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ISU DPT PHTH710 > Skills Check-Off For Shoulder > Flashcards

Skills Check-Off For Shoulder Flashcards

1
Q

C4 Dermatome

A

Top of the Shoulders

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2
Q

C5 Dermatome

A

Lateral Deltoid

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3
Q

C6 Dermatome

A

Tip of Thumb

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4
Q

C7 Dermatome

A

Distal Middle Finger

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5
Q

C8 Dermatome

A

Distal 5th Finger

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6
Q

T1 Dermatome

A

Medial Forearm

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7
Q

C4 Myotome

A

Shoulder Elevation/Shrug

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8
Q

C5 Myotome

A

Shoulder Abduction

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9
Q

C6 Myotome

A

Elbow Flexion, Wrist Extension

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10
Q

C7 Myotome

A

Elbow Extension, Wrist Flexion

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11
Q

C8 Myotome

A

Thumb Abduction/Extension

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12
Q

T1 Myotome

A

Finger Abduction

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13
Q

C5 Nerve Root Reflexes

A

Biceps Brachii Tendon

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14
Q

C6 Nerve Root Reflexes

A

Brachioradialis Tendon

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15
Q

C7 Nerve Root Reflexes

A

Triceps Tendon

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16
Q

Palpation

A
  • AC Joint
  • SC Joint
  • Coracoid Process
  • Greater Tubercle
  • Lesser Tubercle
  • Medial Border of the Scapula
  • Spine of the Scapula
  • Lateral Border of the Scapula
  • Inferior Angle of the Scapula
  • Infraspinous Fossa
  • Supraspinous Fossa
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17
Q

Subacromial Impingement

A
  • Diagnostic Cluster- HIP- Hawkins-Kennedy, Infraspinatus Test (ER RT), Painful Arc
  • Hawkins-Kennedy Test
  • Neer Test
  • Painful Arc Test
  • Empty Can (Jobe’s) Test
  • Infraspinatus (External Rotation Resistance Test) Test
  • Cross-Body Adduction Test
  • Drop Arm Sign
  • Internal Rotation Resisted Strength Test
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18
Q

Rotator Cuff Pathology Tests

A
  • Diagnostic Cluster- DIP- Drop Arm, Infraspinatus (ER RT), Painful Arc
  • Full Can/Empty Can (Jobe’s) Test
  • Drop Arm
  • Infraspinatus (External Rotation Resistance Test) Test
  • Drop Sign
  • Rent Test
  • External Rotation Lag Sign
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19
Q

Shoulder Instability

A
  • Sulcus Test
  • Load Shift Test
  • Modified Apprehension-Relocation (Jobe Relocation) Test
  • Anterior Apprehension Test
  • Jerk Test (Posterior Shoulder Instability)
  • Posterior Drawer Test
  • Hyperabduction Test
  • Anterior Drawer Test
  • Anterior Release/Suprise Test
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20
Q

Labral Tear Tests

A
  • O’Brien’s Test (Active Compression)
  • Biceps Load Test
  • Biceps Load Test II
  • Crank Test
  • Clunk Test
  • Kim’s Test (Posteriorinferior Labral Lesion)
  • Jerk Test (Posteriorinferiror Labral Involvement)
  • Pain Provocation Test
  • Modified Dynamic Labral Shear Test
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21
Q

Muscle Involvement Tests

A
  • Speed’s Test (Biceps Involvement)
  • Yergason’s Test (Biceps Involvement)
  • Pec Major Length
  • Pec Minor Length
  • Latissimus Dorsi Length
  • Hornblower’s Sign
  • Bear Hug Test
  • Belly Press (Napoleon Sign)
  • Internal Rotation Lag Sign
  • Lift Off Sign
  • External Rotation Lag Sign
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22
Q

AC Joint Involvement

A
  • AC Shear Test (Paxinos Test)
  • Piano Key Sign
  • O’Brien’s Test (Active Compression)
  • Crossover Horizontal Adduction
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23
Q

Hawkins-Kennedy Test

A
  • SUBACROMIAL IMPINGEMENT, Subacromial Bursitis, Rotator Cuff Tear, Superior Labral Tear
  • Sitting or Supine- Examiner to side
  • 90 Degrees of Shoulder Flexion
  • One hand stabilizes the scapula (typically superior portion)
  • Forced Humeral IR
  • Positive test- Concordant shoulder pain
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24
Q

