Shoulder Labs Flashcards
what is a Sprengel’s deformity?
congenital deformity where scapula sits higher
what ROM and MMT MUST be measured for shoulder?
flex
abduction
IR
ER
painful arc occurs with arm elevation at _____ degrees and increases suspicion of ____ pathology
60-120 deg
RC
pain at the end of arm elevation ROM indicates _____ pathology
AC joint
scapular dyskinesis can be related to ____ impingement
SA
what is a SICK scapula?
malposition of Scapula
Inferior medial border
Coracoid with pain & malposition
scapular dysKinesia
in what position is shoulder resisted testing done in?
midrange
what motions go with the glides?
distraction
inferior
posterior
anterior
distraction - all
inferior - abduction
posterior - flex, IR, horz add
anterior - ext, ER, horz abd
which shoulder joint play is done in prone?
anterior glide
where does RC commonly refer pain?
deltoid
what are the impingement special tests?
Neer
Hawkins-Kennedy
cross-body adduction
painful arc
muscle/tendon pathology (RC) tests
Speed’s
full can
empty can
ER lag sign
belly press
lift-off sign/IR lag sign
drop arm
how to perform Neer test
- passively elevate pt arm in max IR in scapular plane
- repeat with ER
positive Neer test
reproduction of their pain
supraspinatus or biceps injury
how to perform Hawkins-Kennedy test
passively flex arm to 90 and forcibly IR
repeat further into horz add - stop when pain
what does the motion of the Neer test cause?
greater tuberosity to jam against antero-inferior border of acromion
what does the motion of the Hawkins-Kennedy test cause?
presses supraspinatus tendon against anterior surface of coraco-acromial ligament and coracoid process
positive Hawkins-Kennedy test
reproduction of their pain
supraspinatus tendinopathy
which test can assess both subacromial impingement and AC joint pathology?
cross-body adduction test
position of arm for cross-body adduction test
90 deg flexion
passively horz add
how to perform Speed’s test?**
flex to 90
forearm supination
elbow fully extended
resist flexion
positive Speed’s test
pain at bicipital groove
biceps long head tendinopathy
positive full can & empty can test
weakness OR pain
supraspinatus tendinopathy
when to do empty can test?
if no reproduction with full can (more provocative)
UE position for ER lag sign & infraspinatus strength test
45 deg in scapular plane
maintain ER
strength test - against resistance
lag sign - maintain when passive ER
which special tests assess subscapularis?
belly press test
lift off test/IR lag sign (harder)
common compensation for belly press test
adduction of UE
elbow moves posteriorly
UE position for drop arm test
90 deg abduction
elbow fully extended
shoulder ER
positive drop arm test
SIGNIFICANT RC pathology
(shoulder shrug compensation)
instability special tests
apprehension & relocation tests
sulcus sign
posterior apprehension test
SLAP lesion special tests
active compression/O’Brien’s test
Biceps Load I
Biceps Load II
labral special test
clunk test
scapular stability special tests
scapular dyskinesis test
scapular assistance test
wall (or floor) push up
pec minor tightness
AC joint pathology special tests
presence of step deformity
palpation
cross-body adduction test
active compression/O’Brien’s test
UE position for apprehension test
supine
90 deg abduction
max ER
what test is performed only if apprehension test is positive?
Jobe relocation test
a ____ force is applied to humeral head during Jobe relocation test
posterior
positive Jobe relocation test
decreased apprehension or reduction in symptoms
able to ER further
UE position for sulcus sign test
abduct arm 20-50 deg
neutral rotation
sulcus sign grades:
1+ = ___cm
2+ = ___cm
3+ = ___cm
1+ = 1 cm
2+ = 1-2 cm
3+ = >2 cm
a positive sulcus sign indicates _____
inferior instability or MDI
positive sulcus sign
depression greater than 1 finger width b/w acromion and humeral head
UE position for posterior apprehension test
90 deg flexion
horz add
posterior force at elbow
how to perform active compression/O’Brien’s test
90 flex, elbow extended, 15 deg horz add
1. IR
2. ER
provided resistance with downward force at IR & ER
positive active compression/O’Brien’s test
pain w/ IR that is reduced with ER
SLAP pathology
Biceps Load I vs II
I: 90 deg flexion
II: 120 deg flexion (better)
UE position for Biceps Load I & II
supine
90 or 120 deg flexion
full ER
elbow flexed to 90 deg
forearm supination
resist elbow flexion
(+) = pain
how to perform clunk test
passively fully abduct over head
push humeral head anteriorly
while ER at humerus
positive clunk test
clunk or grinding sound
may cause apprehension if unstable
what test is done next if scapular dyskinesis test is positve?
scapular assistance test
wall (or floor) push up test
positive scapular assistance test
decrease shoulder symptoms
or increase elevation ROM
2/2 opening subacromial space with upward rotation assistance
tightness of pec minor may lead to scapular ____ & _____
protraction & tilting of inferior edge
which test can be used to assess SLAP lesion or AC joint pathology?
active compression/O’Brien’s test
