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Orthopedics I: Shoulder > Shoulder Examination > Flashcards

Shoulder Examination Flashcards

1
Q

What are 6 essential questions to ask during the History part of the shoulder exam?

A
  1. What is the patient’s age?
  2. When did it start? (when did you decide you needed treatment for problem?)
  3. Was it traumatic or insidious onset?
  4. What are the movements that hurt, what is the pain behavior?
  5. What types of things relieve the pain?
  6. What functional limitations are there?
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2
Q

RC cuff problems usually happen in which age group? Instability? Frozen shoulder?

A

Rotator cuff: 40-60 y/o
Instability: Late teens & 20’s
Frozen shoulder: Older adults (and diabetics)

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3
Q

What should you be looking for from an anterior view during the observation part of the shoulder exam? posterior view?

A 
Anterior:
Shoulder elevation differences, AC joint abnormalities.
Posterior:
Muscle atrophy
Position of the scapula
Position of the humerus
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4
Q

What is the order in a shoulder exam (generally)?

A
  1. Cervical scan (if neurological symptoms)
  2. AROM Functional Tests
  3. PROM with overpressure
  4. Resisted Tests
  5. Ligament Tests
  6. PAM Testing
  7. Special Tests
  8. Palpation
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5
Q

What active functional tests should you have the pt do during the AROM section?

A
  1. Reach behind back from below (add, IR)

2. Reach behind back from above (abd, ER)

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6
Q

If you find a pt. has limited AROM in a particular direction, what are the 2 things you should do right afterward.

A
  1. Goni that sucker!

2. PROM with overpressure, as well.

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7
Q

What question should you ask if there is a limitation in AROM?

A

Is the shoulder stiff, painful, or both?

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8
Q

What are the 3 tests for the posterior or external rotator portion of the rotator cuff? What position should the patient be in while performing them?

A
  1. Pure External Rotation
  2. Scaption or Empty Can
  3. Shoulder Abduction
    These should be done in sidelying with the affected shoulder up.
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9
Q

What muscle is implicated in these resisted tests? Why?
+ Pure External Rotation
+ Scaption
- Shoulder Abduction

A

Teres Minor:

because teres minor is an adductor more than an abductor.

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10
Q 
What muscle is implicated in these resisted tests?
Why?
\+ Pure External Rotation
- Scaption
- Shoulder Abduction
A

Infraspinatous:

because infraspinatous is a pure external rotator, and does not scaption or abduct the arm.

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11
Q 
What muscle is implicated in these resisted tests?
Why?
\+ Pure External Rotation
\+ Scaption
\+ Shoulder Abduction
A

Supraspinatous:

Because supraspinatous works like a champ in all 3 of these movements.

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12
Q

What are the 5 internal rotators of the shoulder?

A
  1. Subscapularis
  2. Teres major.
  3. Latissimus dorsi
  4. Pectoralis major
  5. Anterior deltoid
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13
Q

What internal rotator(s) does the Pure Internal Rotation test rule out? rule in?

A

It rules them all in and none of them out.

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14
Q

What muscle is implicated in these resisted tests?
+ Pure Internal Rotation
+ Teres Major resistance
- Latissimus Dorsi

A

teres major (because the notes say a negative lat dorsi test will implicate teres major after a positive teres major test).

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15
Q 
What muscle is implicated in these resisted tests?
\+ Pure Internal Rotation
\+ Teres Major resistance
\+ Latissimus Dorsi resistance
- Horizontal abduction
- Flexion
A

latisimus dorsi (because it does more extension rather than flexion, the horizontal abduction and flexion tests should come out negative).

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16
Q 
What muscle is implicated in these resisted tests?
\+ Pure Internal Rotation
\+ Teres Major resistance
\+ Latissimus Dorsi resistance
\+ Horizontal Abduction
\+ Flexion
A

pectoralis major and ant. deltoid

17
Q 
What muscle is implicated in these resisted tests?
\+ Pure Internal Rotation
- Teres Major resistance
- Latissimus Dorsi resistance
- Horizontal Abduction
- Flexion
A

Subscapularis (because it is a pure internal rotator, therefore all other tests which do other motions will be negative)

18
Q

What 2 muscles does resisted abduction test?

A
  1. Middle Deltoid

2. Supraspinatous

19
Q

What 4 muscles does resisted flexion test?

A
  1. Ant. Deltoid
  2. Pectoralis Major
  3. Coracobrachialis
  4. Long head of biceps
20
Q

What 4 muscles does resisted extension test?

A
  1. Post. deltoid
  2. Triceps
  3. Latissimus dorsi
  4. Teres Major
21
Q

What 4 muscles does resisted adduction test?

A
  1. Pec Major
  2. Latissimus dorsi
  3. Elbow extensors
  4. Elbow flexors
22
Q

What muscle does resisted elbow extension test?

A
  1. Triceps
23
Q

To test the Superior band of the GH ligament, what position should you place the GH joint in and what type of glide should you apply to the humerus?

A

position: ER of GH joint in neutral abduction with slight extension.
glide: anterior

24
Q

To test the Middle band of the GH ligament, what position should you place the GH joint in and what type of glide should you apply to the humerus?

A

position: ER of GH joint in 45° abduction with slight extension.
glide: anteromedial

25
Q

To test the Anterior Inferior band of the GH ligament, what position should you place the GH joint in and what type of glide should you apply to the humerus?

A

position: ER of the GH joint in 90° abduction with slight extension.
glide: anteromedial

26
Q

To test the Posterior Inferior band of the GH ligament, what position should you place the GH joint in and what type of glide should you apply to the humerus?

A

position: IR of the GH joint in 90° abduction with slight extension.
glide: posterior

27
Q

How do you test the Anterior Coracohumeral Ligament?

A

Put the pt’s GH joint in extension, traction (by placing wrist between knees and pulling), and lateral distraction (with hands).

28
Q

How do you test the Posterior Coracohumeral Ligament?

A

Put the pt. in flexion to pain threshold, then simultaneously posterior glide and inferior glide the humeral head.

Orthopedics I: Shoulder (5 decks)

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