracobrachialis ms.
180°
Arm extension
Latissimus dorsi and teres major ms.
60°
Arm abduction
deltoid and supraspinatus ms.
180°
Arm horizontal adduction
pectoralis major and latissimus dorsi ms.
40-50° or 130-140°
Arm horizontal abduction
supraspinatus and mid deltoid ms.
130-145° or 40-55°`
Arm external rotation
Infrspinatus and tere minor ms.
90°
Arm internal rotation
Subscapularis and pectoralis minor ms.
90°
Biceps Reflex Nerve Root
C5
Brachioradialis Reflex Nerve Root
C6
Triceps Reflex Nerve Root
C7
Pulses tested in shoulder exam
Radial A., Brachial A., Ulnar A.
Apprehension Test
Patient is seated or supine. Shoulder abducted to 90° and elbow flexed to 90°. Stabilize shoulder with one hand (blocking linkage) and force arm into external rotation with the other hand.
(+) Test: Patient apprehensive
of repeat dislocation
Indicates: Glenohumeral instability
Sulcus Sign
Grasp patient’s elbow and apply inferior traction.
(+) Test: Indention appears in area beneath the acromion
Indicates: Glenohumeral instability
Yergason’s Test
Patient’s arm at side with elbow flexed to 90°. Physician uses one hand to palpate bicipital groove and monitors there, while the other hand grasps the patient’s wrist. Have patient supinate and externally rotate against physician’s resistance.
(+) Test: Pain and/or tendon
subluxation out of groove
Indicates: Unstable bicipital tendon
Speed’s Test
Patient’s arm flexed (50°-90°) at the shoulder with hand supinated. Slightly flex patient’s elbow. Resist at forearm while patient flexes shoulder.
(+) Test: Pain in bicipital groove
Indicates: Bicipital tendonitis
of longhead biceps
Empty Can Test
Flex patiet’s shoulders to 90° while horizontally abducting to 45°. Then internally rotate both arms so thumbs are pointing down. Press down on forearms while patient resists.
(+) Test: Pain or weakness
Indicates: Rotator cuff pathology (specifically supraspinatus)
Drop-Arm Test
Patient abducts arm to 90°, then slowly drops the arm.
(+) Test: Arm will drop or gentle tap on wrist will cause arm to drop.
Indicates: Full thickness tear of supraspinatus.
Painful Arc Test
Patient abducts arm starting at their side.
(+) Test: Pain is elicited within 60-120° degrees of shoulder abduction.
Indicates: subacromial impingement and/or rotator cuff injury.
Neer Impingement
Stabilize patient’s shoulder. With forearm pronated, passively flex shoulder to fully flexed position.
(+) Test: Pain
Indicates: Subacromial bursa or rotator cuff impingement
Hawkins Test
Flex shoulder to 90°, flex elbow to 90°, and passively rotate the humerus into internal rotation. This opposes rotator cuff against coracoacromial ligament and acromion
(+) Test: Pain
Indicates: Rotator cuff or subacromial bursa impingement.
Lift Off Test
Place patient’s arm into internal rotation and extension. Patient pushes arm into further internal rotation as physician resists.
(+) Test: Weakness (inability to resist)
Indicates: Subscapularis weakness
Cross Arm Test
Physician passively adducts patient’s arm across their chest and rests patient’s hand on their opposite shoulder.
(+) Test: Pain in AC joint with end range
adduction
Indicates: AC joint pathology
Apley Scratch Test
Physician should make note of how far the
patient can reach.
Upper: patient abducts arm placing palm of hand
behind their neck with palm facing toward the body.
Patient should attempt to scratch the lowest possible
vertebrae (coupled external rotation and abduction)
Lower: patient places arm behind their back with
palm facing outward and dorsum of hand resting on
their mid-back. Patient should attempt to scratch the
highest possible vertebrae (coupled internal rotation
and adduction)