Neer Test

A
  • SUBACROMIAL IMPINGEMENT, Subacromial Bursitis, RC Tear, Superior Labral Tear
  • Sitting or Standing- Examiner to side
  • Active shoulder flexion
  • One hand stabilizes lateral border of the scapula
  • Forced Shoulder flexion toward end-range
  • Positive Test- Concordant shoulder pain
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25
Q

Painful Arc Test

A
  • SUBACROMIAL IMPINGEMENT (All stages of Subacromial Impingement
  • Standing
  • Active Shoulder Abduction
  • Positive Test- Concordant pain in the 60-120 degree range. Pain outside is considered negative
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26
Q

Empty Can (Jobe’s) Test

A

-Supraspinatus Test
-ROTATOR CUFF TEAR, SUBACROMIAL IMPINGEMENT (All stage of Subacromial Impingement)
-Sitting or Standing- Examiner behind
-90 Degrees Shoulder Abduction with thumbs up
Downward pressure on arms
-90 Degrees Shoulder Abduction in Scapular Plane with thumbs down
Downward pressure on arms
-Positive Test- Weakness and/or pain in Empty Can position

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27
Q

Infraspinatus (External Rotation Resistance Test) Test

A

SUBACROMIAL IMPINGEMENT (All stages of Subacromial Impingement)
Standing
MMT for External Rotation in standing
Positive Test- Pain or weakness

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28
Q

Cross-Body Adduction Test

A
  • SUBACROMIAL IMPINGEMENT, AC JOINT DAMAGE
  • Sitting Position- Examiner to side
  • 90 degrees of Shoulder Flexion
  • Passive Horizontal adduction to end range
  • Positive Test- Shoulder pain
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29
Q

Drop Arm Test

A
  • SUBACROMIAL IMPINGEMENT, Supraspinatus Tear (ROTATOR CUFF PATHOLOGY)
  • Standing- Examiner behind
  • Passive Shoulder Abduction to 90 degrees
  • Patient slowly lowers the arm
  • Positive Test- Inability to lower the arm
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30
Q

Internal Rotation Resisted Strength Testing

A
  • SUBACROMIAL IMPINGEMENT (Internal/Intraarticular vs. External/Subacromial Impingement)
  • Standing- Examiner behind/to side
  • 90 degrees shoulder abduction, 90 degrees elbow flexion
  • MMT toward IR with the shoulder fully in ER and then toward ER with the shoulder fully in ER
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31
Q

External Rotation Lag Sign

A
  • Supraspinatus/Infraspinatus Tear
  • Sitting- Examiner behind
  • 90 degrees of elbow flexion and 20 degrees of elevation in the scapular plane
  • ER pt’s arm to end range and then patient maintains position upon release
  • Positive Test- Lag and inability to maintain position
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32
Q

Drop Sign Test

A
  • ROTATOR CUFF PATHOLOGY, Infraspinatus Tear, Irreparable Fatty Degeneration of Infraspinatus
  • Sitting- Examiner behind
  • Elbow in 90 degrees of flexion and 90 degrees of elevation in the scapular plane
  • Passive ER to near end-range and release their arm while the patient maintains the position
  • Positive Test- Infraspinatus Tear is indicated by a lag showing the inability to maintain the arm position
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33
Q

Rent Test

A
  • ROTATOR CUFF TEAR
  • Sitting- Examiner behind
  • Examiner holds the pt’s elbow and extends the arm at shoulder, slowly IR and ER shoulder
  • Positive Test- Depression by about 1 finger width at the acromion
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34
Q

Sulcus Test

A
  • INFERIOR LAXITY, Superior Labral Tear
  • Sitting or supine
  • Examiner performs inferior force by pulling superior to the elbow straight down and in scapular plane
  • Positive Test- Significant distance between acromion and superior portion of the humeral head
35
Q

Load Shift Test

A
  • ANTERIOR, POSTERIOR, INFERIOR INSTABILITY
  • Supine- Examiner next to
  • Grasp proximal humerus with one hand providing a compression and “loading” of the humerus into the glenoid fossa
  • Examiner provides AP and PA force noting the amount of movement
36
Q

