Shoulder Exam OSCE

Question 1

what is the structure for all musculoskeletal exams?

Answer 1

look, feel, move

Question 2

what to do and assess for the look aspect of shoulder exam?

Answer 2

front side and back view. get pt to turn if needed.
symmetry, posture, swelling, deformity, wasting, skin, scars, muscle

Question 3

what to do and assess for in the feel aspect of shoulder exam

Answer 3

temperature, bones (clavicle, scapula, GHJ, humeral head)
muscles (deltoid, supra/infraspinatus, traps

Question 4

what is important to ask the patient?

Answer 4

do you have any pain?
assess normal shoulder first

Question 5

what is done in the move aspect of the exam?

Answer 5

active and passive ROM (listen for crepitus)
flex, extend, abduct, int/ext rotation
Painful arc- palm downward, abduct shoulder, note angle when pain is experienced

Question 6

rotator cuff x4

Answer 6

supraspinatus:
- resisted abduction from 0*
- full adduction, 90* flexion (scarf test)
infraspinatus and teres minor
- resisted external rotation
subscapularis
- resisted internal rotation/lift off from back

Question 7

what other questions can be asked of the patient?

Answer 7

function of the joint
- able to wash own hair and dress selff

Question 8

offer:

Answer 8

examine joints above and below
spine and elbow
upper limb neuro and vasc exam.