Shoulder Exam

Question 1

Arm Flexion

Answer 1

Anterior deltoid and coracobrachialis ms.

180°

Question 2

Arm extension

Answer 2

Latissimus dorsi and teres major ms.

60°

Question 3

Arm abduction

Answer 3

deltoid and supraspinatus ms.

180°

Question 4

Arm horizontal adduction

Answer 4

pectoralis major and latissimus dorsi ms.

40-50° or 130-140°

Question 5

Arm horizontal abduction

Answer 5

supraspinatus and mid deltoid ms.

130-145° or 40-55°`

Question 6

Arm external rotation

Answer 6

Infrspinatus and tere minor ms.

90°

Question 7

Arm internal rotation

Answer 7

Subscapularis and pectoralis minor ms.

90°

Question 8

Biceps Reflex Nerve Root

Answer 8

C5

Question 9

Brachioradialis Reflex Nerve Root

Answer 9

C6

Question 10

Triceps Reflex Nerve Root

Answer 10

C7

Question 11

Pulses tested in shoulder exam

Answer 11

Radial A., Brachial A., Ulnar A.

Question 12

Apprehension Test

Answer 12

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

Question 13

Sulcus Sign

Answer 13

Grasp patient’s elbow and apply inferior traction.

(+) Test: Indention appears in area beneath the acromion

Indicates: Glenohumeral instability

Question 14

Yergason’s Test

Answer 14

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

Question 15

Speed’s Test

Answer 15

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

Question 16

Empty Can Test

Answer 16

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)

Question 17

Drop-Arm Test

Answer 17

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.

Question 18

Painful Arc Test

Answer 18

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.

Question 19

Neer Impingement

Answer 19

Stabilize patient’s shoulder. With forearm pronated, passively flex shoulder to fully flexed position.

(+) Test: Pain

Indicates: Subacromial bursa or rotator cuff impingement

Question 20

Hawkins Test

Answer 20

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.

Question 21

Lift Off Test

Answer 21

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

Question 22

Cross Arm Test

Answer 22

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

Question 23

Apley Scratch Test

Answer 23

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)