Modified Apprehension-Relocation Test/Jobe Relocation Test

A
  • ANTERIOR INSTABILITY, Labral Tear, SLAP Lesion
  • Supine- Examiner next to
  • 120 degrees shoulder abduction- Examiner performs passive max ER
  • Examiner then applies PA force to the humeral head
  • Positive Test- Reports of apprehension or pain and positive test for instability is indicated by a decrease in the pain or apprehension (no change in symptoms indicates impingement)
37
Q

Anterior Apprehension Test

A
  • ANTERIOR INSTABILITY, Labral Tear, SLAP Lesion
  • Supine- Examiner next to
  • 90 degrees shoulder abduction- Examiner performs passive max ER
  • Examiner then applies PA force to the humeral head
  • Positive Test- Reports of apprehension or pain and positive test for instability is indicated by a decrease in the pain or apprehension (no change in symptoms indicates impingement)
38
Q

Posterior Shoulder Apprehension Test

A

Shoulder Instability

39
Q

Posterior Drawer Test

A
  • POSTERIOR LAXITY
  • Supine- Examiner next to
  • Examiner stabilizes upper arm and abducts between 80-100 degrees and does an AP force to the humerus
  • Positive test- Note the amount of translation
40
Q

Hyperabduction Test

A
  • INFERIOR LAXITY
  • Sitting position- Examiner behind
  • Stabilize scapula with downward force on the supraclavicular region and passively place elbow in 90 flexion and pronation
  • Move to maximum abduction
  • Positive test- Passive abduction greater than 105 degrees
41
Q

Anterior Drawer Test

A
  • ANTERIOR LAXITY, ANTERIOR INSTABILITY
  • Supine- Examiner next to
  • One hand stabilizes the scapular and the other grasps and applies a PA force to the proximal humerus between 80-100 degrees of abduction
  • Positive test- Note the amount of anterior translation
42
Q

Anterior Release/Surprise Test

A
  • ANTERIOR INSTABILITY
  • Supine- Examiner to the side
  • Posterior force on the humeral head while moving the pt’s shoulder into 90 degrees of abduction and end-range ER
  • Release posterior force
  • Positive test- Report of sudden pain, and increase in pain, or reproduction of pain
43
Q

O’Brien’s (Active Compression) Test

A
  • LABRAL TEAR, SLAP LESION, LABRAL ABNORMALITY, AC JOINT PATHOLOGY
  • Standing- Examiner behind
  • 90 degrees shoulder flexion, 10 degrees horizontal adduction, and and max IR with the elbow in full extension
  • Examiner applies downward force at the wrist while pt resists
  • Pain on top of shoulder=AC Joint Pathology
  • Pain of the inside of the shoulder=SLAP lesion
  • Downward force repeated with arm in full external rotation and is positive with pain or painful clicking in IR and less or no pain in ER
44
Q

Biceps Load Test

A
  • SLAP LESION with Anterior Shoulder Dislocation
  • Supine- Examiner to side
  • Place pt in 90 degree abduction, 90 degree elbow flexion, and supination
  • Move pt to end range ER
  • Pt performs resisted elbow flexion
  • Positive test- No change in apprehension or pain that is worsened with resisted elbow flexion
45
Q

Biceps Load Test II

A
  • SLAP LESION
  • Supine- Examiner to side
  • Place pt in 120 degree abduction, 90 degree elbow flexion, and supination
  • Move pt to end range ER
  • Pt performs resisted elbow flexion
  • Positive test- No change in apprehension or pain that is worsened with resisted elbow flexion
46
Q

Crank Test

A
  • LABRAL TEAR, SLAP LESION
  • Sitting or supine- Examiner on side
  • Pt put in 160 degrees of shoulder abduction and 90 degree elbow
  • Compression force to the humerus then rotate the humerus into IR and ER in an attempt to pinch the torn labrum
  • Positive test- Reproduction of pain with or without click
47
Q

Clunk Test

A
  • LABRAL TEAR, SUPERIOR LABRAL TEAR
  • Supine- Examiner to side
  • Passive abduction to end range
  • Examiner applies PA force to the humeral head
  • Positive test- “Clunk” or grinding
48
Q

Kim’s Test (Posteriorinferior Labral Lesion)

A
  • POSTEROINFERIOR LABRAL LESION
  • Sitting with back support- Examiner to side
  • Passively placed in 90 degrees shoulder abduction
  • Examiner provides and axial load and a 45 degree diagonal elevation to the distal humerus concurrent with a posteroinferior glide to the proximal humerus
  • Positive test- Posterior shoulder pain
49
Q

