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Musculo > Shoulder Examination > Flashcards

Shoulder Examination Flashcards

1
Q

What is the order of the shoulder examination (12)

A
  1. Observation
  2. History
  3. Inspection of skin and bony landmarks
  4. UQS as needed (prn)
  5. AROM
  6. PROM
  7. Joint play/accessory motion
  8. Muscle performance
  9. Anthropometrics
  10. Special tests
  11. Functional testing
  12. Provocative palpation
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2
Q

What do you observe during the examination of the shoulder (6)

A
  1. Posture
  2. Protection of arm
  3. Head position/protection
  4. Affect/demeanor
  5. Limb position
  6. Movement patterns
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3
Q

What are 3 common limb positions with shoulder problems

A
  1. Adducted and IR
  2. Cradled/supported
  3. Hand on top of head
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4
Q

What is the hand on top of the head called

A

Bakody’s Sign

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5
Q

Is Bakody’s sign a shoulder problem

A

No

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6
Q

What type of problem is Bakody’s sign

A

Cervical pain C4-6 (median nerve)

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7
Q

What are 3 common movement patterns with shoulder problems

A
  1. Total neglect
  2. Elbow down movement only
  3. Substitution
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8
Q

What are some substitutions of the shoulder (3)

A
  1. Scapular
  2. Trunk
  3. Head
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9
Q

What should you ask about in the patient history interview (9)

A
  1. Age
  2. Occupation
  3. Develpomental hx
  4. Living environment
  5. Meds
  6. Other medical intervention
  7. Health status
  8. Behavioral health risks
  9. Functional status and activity level
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10
Q

What else should you ask about in the patient history (7)

A
  1. Area of complaints
  2. Duration since onset
  3. MOI
  4. Nature of complaint
  5. Behavior of complaint
  6. Review of systems
  7. Functional status
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11
Q

50% of the patients referred to PT have at least one of these comorbidities (12)

A
  1. Hypertension
  2. Depression
  3. Asthma
  4. Chemical dependency
  5. Anemia
  6. Thyroid problems
  7. Cancer
  8. Diabetes
  9. RA
  10. Kidney problems
  11. Hepatitis
  12. Heart attack
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12
Q

What are the warning signs that pathology may be visceral (8)

A
  1. Pain is constant
  2. Insidious onset
  3. Pain described as throbbing, pulsating, deep aching, knifelike or colicky
  4. Rest doesn’t relieve pain or symptoms
  5. Constitutional symptoms present
  6. Pain changes in relation to organ function
  7. Pain worse during sleeping
  8. Shoulder pain increases with exertion activity that does not stress the shoulder
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13
Q

What are the constitutional symptoms (8)

A
  1. Fever
  2. Night sweats
  3. Nausea
  4. Vomiting
  5. Pale skin
  6. Dizziness
  7. Fatigue/malaise
  8. Unexplained weight loss
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14
Q

What amount of unexplained weight loss do you look for

A

Greater than 5% body weight

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15
Q

What oragns cause mid scapular pain (3)

A
  1. Liver
  2. Pancreas
  3. Gallbladder
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16
Q

What is being older the 50 a red flag for

A

Risk of RC tear or other serious pathology

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17
Q

What is night pain a red flag for

A

Risk of serious pathology

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18
Q

What is weight loss a red flag for

A

Risk of cancer or autoimmune dysfunction

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19
Q

What is fever a red flag for

A

Risk of systemic infection

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20
Q

What is pain unrelated to activity a red flag for

A

Risk of referred pain from visceral source

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21
Q

What is pain not relieved by rest a red flag for

A

Risk of referred pain from visceral source

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22
Q

What is a history of smoking a red flag for

A

Risk of lung cancer and referred pain from cardiac system

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23
Q

What is previous hx of cancer a red flag for

A

Risk of referral of pain and/or metastasis

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24
Q

What is cardiac risk factors a red flag for

A

Myocardial infarction refer to left shoulder

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25
Q

What is pleuritic pain a red flag for

A

Risk of pancoast tumor

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26
Q

What are the 5 types of extrinsic causes of shoulder pain

A
  1. Neurological
  2. Cardiovascular
  3. Pulmonary
  4. Malignancy
  5. Abdominal
27
Q

