Shoulder Exam Tests Flashcards
What is included in the shoulder girdle?
-SC joint, AC joint, GH joint, and scapula
Range of motion for GH joint
- flexion= anterior deltoid/coracobrachialis, 180
- extension= latissimus and teres major, 60
- abduction= supraspinatus/mid-deltoid, 180
- adduction= pec major/latissimus, 40-50
- external rotation= infraspinatous/teres minor, 90
- internal rotation= subscapularis/pec minor, 90
Range of motion for AC joint
-axial rotation 10 degrees
Range of motion of SC joint
- abduction= distal clavicle moves superiorly, proximal moves inferiorly
- adduction= distal clavicle moves inferiorly, proximal moves superiorly
- horizontal flexion= distal clavicle moves anteriorly, proximal moves posteriorly
- horizontal extension= distal clavicle moves posteriorly, proximal moves anteriorly
Range of motion for scapula
- retraction= rhomboids, moving closer together “attention”
- protraction= serratus anterior, moving away from spine “reach”
- elevation= upper trapezius/levator scapulae, shoulder shrug
- depression= lower trapezius/lower rhomboids, return from elevation
- upward/downward rotation= combine motions
What are 2 tests used for supraspinatus rotator cuff muscle?
- empty can and full can test
- drop arm test
What is the empty can test for supraspinatus
- flex pt shoulder to 90 while also abducting 45
- internally rotate both arms so thumbs point down
- press down on forearms while pt resists
- positive test= pain/weakness
- indicates supraspinatus pathology
- *can also do full can test w/thumbs up
What is drop arm test for supraspinatus?
- pt abducts arm 90-180
- slowly drops arm
- postitive test= arm will drop or gentle tap on wrist will cause arm to drop
- indicates full thickness tear of supraspinatus
What are 2 tests for GH instability?
- apprehension test
- sulcus sign
What is the apprehension test for GH instability?
- pt seated or supine shoulder abducted to 90 and elbow flexed to 90
- stabilize pt shoulder with 1 hand and force arm into external rotation with other hand
- positive test= pt apprehension about dislocation
- indicates GH instability
What is the sulcus sign for GH instability
- grasp pt elbow and apply inferior traction (pull arm down inferiorly)
- positive test= indentation appears in area beneath acromion
- indicates GH instability
What are 2 tests for the long head of the biceps
- yergasons test
- speeds test
What is yergasons test for long head of the biceps
- pt arm at side with elbow flexed to 90
- use hand to palpate bicipital groove and monitor there while other hand grasps pt wrist
- pt supinate and externally rotate against doc resistence
- positive test= pain or tendon subluxation out of groove
- indicates unstable bicep tendon/subluxation/bicepital tendonitis
What is speeds test for long head of biceps
- pt arm foward flexed 50-90 at shoulder with hand supinated
- slightly flex pt elbow
- resist at forearm while pt further flexes shoulder (resist cephalad motion)
- monitor pain at biceps tendon
- positive test= pain i bicipital groove
- indicates bicepital tendonitis of long head of biceps
What are 2 tests for rotator cuff impringment
- neer impringment test
- hawkins test
What is the neer impringment test
- stabilize pt shoulder, forarm pronated
- passively flex shoulder to fully flexed position
- positive test= pain
- indicates subacromial bursa or rotator cuff impringment
What is the hawkins test
- flex shoulder to 90, flex elbow to 90, slightly adduct, passively rotate humerus into internal rotation
- this opposes rotator cuff against coracoacromial ligament and acromion
- positive test= pain
- indicates rotator cuff (usually supraspinatus) or subacromial bursa impringment
What are 2 tests used for ROM
- apley scratch test
- life off test
What is the apley scratch test
- 2 maneuvers, doc notes how far pt can reach with each one
1. Upper= pt abducts arm with palm of hand behind neck facing toward body and attempt to scratch lowest possible vertebrae
2. Lower= pt places arm behind back with palm outward and attempt to scratch highest possible vertebrae (*coupled internal rotation and adduction)
What is the lift off test for subscapularis?
- pt arm internal rotation adn adduction
- pt extends arm into doc resistance
- positive test= weakness (inability to resist)
- indicates subscapularis weakness
OSE for GH joint
- anterior adn posterior glide of humeral head
- similar to load and shift
- stabilize shoulder, contact proximal humerus, move anterior/posterior looking for EOM and ROM
OSE for SC joint flexion/extension
- index finger on clavicular head next to sternum
- pt flex arms to 90 and reach to ceiling
- proximal clavicle moves posterior and distal anterior
-return from horizontal flexion (extension) and proximal clavicle moves anterior
OSE for SC joint ab/adduction
- place index finger on clavicular head and have pt shrug their shoulders
- proximal clavicle moves inferior adn distal moves superior
- return from abduction (adduction)
- proximal clavicle moves superior