Jerk Test (Posteriorinferior Labral Lesion)

A
  • POSTEROINFERIOR LABRAL LESION
  • Sitting- Examiner stands behind
  • Stabilize scapula and passively raise to 90 degrees of abduction and IR
  • Axial compression and then move to horizontal adduction
  • Positive test- Sharp shoulder pain with or without clunk or click
50
Q

Pain Provovation Test

A
  • SLAP LESION
  • Sitting- Examiner behind
  • Passively placed into 90 degrees of abduction, end range of ER, 90 degrees of elbow flexion, and maximal supination
  • Pain is rated by pt
  • Examiner then fully pronates the pt’s forearm and rates pain again
  • Positive test- Pain in pronated position or worse pain in pronation than supination
51
Q

Modified Dynamic Labral Shear Test

A
  • LABRAL TEAR
  • Sitting or Standing- Examiner to the side
  • 90 degree elbow flexion, 120 degrees shoulder abduction in scapular plane, and end range ER
  • Examiner moves pt into maximal horizontal abduction and the applies PA force to humeral head while lowering arm from 120 to 60 degrees of abduction
  • Positive test- Reproduction of pain and/or painful click/catch between 120-90 degrees of abduction
52
Q

Speed’s Test

A
  • All stages of Subacromial Impingement, Superior Labral Anterior to Posterior SLAP Lesion, Any Labral Lesion, BICEPS PATHOLOGY
  • Standing
  • Pt has extended elbow and supinated forearm
  • Examiner resists shoulder flexion from 0-60 degrees (make test)
  • Positive test- Localized concordant pain in the biciptial groove
53
Q

Yergason’s Test (Biceps Involvement)

A
  • Subacromial Impingement, Superior Labral Anterior to Posterior (SLAP) Lesion, Any Labral Lesion, LONG HEAD OF THE BICEPS PATHOLOGY
  • Sitting or Standing- Examiner stands in front
  • Elbow flexed 90 degrees with pronated forearm and upper arm at side
  • Examiner resists active supination
  • Positive test- Concordant pain to the bicipital groove
54
Q

Pec Major Length Test

55
Q

Pec Minor Length Test

56
Q

Lattisimus Dorsi Length Test

57
Q

Bear Hug Test

A
  • SUBSCAPULARIS TEAR
  • Sitting
  • Pt places palm of involved arm onto opposite shoulder
  • Examiner attempts to pull the hand upward and off the opposite shoulder
  • Positive test- Pt can’t hold hand against the shoulder
58
Q

Belly Press (Napoleon Sign) Test

A
  • SUBSCAPULARIS TEAR
  • Sitting or Standing
  • 90 degree elbow flexion and IR of the shoulder causing the palm to be pressed into the stomach
  • Positive test- Elbow dropping behind the body into extension
59
Q

Internal Rotation Lag Sign Test

A
  • SUBSCAPULARIS TEAR
  • Seated with affected arm behind back- Examiner behind
  • Examiner lifts arm off back and moves wrist causing further IR
  • Pt asked to maintain IR after wrist is released
  • Positive test- Lag that occurs with the inability of the pt to maintain the arm off the back
60
Q

Lift Off Sign

A
  • SUBSCAPULARIS TEAR
  • Sitting with affected arm behind back
  • Pt lifts the arm off the back
  • Positive test- Inability of the pt to lift the arm off the back
61
Q

External Rotation Sign

A
  • SUPRASPINATUS/INFRASPINATUS TEAR
  • Sitting- Examiner behind
  • Examiner hold pt’s wrist and elbow and places pt in 90 elbow flexion and 20 degrees of abduction in scapular plane
  • Passively placed in max ER position and asked to maintain after released
  • Positive test- A lag that occurs with the inability of the pt to maintain the position
62
Q

Hornblower’s Sign Test

A
  • Irreparable Fatty Degeneration of TERES MINOR
  • Sitting
  • Examiner places pt in 90 degrees of abduction in the scapular plane and 90 degrees of elbow flexion
  • MMT against ER
  • Positive test- Inability to ER by pt
63
Q

Piano Key Sign

A
  • AC SEPARATION
  • Sitting or Standing
  • Clinician applies downward force on the elevated end of the clavicle
  • Positive test- Pain or Excessive movement of the clavicle
64
Q