What are sources of neurological symptoms (5)

A
  1. Cervical radiculopathy
  2. Upper trunk brachial plexopathy
  3. Neurologic amyotrophy
  4. Focal mononeuropathy
  5. Muscular dystrophy
28
Q

What are sources of cardiac pain (4)

A
  1. Cardiac ischemia
  2. TOS
  3. Aortic disease
  4. Axillary dsytrophy
29
Q

What are sources of pulmonary pain (4)

A
  1. Upper lobe pneumonia
  2. Pulmonary embolism
  3. Pneumothorax
  4. Pneumoperitoneum
30
Q

What are sources of malignancy (2)

A
  1. Pancoast tumor

2. Metastatic cancer

31
Q

What are sources of abdominal pain (5)

A
  1. Biliary disease
  2. Hepatic disease
  3. Pancreatitis
  4. Splenic injury
  5. Perforated viscus
32
Q

What should you ask about a FOOSH

A

Which way they fell and the position of their arms

33
Q

What is a sclerotome

A

Deep somatic tissue (bone)

34
Q

What does shifting or popping out signify

A

Instability

35
Q

What does clicking, snapping, or grinding signify

A

Wear ant tear, labral tear

36
Q

What does an ache signify

A

Muscle

37
Q

What does a sharp pain signify

A

Nerve

38
Q

What does stiffness signify

A

Capsule, DJD, effusion

39
Q

What does burning signify

A

Nerve

40
Q

What does dead arm signify

A

TOS

41
Q

What is DeJourne’s Triad

A

Sneezing, coughing, straining

42
Q

What does laying on shoulder/night pain signify

A

Muscular, hypermobility

43
Q

What does reaching overhead pain signify

A

Impingement, tendinitis, Spur on acromion

44
Q

What does washing back of head pain signify

A

Inferior capsule tight

45
Q

What does applying deodorant pain signify

A

Instability, impingement

46
Q

What does reaching for wallet pain signify

A

Adhesive capsulitis, subscapularis strain/tear

47
Q

What does reaching into backseat of car pain signify

A

Anterior instability, posterior impingement, biceps tendinitis

48
Q

What does pushing open door pain signify

A

Posterior capsule instability

49
Q

What does pushing up from chair pain signify

A

AC joint problem

50
Q

What does getting change at toll pain signify

A

Impingement of lack of strength

51
Q

What does overhand throwing pain signify

A

Have to know where symptoms are

52
Q

Where do the origin of symptoms come from with DeJourne’s Triad

A

Space occupying lesion

53
Q

What is a rare genetic disorder of collagen disorder that have deficit in development of collagen and is life threatening

A

Ehlers-Danlos (ED)

54
Q

What are people with Ehlers-Danlos at higher risk of

A

RA or JRA

55
Q

True or False:

People with Ehlers-Danlos are usually hypermobile

A

True

56
Q

What is an autosomal dominat genetic disorder of CT, disproportionate long pibs, fingers, tall structure, pectus excavatum and predisposed to CV disorders

A

Marfan’s Syndrome

57
Q

What is pectus excavatum

A

Sternum is concave into chest

58
Q

Pt reports of lateral shoulder pain with overhead

activities or demonstration of painful arc (diagnosis)

A

AC joint, bursitis, tendinitis, or subacromial impingement

59
Q

Pt reports instability, apprehension, and pain with

activities most often when shoulder is ABDed and ERed (diagnosis)

A

Anterior instability and possible labral tear (if blocking is present)

60
Q

Decreased ROM and pain with resistance (diagnosis)

A

Possible RC or long head of biceps tendinitis/tear

61
Q

Pt reports of pain and weakness with muscle loading,

night pain. Age > 60 (diagnosis)

A

Possible RC tear

62
Q

Pt complaints of poorly located shoulder pain with
occasional radiation into elbow. Pain usually
aggravated by movement and relieved by rest. Age >
45. Females more affected than males (diagnosis)

A

Possible adhesive capsulitis

63
Q

Pt reports of a fall on the shoulder followed by pain

over AC joint (diagnosis)

A

Possible AC sprain

64
Q

Pt complaints of UE heaviness or numbness with

prolonged postures and when lying on involved side (diagnosis)

A

TOS

Musculo (18 decks)

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