Shoulder Special Tests Flashcards

1
Q

Apprehension test for anterior shoulder dislocation

A
  • Supine, arm 90 degrees ABD
  • Therapist ERs the shoulder
  • Positive test: look of apprehension or a facial grimace prior to reaching end point
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2
Q

Apprehension test for posterior shoulder dislocation

A
  • Supine, arm 90 degrees ABD
  • Therapist applies posterior force through long axis of humerus
  • Positive test: look of apprehension or a facial grimace prior to reaching end point
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3
Q

Sulcus sign

A
  • Sitting/ standing
  • Therapist position’s patient’s arm in 20-50 degrees of ABD
  • Therapist grasps patient’s elbow and pulls arm inferiorly
  • Positive test: sulcus sign/ indicates inferior instability
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4
Q

Sulcus sign grading

A

According to vertical length of depression
1+: <1 cm
2+: 1-2 cm
3+: >2 cm

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5
Q

Ludington’s Test

A

For long head biceps rupture

  • Pt sitting, clasping both hands behind had with fingers interlocked
  • Patient alternately contracts and relaxes biceps muscles
  • Positive test: Absence of movement in the biceps tendon
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6
Q

Speed’s Test

A

For Bicipital Tendonitis

  • Pt sitting or standing, elbow extended, forearm supinated
  • Therapist: One hand over bicipital groove, other over volar surface of forearm
  • Therapist resists active shoulder flexion
  • Positive test: Pain or tenderness in bicipital grove region
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7
Q

Yergason’s Test

A

For Bicipital Tendonitis

  • Pt sitting, 90 degrees elbow flexion, forearm pronated
  • Stabilize humerus against thorax
  • Therapist: One hand on forearm, other on bicipital groove
  • Pt instructed to actively supinate and laterally rotate against resistance
  • Positive: Pain/ tenderness over groove
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8
Q

Drop arm test

A

For Rotator Cuff Tear

  • Arm at 90 degrees abd
  • Instructed to slowly lower arm to side
  • Positive: pt cannot slowly lower arm to the side, or presence of severe pain
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9
Q

Hawins-Kennedy

A

For Supraspinatus Impingement

  • Flex shoulder to 90 degrees, IR arm
  • Positive: pain
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10
Q

Infraspinatus Test

A

For infraspinatus strain/tear

  • Elbow flexed 90 degrees, IR 45 degrees
  • Patient resists as therapist applies medially directed force to forearm
  • Positive: Pain or weakness
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11
Q

Lateral Rotation Lag Sign

A

For Infraspinatus or Supraspinatus pathology

  • Pt passively placed in 20 degrees of scaption, end range ER
  • Instructed to hold position
  • Positive: Pt can’t hold position
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12
Q

Lift off sign

Medial rotation lag sign

A

For Subscapularis Lesion

  • Pt places dorsum of hand on their low back
  • Pt instructed to move hand away from back
  • If pt is unable, PT should passively move pt’s hand away from back and see if they can hold it
  • Positive: Pt can’t hold position
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13
Q

Neer impingement test

A

For Supraspinatus Impingement

  • Therapist places one hand on posterior scapula, other hand stabilizing elbow
  • Therapist elevates patient’s arm through flexion
  • Positive: Grimace or pain
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14
Q

Supine impingement test

A
  • Pt supine
  • Therapist passively moves shoulder into full flexion
  • Therapist ER and ADD shoulder, then IR shoulder
  • Positive: Pain with the IR
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15
Q

Supraspinatus test

A

For Supraspinatus tear/impingement or suprascapular nerve involvement

  • Pt with arm 90 degrres ABD, 30 degrees horizontal ADD, thumb pointing downward
  • Therapist resists patient’s attempt to abduct arm
  • Positive: weakness or pain
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16
Q

Adson Maneuver

A

For Thoracic Outlet Syndrome

  • Therapist monitors radial pulse, asks patient to rotate head toward test shoulder
  • Patient instructed to extend head while therapist ER and extends shoulder
  • Positive: Absent/ diminished radial pulse
17
Q

Allen Test

A

For TOS

  • Test arm at 90 ABD, full ER, 90 elbow flexion
  • Patient rotates head away from test shoulder
  • Therapist monitors radial pulse
  • Positive: absent/ diminished pulse
18
Q

Costoclavicular Syndrome Test

A

For compression of subclavian artery between first rib and clavicle

  • Therapist monitors radial pulse and assists patient to assume a military posture
  • Positive: diminished pulse
19
Q

Roos Test

A

For TOS

  • Both arms at 90/90/90
  • Open/close hands for 3 minutes
  • Positive: Inability to maintain position, weakness of arms, sensory loss, ischemic pain.
20
Q

Wright test (hyperabduction test)

A

For compression in costoclavicular space

  • Sitting or supine
  • Therapist moves pt’s arm overhead in frontal plane while monitoring radial pulse
  • Positive: diminished pulse
21
Q

Acromioclavicular crossover test

A

For AC joint injury

  • Therapist moves shoulder into 90 degrees flexion, then fully horizontally adducts shoulder
  • Positive: pain over AC joint
  • Can be active or passive
22
Q

Active compression test (O’Brien’s test)

A

For superior labral tear

  • Shoulder flexed 90 degrees, horizontally adducted 10-15 degrees, medial rotation (thumb down)
  • Pt resists therapist’s force pressing arm down
  • Shoulder is then ER, same downward force applied
  • Positive: pain with IR, decreased pain with ER
  • Must ensure pain isn’t over AC joint
23
Q

Glenoid labrum tear test

A

For glenoid labrum tear

  • Patient supine
  • Therapist passively abducts and laterally rotates arm over patient’s head, then applies anterior directed force to the humerus
  • Positive: Clunk or grinding sound
24
Q

Jerk Test

A
  • Shoulder elevated 90 degrees, IR with elbow bent.
  • Therapist provides axial compression through elbow while horizontally adducting shoulder
  • Positive: sudden clunk or jerk as humerus subluxes posteriorly. May hear another clunk when you return pt to starting position (humerus reducing) - indicates posterior instability
  • Positive: pain- indicates posterior labral lesion
25
ULTT1
Median nerve 1. Shoulder depression 2. 110 degrees ABD 3. Elbow extension 4. Forearm supination 5. wrist extension 6. Finger/thumb extension Sensitization test: Contralateral cervical sidebend
26
ULTT2
Median nerve, musculocutaneous nerve, axillary nerve 1. Shoulder depression 2. 10 degrees ABD 3. Same steps 3-6 7. Shoulder ER Sensitization test: Contralateral cervical sidebend
27
ULTT3
Radial nerve 1. Shoulder depression 2. 10 degrees ABD 3. Elbow extension 4. Forearm pronation 5. Wrist flexion and ulnar deviation 6. Finger and thumb flexion 7. Shoulder IR Sensitization: contralateral cervical sidebend
28
ULTT4
Ulnar nerve 1. Shoulder depression 2. 10-90 degrees ABD 3. Elbow flexion 4. Forearm supination 5. Wrist extension, radial deviation 6. Finger and thumb extension 7. Shoulder ER Sensitization: contralateral cervical sidebend