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NMS > Shoulder Ortho Tests > Flashcards

Shoulder Ortho Tests Flashcards

1
Q

Procedure of Apprehension Test (Ant. Apprehension test)

A
  • Patient seated, Dr. behind them.
  • Dr. asks patient to look at them.
  • Dr. SLOWLY brings the should to 90 abduction w external rotation while stabilizing the shoulder from behind.
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2
Q

Interpretation of Apprehension/Ant. Apprehension test?

A

+ if there is one of the following:
- Pain over ant. capsule resembling the pain from previous dislocation(s).
- Look of apprehension on patient’s face.
- Laxity compared to the other side.

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3
Q

Procedure of Relocation Test?

A

**ONLY DONE IF APPREHENSION TEST IS + **
The same position as the Apprehension test.
- Stabilize patient with inside hand and a wide C contact.

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4
Q

Interpretations of Relocation Test

A
    • if patient experiences relief of symptoms that manifested during the apprehension test.
  • Decreased apprehension = anterior instability.
  • Decreased pain = anterior instability and cuff disease.
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5
Q

Procedure of Posterior Dislocation Apprehension test?

A
  • Patient lying supine with shoulder 90 flexed and internally rotated.
  • Dr. applies a posterior force on the elbow
  • Dr. is watching the patient for signs of apprehension, pain, or resistance to the force.
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6
Q

Interpretation of Posterior Dislocation Apprehension test?

A
    • test is indicated by signs of apprehension, pain or resistance to the force.
    • indicates posterior dislocation trauma of the humerus.
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7
Q

Procedure to Jobes test?

A
  • Patient is lying supine with shoulder in same position as Apprehension test.
  • Dr. applies A-P force to proximal humerus while externally rotating the shoulder.
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8
Q

Interpretation of Jobes test?

A
    • is a decrease in pain and/or apprehension test is a positivie test.
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9
Q

Procedure of Sulcus Sign?

A
  • Patient is seated with their hand internally rotated in their lap.
  • Dr. applies inferior traction/pulls the patient’s humerus down by grasping the patient’s elbow.
  • Dr. looks/palpates over the inferior aspect of the acromion process.
  • Test should be repeated at 45 abduction.
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10
Q

Interpretations of Sulcus Sign?

A
  • Increased laxity at 0 abduction = Rotator interval laxity.
  • Increased laxity at 45 abduction = laxity of the inferior GH ligament complex.
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11
Q

Procedure of Load and Shift / Drawer test?

A
  • Patient is seated, supine or side-lying.
  • Dr. stabilizes the superior shoulder with their cephalad hand.
  • Dr. takes caudal hand with a big C contact and contacts the anterior and posterior aspect of the humeral head.
  • Dr. compresses the humeral head into the glenoid then slides the head anterior and posterior.
  • Normal movement is <25% of the diameter of the humeral head and posterior 50%
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12
Q

Interpretations of Load and Shift /Drawer test?

A
    • test = abnormal AP/PA translation and/or popping, grinding, and slapping.
  • Indicating instability of the GH joint and possible labrum damage.
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13
Q

Procedure of Dugas test?

A

The patient is seated.
- Dr. tells patient to anteriorly touch their opposite shoulder with their hand.
- Once they do that, Dr. tells them to stay in that position but lower their elbow to their chest.

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14
Q

Interpretations of Dugas test?

A
  • Inability to touch the anterior opposite shoulder or unable to lower arm to chest = anterior dislocation of humerus.
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15
Q

Procedure of Apley’s Scratch test?

A
  • Patient can sit or stand.
  • Dr. asks patient to reach over their head and touch the back side of their opposite shoulder.
  • After that Dr. asks the patient to reach behind their backs and touch their opposite shoulder.
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16
Q

Interpretation of Apleys Scratch test?

A
  • Exacerbation of pain in the shoulder = Degenerative tendinitis of the rotator cuff – Usually supraspinatus tendon.
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17
Q

Procedure of Subacromial Push Bottom sign?

A
  • Patient is seated.
  • Dr. stands behind the patient and applies pressure to the subacromial bursa.
18
Q

Interpretations of Subacromial Push Button sign?

A
  • Increase in pain = subacromial bursitis.
19
Q

Procedure of Subacromial Bursa/ Dawbarn’s sign?

A
  • Repeat subacromial push button sign (anterolateral and inferior to the acromion) then note the amount of pain (0-10 scale)
  • Doctor keeps finger in painful area and passively abducts arm to 90.
20
Q

Interpretations of Subacromial Bursa/Dawbarn’s sign?

A

Decreased tenderness or pain disappearing = Subacromial bursitis.

21
Q

Procedure of Drop Arm/Codman’s Drop Arm/ Codman’s test?

