Shoulder Pain Flashcards
1
Q
Symptoms
Where do you put this in the SOAP note
A
What the patient reports
Subjective
2
Q
Signs
Where do you put this in the SOAP note
A
Things the physician can assess
Objective
3
Q
- Shoulder specific anatomy
A
- Sternoclavicular joint
- Clavicle
- Acromioclavicular joint
- Acromion process
- Coracoid process
- Spine of Scapule (T3)
- Inferior Border of Scapula (T6)
- Glenohumeral joint
- Bicipital groove
- Axilla lymph nodes
4
Q
A
- Acromioclavicular joint
- Coracoid Process
- Clavicle
- Sternoclavicular joint
- Acromion
- Subacromial Bursa
- Supraspinatus Tendon
- Glenoid fossa
- Biceps tendon
- Subascapularis tendon (cut)
- Biceps m.
- Subscapularis m.
5
Q
Reflex testing
A
- C5- biceps
- C6-brachioradialis
- c7-triceps
6
Q
_ is the most sensitive indicator of joint disease
A
ROM
7
Q
Normal shoulder ROMs
A
- Flexion: 180 deg
- Extension: 60 deg
- ABduction: 80
- ADduction:
8
Q
- How do you perform an apprehension test?
- What does a positive test indicate?
A
- Shoulder ABducted to 90 deg and elbow flexed/
- Stabilize shoulder with one hand and force arm into external rotation with other hand
- test when patient is apprehensive of repeat dislocation
9
Q
- What is a positive sulcus sign indicative of?
A
- Glenohumeral instability
- (indentation appears in area beneath acromion)
10
Q
- How do you perform Yergason’s Test?
- What does a positive test indicate?
A
- Patient arm at side with elbow flexed to 90 deg
- Physician uses one hand to palpate bicipital groove and monitors there while other hand grasps patient’s wrist
- Patient Supinate and externally rotates against resistance
- + test with pain and/or tendon subluxation out of groove
- Indicates unstable bicipital tendon
11
Q
- How do you perform Speed’s Test?
- What is a positive test indicative of?
A
- Patient arm flexed 50-90 deg
- Hand is supinated
- Slightly flex patient’s elbow
- Resist at forearm while patient flexes shoulder
- + test with pain in bicipital groove, indicative of bicipital tendonitis of longhead biceps
12
Q
- How do you perform an Empty Can Test?
- What is a positive test indicative of?
A
- Patient flexes shoulders to 90 deg and horizontally abducts to 45 deg
- Internally rotate patient’s arms so thumbs are pointing down
- Press on forearms while patient resists
- + test with pain or weakness
- Indicative of rotator cuff pathology (supraspinatus in particular)
13
Q
- How do you perform a Drop-Arm test?
- What is a positive test indicative of?
A
- Patient Abducts arm to 90 deg then slowly drops arm
- + test if shoulder abruptly drops
- Indicative of full thickness supraspinatus tear
14
Q
- How do you perform a Cross-Arm Test?
- What is a positive test indicative of?
A
- Doc passively ADducts patient’s arm across chest and rests patient hand on their opposite shoulder
- + test with pain in AC joint with end range ADduction
- Indicative of AC joint pathology
15
Q
- How do you perform a painful arc test?
- What is a positive test indicative of?
A
- Patient actively ABducts arm (starting position at their side)
- + test with pain between 60-120 degrees
- Indicates subacromial impingement and/or rotator cuff injury
16
Q
- How do you perform Neer Impingement?
- What is a positive test indicative of?
A
- With forearm pronated, passively flex patient’s shoulder to 180 deg
- + test with pain
- Indicative of subacromial bursitis or rotator cuff impingement
17
Q
- How do you perform a Hawkin’s test?
- What is a positive test indicative of?
A
- Doc passively will ADduct and internally rotate the arm with the shoulder and elbow flexed to 90 deg
- Stabilize shoulder with other hand
- + test with pain
- Indicative of rotator cuff impingement or subacromial bursa impingement
18
Q
- How do you perform the Lift off test?
- What is a positive test indicative of?
A
- Put patient’s arm into internal rotation and extension
- Patient pushes arm into further internal rotation as physicial resists
- + test with pain
- Indicative of subscapularis m. weakness
19
Q
- How do you perform the Apley Scratch test?
- What is a positive test indicative of?
A
- Top arm externally rotated and abducted
- Bottom arm internally rotated and adducted
- Physician makes note of if hands can touch and how well they move
- + test with pain
- Indicative of subscapularis m. weakness