Paxinos Sign Test

A
  • AC JOINT PAIN
  • Sitting- Examiner behind
  • Thumb is placed under the posterolateral aspect of the acromion and the index and middle fingers on the distal clavicle
  • Anterosuperior force with the thumb with an inferior force with the index and middle finger
  • Positive test- Pain reproduction or increase in pain
65
Q

Joint Mobilizations

A

Pain Control- Grade 1 to Grade 2

ROM Gains- Grade 3 to Grade 4

66
Q

GH Shoulder Traction

A
  • Primarily demonstrates neurophysiological benefits, specifically useful for patients with pain as the primary disorder
  • Pt in supine
  • Forearm in pronation and a traction force
  • This should cause pain reduction
67
Q

GH Inferior Glides

A
  • GH Inferior Glides will stretch the inferior portion of the capsule
  • This will improve Abduction and some Flexion
  • Pt supine
  • Shoulder in neutral position or slight abduction or the range of abduction
68
Q

AC PA Glides

A
  • Improves shoulder retraction
  • Pt in supine
  • PA glide to the posterior “V” notch
  • Scapula can be adjusted to sensitize the movement
69
Q

AC Inferior Glides

A
  • Improves arm elevation
  • Pt in supine
  • Clinician places thumbs on the superior surface and pushes down
  • Scapula can be adjusted by moving the arm into flexion or abduction
70
Q

AC AP Glides

A
  • Improves scapular protraction
  • Pt in supine
  • Clinician places thumbs on anterior “V” notch and pushes anteriorly
  • Position of the scapula can be adjusted in order to sensitize movements
71
Q

SC Inferior Glides

A

-Improves arm elevation
-Pt in supine
Clinician places thumbs superior to the SC joint and lateral to the actual joint space
-Arm can be placed in greater or less elevation to sensitize movements

72
Q

Hold Relax

A

Good for Stretching

73
Q

Posterior Capsule Mobilization

A
  • Improves Internal Rotation and some Flexion
  • Pt in supine- Clinician stands to side
  • Clinician stabilizes shoulder blade from the superior border with the shoulder and elbow in 90 degree flexion
  • Clinician performs IR (to end range) and horizontal adduction (just past midline)
  • Clinician applies inferior force pushing the humerus into the mat
74
Q

Active End-Range Flexion with Downward Glides

A
  • Mobilization with movement
  • Used to promote the final degrees of end range flexion
  • Pt in supine
  • While the pt actively moves into flexion, Clinician applies a scoop force inferiorly and a little anteriorly
  • Clinician can also further encourage flexion with over-pressure from the other hand
75
Q

Active Internal Rotation with AP Glides

A
  • Improves IR and stretches the posterior capsule
  • Pt in supine
  • Shoulder abducted 90 degrees
  • Clinician applies AP glide while the patient actively moves into IR
  • Clinician may further IR with other hand
76
Q

Posterior Capsule Stretch

A
  • “Sleeper Stretch”
  • Pt lies on the affected side with 90 shoulder abduction
  • Pt performs passive IR using opposite arm to the point of tension
  • Position is held for 15-30 seconds
77
Q

Scapulothoracic Mobilization

A
  • Improves the mobility of the upper quadrant
  • Pt in side-lying- Affected side up- Clinician faces the patient
  • Clinician secures the inferior border of the scapula by putting fingers under the hand
  • Clinician can apply a downward, medial, lateral, or upward force of the scapula and may combine movements
78
Q

Flexion effects on capsule

A

Stresses the posterior and inferior portion of the capsule

79
Q

Extension effects on capsule

A

Stresses the anterior and superior portion of the capsule

80
Q

Abduction effects on capsule

A

Stresses the inferior portion of the capsule

81
Q

Adduction effects on capsule

A

Stresses the superior portion of the capsule

82
Q

AC Joint Mobilizations

A

AP improves protraction
PA improves retraction
Inferior glide improves shoulder abduction

83
Q

SC Joint Mobilizations

A

Inferior glide improves elevation

84
Q

Normal ROMs

A 
Flexion- 180 degrees
Extension- 60 degrees
IR- 70-90 degrees
ER- 90 degrees
Abduction- 165 degrees
Horizontal Adduction- 145 degrees?
Horizontal Abduction- 45 degrees

ISU DPT PHTH710 (11 decks)

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