Special Tests: Shoulder Flashcards

1
Q

Apprehension Test (anterior shoulder instability)

A

With Pt supine, passive abduction to 90 and ER to end range. (+) if Pt c/o pain or instability.

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2
Q

Relocation Test (anterior shoulder instability)

A

With Pt supine, GH at edge of table - 90 abduction and ER - force is applied by clinician on head of humerus, posteriorly. If pain, apprehension diminish, (+).

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3
Q

Bony Apprehension Test (anterior shoulder instability)

A

With Pt seated/standing, abduction to 45, then 45 or less of ER. (+) if Pt appears apprehensive.

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4
Q

Anterior Drawer Test (anterior shoulder instability)

A

With pt supine, arm at 60-80 abduction, neutral rotation - humeral head is then translated anteriorly (quick motion). (+) of pt reports pain or comparable sign.

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5
Q

Load and Shift (anterior shoulder instability AND posterior shoulder instability))

A

With pt in sitting, Pinch head of humerus with thumb posterior. (+) if excessive translation (typically anteriorly >25%).

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6
Q

Posterior Drawer Test (Posterior shoulder instability)

A

With pt supine, arm is abducted to 80-100, Must identify joint line first. Then AP force is applied to humerus (quickly).

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7
Q

Sulcus Sign (Inferior instability)

A

With pt standing/sitting, Stabilize at shoulder. Ided mnferior force is exerted on the humerus, proximal to elbow - presence of “sulcus” indicates inferior laxity.

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8
Q

Crank Test (Labrum)

A

With pt supine, attain 160 abduction / elbow 90 - first, compression is applied to GH (palm into olecranon), then humerus is repeatedly rotated in small IR / ER arc of motion in attempt to pinch or catch a torn labrum. (+) if pain reproduced and “click” experienced.

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9
Q

Compression Rotation Test (Labrum)

A

With pt supine, attain abduction 90, elbow 90 - compressive force is applied to humerus (use thigh, stop before shoulder shrugs up), then rotation back and forth between IR/ER is performed (switch stances). Larger arc of motion than crank test. (typically start with this before progressing to crank test).

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10
Q

Active Compression (O’Brien Test) (Labrum)

A

With pt standing, shoulder flexed to 90, h. adduction 10 (thumb in front of sternum), max IR - pt then resists downward force - then repeated in max ER (palm up), 10 horiz. abduction. (+) if pain is worse in IR vs ER

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11
Q

Yergason (Labrum)

A

HandshakeWith pt seated / standing, elbow flexed to 90 and forearm pronated - pt is then instructed to supinate while clinician resists at wrist. (+) if pain is localized to bicipital groove (palpate with hand).

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12
Q

Biceps Load Test I (Labrum) - NOT ON SKILL CHECK

A

With pt supine, 90 abduction, forearm neutral/slight supination - then passively move to end range ER - pt is then asked to flex elbow while clinician resists. (+) if reproduction of pain.

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13
Q

Biceps Load Test II (Labrum)

A

With pt supine, 120 abduction, forearm supination and end-range ER. Use thigh to support elbow. Pt is asked to flex elbow while examiner resists. (+) if no change in apprehension or pain that is worsened with resisted elbow flexion.

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14
Q

AC Shear Test (AC joint)

A

With pt seated, clinician cups hand over clavicle and spine of scapula, then proceeds to apply compressive force through AC joint. (+) if pain is reproduced.

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15
Q

Biceps Speed Test (Biceps tendinits)

A

With pt standing , full elbow extension and full supination - clinician resists from 0-60 of shoulder flexion. (+) if pain is reproduced concordant to bicipital groove.

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16
Q

Neer’s Test (Subacromial impingement)

A

Scapula stabilized; pt’s arm passively taken to end-range overpressure, at angle between flex/ABDuction. If (+) thought to represent impingement of RC on anterosuperior glenoid labrum rim.

17
Q

Hawkins-Kennedy Test (Subacromial impingement)

A

Arm is passively flexed to 90 in plane of scapular; humerus is stabilized, and forearm is taken into IR. RC tendons may be impinged under acromion if (+).

18
Q

Cross Body Adduction Test (Subacromial impingement)

A

90 shoulder flexion. Can have Pt set hand on opp. shoulder - then passive horizontal adduction to end range. (+) if pain.

19
Q

ERLS (Subacromial impingement OR RC tear)

A

Shoulder in 20 scaption; passive ER to end-range - if lag presents due to inability to maintain end-range ER then (+).

20
Q

IRLS (Subacromial impingement)

A

If unable to perform lift off test, subscapularis tear is suspected.

21
Q

Painful Arc Test (Subacromial impingement)

A

Typically considered to fall between 60-120 of active abduction with reproduction of pain while performing.

22
Q

Empty Can/Full Can Test (Subacromial impingement)

A

Scaption. Thumb up flex to 90 (full can). Reset. Thumb down flex to 90 (empty can).

23
Q

Lateral Jobe Test (RC tear)

A

With pt seated / standing, abduction to 90 with IR to end-range - then clinician applies inferior force at elbow. (+) if pain reproduction or weakness / inability to perform test.

24
Q

Drop Arm Test (RC tear)

A

With pt in standing, arm is passively elevated to 90 scaption/abduction with thumb up (more impingement related) or palm down. (+) if pt is unable to lower arm with control / slowly (5 count). Looking for smooth lower.

25
Q

Drop Sign Test (RC tear)

A

With pt seated , 90 scaption/abduction then passive ER to near end-range - pt is asked to maintain position. (+) if lag occurs with inability to maintain full, end-range ER

26
Q

Hornblower Sign (RC tear)

A

With pt seated/standing, pt is asked to attain position of “hands to mouth” as if replicating the position of playing trumpet. If unable to to raise hand to mouth without abducting shoulder, (+).

27
Q

Weakness with Elevation (RC tear)

A

Raise arm