Shoulder Pain/Exam

Question 1

Name the 4 muscles involved in the rotator cuff. Which one is most commonly injured?

Answer 1

Supraspinatus M. (most common), Infraspinatus M., Teres Minor M., and Subscapularis M.

Question 2

What are the 4 top causes of chronic shoulder pain?

Answer 2

rotator cuff disorder, adhesive capsulitis, shoulder instability, and shoulder arthritis

Question 3

Which rotator cuff muscle is not palpable?

Answer 3

Subscapularis M.

Question 4

Arm Flexion

Answer 4

180 - anterior deltoid and coracobrachialis

Question 5

Arm Extension

Answer 5

60 - latissimus dorsi and teres major

Question 6

Arm Abduction

Answer 6

180 - deltoid and supraspinatus

Question 7

Arm horizontal adduction

Answer 7

130-140 - pectoralis major and latissimus dorsi

Question 8

arm horizontal abduction

Answer 8

40-55 - supraspinatus and teres minor

Question 9

arm external rotation

Answer 9

90 - infraspinatus and teres minor

Question 10

arm internal rotation

Answer 10

90 - supscapularis and pectoralis minor

Question 11

Biceps reflex

Answer 11

C5

Question 12

Brachioradialis reflex

Answer 12

C6

Question 13

Triceps reflex

Answer 13

C7

Question 14

Apprehension Test

Answer 14

shoulder abducted to 90 and elbow flexed to 90; stabilize shoulder w/ 1 hand and force arm into external rotation with other

(+) = pt apprehensive of repeat dislocation
Indicates: glenohumeral instability

Question 15

Sulcus Sign

Answer 15

stabilize shoulder, grasp pt’s elbow and pull down

(+) = indentation appears beneath acromion
Indicates: glenohumeral instability

Question 16

Yergason’s Test

Answer 16

pt’s arm at side w/ elbow flexed to 90; palpate bicipital groove with one hand and grasp pt’s wrist w/ other; have pt supinate and externally rotate against resistance

(+) = pain and/or tendon subluxation out of groove
Indicates: unstable bicipital

Question 17

Speed’s Test

Answer 17

pt’s arm flexed (50-90) at shoulder w/ arm supinated; slightly flex pt’s elbow and resist at forearm while pt flexes shoulder; monitor bicipital groove

(+) = pain in bicipital groove
Indicates: bicipital tendonitis of long head of biceps

Question 18

Empty Can Test

Answer 18

pt’s shoulder flexed to 90 and arms horizontally abducted to 45; internally rotate both arm and press down on forearms while pt resists

(+) = pain or weakness
Indicates: rotator cuff pathology (specifically supraspinatus)

Question 19

Drop Arm Test

Answer 19

Pt abducts arm then slowly drops arm

(+) arm will drop abruptly or gentle tap on wrist will cause arm to drop
Indicates: full thickness tear of supraspinatus

Question 20

painful arc test

Answer 20

pt abducts arm starting at their side

(+) pain elicited within 60 and 120 degrees
Indicates: subacromial impingement and/or rotator cuff injury

Question 21

Neer Impingement

Answer 21

stabilize pt’s shoulder and with forearm pronated, passively flex shoulder into fully flexed position

(+) = pain
Indicates: subacromial bursa or rotator cuff impingement

Question 22

Hawkins Test

Answer 22

flex shoulder and elbow to 90 and passively rotate humerus into internal rotation

(+) = pain
Indicates: rotator cuff or subacromial bursa impingement

Question 23

Lift Off Test

Answer 23

place pt’s arm into internal rotation and extension (behind their back); pt pushes arm further into internal rotation as physician resists

(+) = weakness
Indicates: subscapularis weakness

Question 24

Cross Arm Test

Answer 24

physician passively adducts pt’s arm across their chest and rests it on opposite shoulder

(+) = pain in AC joint with end range adduction
Indicates: AC joint pathology

Question 25

Apley Scratch Test

Answer 25

physician should make note how far the pt can reach both hands behind their back

Question 26

Top of shoulder dermatome

Answer 26

C4

Question 27

Axillary Region dermatome

Answer 27

T1