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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
Painful Arc Test
- 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
26
Empty Can (Jobe's) Test
-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
27
Infraspinatus (External Rotation Resistance Test) Test
SUBACROMIAL IMPINGEMENT (All stages of Subacromial Impingement) Standing MMT for External Rotation in standing Positive Test- Pain or weakness
28
Cross-Body Adduction Test
- 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
29
Drop Arm Test
- 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
30
Internal Rotation Resisted Strength Testing
- 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
31
External Rotation Lag Sign
- 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
32
Drop Sign Test
- 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
33
Rent Test
- 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
34
Sulcus Test
- 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
Load Shift Test
- 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
Modified Apprehension-Relocation Test/Jobe Relocation Test
- 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
Anterior Apprehension Test
- 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
Posterior Shoulder Apprehension Test
Shoulder Instability
39
Posterior Drawer Test
- 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
Hyperabduction Test
- 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
Anterior Drawer Test
- 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
Anterior Release/Surprise Test
- 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
O'Brien's (Active Compression) Test
- 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
Biceps Load Test
- 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
Biceps Load Test II
- 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
Crank Test
- 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
Clunk Test
- 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
Kim's Test (Posteriorinferior Labral Lesion)
- 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
Jerk Test (Posteriorinferior Labral Lesion)
- 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
Pain Provovation Test
- 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
Modified Dynamic Labral Shear Test
- 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
Speed's Test
- 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
Yergason's Test (Biceps Involvement)
- 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
Pec Major Length Test
IDK
55
Pec Minor Length Test
IDK
56
Lattisimus Dorsi Length Test
IDK
57
Bear Hug Test
- 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
Belly Press (Napoleon Sign) Test
- 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
Internal Rotation Lag Sign Test
- 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
Lift Off Sign
- 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
External Rotation Sign
- 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
Hornblower's Sign Test
- 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
Piano Key Sign
- 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
Paxinos Sign Test
- 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
Joint Mobilizations
Pain Control- Grade 1 to Grade 2 | ROM Gains- Grade 3 to Grade 4
66
GH Shoulder Traction
- 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
GH Inferior Glides
- 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
AC PA Glides
- Improves shoulder retraction - Pt in supine - PA glide to the posterior "V" notch - Scapula can be adjusted to sensitize the movement
69
AC Inferior Glides
- 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
AC AP Glides
- 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
SC Inferior Glides
-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
Hold Relax
Good for Stretching
73
Posterior Capsule Mobilization
- 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
Active End-Range Flexion with Downward Glides
- 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
Active Internal Rotation with AP Glides
- 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
Posterior Capsule Stretch
- "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
Scapulothoracic Mobilization
- 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
Flexion effects on capsule
Stresses the posterior and inferior portion of the capsule
79
Extension effects on capsule
Stresses the anterior and superior portion of the capsule
80
Abduction effects on capsule
Stresses the inferior portion of the capsule
81
Adduction effects on capsule
Stresses the superior portion of the capsule
82
AC Joint Mobilizations
AP improves protraction PA improves retraction Inferior glide improves shoulder abduction
83
SC Joint Mobilizations
Inferior glide improves elevation
84
Normal ROMs
``` 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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