A
  • Patient seated.
  • Dr. passively abducts arm to above 90 then suddenly removes their support causing the deltoid to contract.
    – Alternative is having patient slowly lower their arm down.
22
Q

Interpretations of Drop Arm/ Codmans Drop Arm/ Codmans test?

A
  • Pain and hunching of shoulder = rotator cuff tear or rupture of the supraspinatus tendon.
  • If test is (-) but there is pain over the anterolateral shoulder, that could indicate subacromial bursitis.
23
Q

Procedure of Empty Can/Supraspinatus test?

A
  • Patient is standing with their arms abducted to 90, elbows extended and neutral rotation.
  • Dr. pushes down on patients arms.
  • Shoulders are then moved 30 in horizontal flexion and thumbs pointing down.
  • Dr. pushes down on arms again.
24
Q

Interpretations of Empty Can/Supraspinatus test?

A

Weakness or pain = (+) for weak or injured supraspinatus muscle or tendon.

25
Q

Procedure for Lift Off/Gerber’s/Subscapularis sign?

A
  • Patient is seated or standing with their hand behind their back, palms facing out (should not be painful).
  • Dr. asks the patient to try and lift their hand off their back.
26
Q

Interpretations of Lift Off/Gerber’s/Subscapularis sign?

A

Inability to lift hand form their back = (+) for lesion of the subscapularis muscle or tendon.

27
Q

Procedure for Yergasons?

A
  • Patient seated with their elbows flexed at their side.
  • Dr. applies resistance while the patient is trying to supinate their wrist.
  • While doing this, Dr. tells the patient to resist efforts to extend the elbow.
28
Q

Interpretations of Yergason’s?

A
  • Pain developing or aggravated over the bicipital groove = (+) tenosynovitis of the transverse humeral ligament.
29
Q

Procedure for Clunk test?

A
  • Patient is lying supine.
  • Dr. places one hand behind the humeral head, and the other hand grasps the patients wrist and full abducts the shoulder.
  • Dr. is then going to push anteriorly on the humeral head and examiner externally rotates the shoulder while keeping it fully abducted.
30
Q

Interpretation of Clunk test?

A
  • Any clunk or grinding as the shoulder attempts to dislocate anteriorly = (+) anterior tear of the glenoid labrum.
31
Q

Procedure for Crank test?

A
  • Patient is lying supine with their shoulder abducted 160 in flexion in the scapular plane.
  • Dr. applies an axial force while internally and externally rotating the arm.
32
Q

Interpretations for Crank test?

A

Clicking with pain = (+) labrum tear

33
Q

Procedure for O’Brien sign?

A
  • Patient is seated with their elbows extended and shoulder in 90 flexion and 10/15 horizontal flexion.
  • First Dr. internally rotates and tells the patient to resist downward force.
  • Second, Dr. does the same thing but instead external rotation and downward force.
34
Q

Interpretations of O’Brien sign?

A
  • If the patient experiences pain with external rotation but reduced/no pain with internal rotation = (+) test.
  • Pain in both external and internal position = (-) test.
  • Deep shoulder pain = Glenoid Labrum.
  • Superficial, top of shoulder = AC injury.
35
Q

Procedure for Impingement Syndrome test?

A
  • Patient is supine or seated with their elbow flexed.
  • Dr. applies superior pressure on elbow into subacromial/suprahumeral space.
36
Q

Interpretations of Impingement Syndrome test?

A

Increased pain = (+) for impingement syndrome.

37
Q

Procedure for Hawkins-Kennedy test?

A
  • Patient can be supine or seated.
  • Dr. is infront of patient holding their elbow/shoulder in 90 flexion.
  • Dr. forcibly internally rotates the shoulder (dr. hand is under the deltoid) by supporting the elbow and pushing down on the patients wrist.
  • This motion pushes the supraspinatus tendon against the anterior surface of the coracoacromial ligament.
38
Q

Interpretations of Hawkins-Kennedy test?

A
  • Pain in the anterior GH joint = (+) rotator cuff tendonitis.
  • Additionally, pain may also represent impingement of the supraspinatus tendon.
39
Q

Procedure of Neer’s test?

A
  • Patient is supine or seated.
  • Dr. is next to the patient and forcefully flexes the patient’s arm while depressing the scapula.
  • Causing compression of the greater tuberosity against the anterior-inferior acromial process.
40
Q

Interpretations of Neer’s test?

A
  • Pain in the anterior GH joint = (+) for rotator cuff tendonitis.
41
Q

Procedure for Impingement Relief/Reverse Impingement test?

A
  • Patient is supine with arms in apprehension position.
  • Dr. pushes humeral head from superior to inferior.
42
Q

Interpretations for Impingement Relief/Reverse Impingement test?

A
  • Decrease in pain or alleviation = (+) mechanical impingement under the acromion.

NMS (5 decks)

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