UE Flashcards
Special test(s) to predict bursitis
Neer
Special test(s) to predict Partial Cuff Tear
Neer
Special test(s) to predict Full Thickness Cuff tear Pretest probability = \_\_\_% #/# tests positive = \_\_\_% posttest probability
Painful Arc sign
Infraspinatus strength test
Drop Arm Test (Codman’s)
Pretest probability = 65% #/# tests positive = 90% posttest probability
Special test(s) to predict Impingement overall Pretest probability = \_\_\_% #/# tests positive = \_\_\_% posttest probability; #/# tests positive = \_\_\_%
Painful Arc Sign
Infraspinatus Strength test
Hawkins-Kennedy Test
Pretest probability = 39%
3/3 tests positive = 90% posttest probability;
2/3 tests positive = 69%
Special test(s) to detect biceps brachii integrity/strength (of the tendon)
Speed’s Test
Yergason’s Test
Special test(s) to detect Bankart Lesion, which is a tear of the [ant/post] [sup/inf] labrum & glenoid rim
Special test(s) to detect Bankart Lesion, which is a tear of the ANTERIOR, INFERIOR labrum & glenoid rim
Crank Test
Special test(s) to detect SLAP lesion
- Compression-Rotation (Snyder)
- Anterior, Posterior Slide
- Speed’s Test
- O’Brien’s Test
- Yergason’s Test
- Crank Test (weak for slap, better for any labral tear)
Special test(s) to detect posterior instability (posterior capsule & ligaments)
Posterior Load & Shift
Special test(s) to detect anterior instability (anterior capsule & ligaments)
- Anterior Load & Shift
- Anterior Apprehension, Posterior (Jobe) Relocation, & Surprise Tests
Special test(s) to detect inferior & multidirectional instability (inferior capsule & ligaments)
Sulcus Sign @ 0* (or 20-50*)
**This is more specific for a superior labral tear
Special test(s) to detect impingement. What structures are affected?
STRUCTURES:
- Subacromial bursa
- Supraspinatus
- Long head biceps brachii
TESTS:
- Neer test
- Hawkins Kennedy
- Painful Arc
- Infraspinatus strength tests
- Coracoid impingement test (Long head biceps)
- Yergason’s test
Special test(s) to detect Rotator Cuff Tear. What structures are affected?
STRUCTURES:
- Supraspinatus
- Infraspinatus
- Long head biceps brachii
- *Subscapularis
TESTS:
- External Rotation Lag Sign I @ 20* (Infra- and supraspinatus)
- ER Lag sign II @ 90* ABD (infra- and teres minor)
- Drop Arm Test (HIGH specificity!)
- Empty Can, Full Can
- Infraspinatus Strength Tests (high specificity)
Tests that ALSO test subscap:
- IR Lag sign/Lift Off test (Subscap)
- Belly Press, Belly Off tests (subscap, biceps) HIGH specificity
- Horizontal/Cross-Body Adduction
Special test(s) to detect AC Joint injury?
Shear test
Palpation
Horizontal/Cross-Body Adduction
What is included in the shoulder clearing exam?
- Flexion with OP combined with Abduction
- HBB with OP
- Quadrant with OP
- Resisted cuff tests (elbow at 90* flexion, resist IR and ER)
Considerations in the following patients with shoulder complaints:
- Young mid/adult:
- Mid adult:
- Mid/senior adult:
- Shoulder dislocation:
- Female vs male pts
- Young mid/adult: Ca++ deposits
- Mid adult: Cuff degeneration
- Mid/senior adult: Frozen shoulder (adhesive capsulitis)
- Shoulder dislocation: Decreased recurrence with younger pts
- Female vs males: Females = higher incidence frozen shoulder
Visceral/ Organic/ Non-Musculoskeletal problems that show up as shoulder pain:
- Spleen:
- Gallbladder:
- Diaphragm:
- Cardiac:
- Pancoast Tumor:
- Spleen: pain L shoulder
- Gallbladder: pain R shoulder
- Diaphragm: pain FRONT of either or both shoulders
- Cardiac: (ANGINA) pain L shoulder, scapula, (and/or arm, jaw, neck)
- Pancoast Tumor: (APICAL LOBE OF LUNG) pain R shoulder, ulnar distribution UE
What are the 5 Ds of the subjective exam?
5Ds:
- Dizziness
- Diploplia
- Dysarthria
- Dysphasia
- Drop attacks (fainting)
What are the 3Ns of the subjective exam?
3 Ns:
- Numbness
- Nausea
- Nystagmus (and occasional neck pain)
Full thickness RC tears have been found to be associated with [high/low] cholesterol. Smoking is associated with [full/partial/both] thickness RC tears.
Full thickness RC tears have been found to be associated with HIGH cholesterol. Smoking is associated with FULL & PARTIAL thickness RC tears.
If a patient has limited shoulder ROM, what conditions may present with a capsular pattern?
CAPSULAR pattern
- Arthritis
- Trauma
- OA/DJD
- RA
- Adhesive capsulitis
If a patient has limited shoulder ROM, what conditions may present with a non-capsular pattern?
NON-CAPSULAR Pattern
- Acute bursitis
- Tendinitis, Strain
- Sprain
- AC or SC involvement
If pt has full PROM, what should you consider to be a possible contributor to pain?
Consider TENDONS and BURSAE
If pt does not have full PROM and has an empty end feel, consider…
Limited PROM, Empty end feel:
- Acute bursitis
- Acute frozen shoulder
If all extreme ROMs are painful and have a hard end feel, consider…
Painful and hard end feels:
- Capsular lesion
If all extreme ROMs are painful with a normal or spasm end feel, consider…
Painful extreme ROMs with normal or spasm end feels:
- AC or SC
- Chronic bursitis
- Tendinitis