Shoulder examination Flashcards
In the shoulder examination, what do we GENERALLY INSPECT?
Surrounding area:
Slings
Patient:
Signs of pain
Systemically well
Body habitus
In the shoulder examination, what do we LOOK for?
CHECK SHOULDER AND AXILLA:
Overall alignment
Deformity - one shoulder higher than other? dislocation? winged scapula (get patient to press against wall)?
Scars - arthroscopy? shoulder surgery?
Wasting - trapezius? deltoid? triceps? biceps? suprasinatus? infraspinatus?
Swelling - inflammation? bursitis?
Skin changes - erythema? bruising?
In the shoulder examination, what do we FEEL for?
Temperature:
Clavicle
Deltoid
Structures of shoulder: SCJ Clavicle ACJ Acromion Coracoid process of scapula Deltoid muscle Greater tubercle of humerus Bicep tendon Borders of scapula Supraspinatus Infraspinatus
In the shoulder examination, what MOVEMENTS do we assess?
Functionality:
Hands behind head
Hands behind back
Hand to opposite shoulder
Shoulder flexion
Shoulder extension
Shoulder abduction - pain in lower arc (80-90deg) suggest supraspinatus impingement. Pain in higher arc (>120deg) suggest ACJ injury/pathology
External shoulder rotation - loss of this movement in frozen shoulder
Internal shoulder rotation
Repeat movements passively on those that have reduced ROM or pain
In the shoulder examination, what SPECIAL TESTS do we perform?
Rotator cuff:
Weakness suggests a tear
Suprasinatus - empty can test (indicates weakness or impingement)
Infraspinatus - external rotation with resistance
Subscapularis - Greber’s lift-off test
Impingement test:
Supraspinatus - hawkins-kennedy test
ACJ injury or pathology (e.g. arthritis) - scarf test
In the shoulder examination, what JOINT ABOVE do we test?
Cervical spine:
Flexion, extension, lateral flexion and rotation
In the shoulder examination, what NEUROVASCULATURE do we assess?
Power:
Deltoid - axillary nerve
Sensation:
Deltoid (regimental badge area) - axillary nerve
Vascular:
Radial pulse
