UE Exam Flashcards
What do you all need to palpate on a shoulder exam?
Sternoclavicular joint Supraclavicular fossa AC joint Scapular spine Supraspinatus Infraspinatus Acromion process Rotator cuff Greater tuberosity Intertubercular groove Anterior joint
Testing Motor Strength of Upper Extremity
Flexion/extension External/internal rotation Forward elevation Abduction Internal rotation
Specific Cervical Spine Tests
Spurling's Reverse Spurling's L'Hermitte's sign Adson test Babinski
Describe Spurling’s/Reverse Spurling’s Test
Spurling’s: compression of cervical nerve & pain shoots down ipsilateral arm
Reverse Spurling’s: compression of cervical nerve & pain shoots down contralateral arm
Describe L’Hermitte’s Sign
Passive or active neck flexion elicits a pain/electric sensation shooting down back or into the legs
What is Adson’s test, testing for?
Thoracic outlet syndrome
Describe Adson’s Test
When extension at the shoulder demonstrates an absent or diminished pulse
Describe Hoffman’s Test
Have patient relax hand
Flick nail of middle finger
Muscles in hand should not flex
What does a positive Hoffman’s test indicate?
There is a lesion that originates in the CNS & is not a radiculopathy or peripheral nerve lesion
Shoulder Impingement Tests
Neer’s
Hawkin’s
Subscapularis Tests
Belly press
Lift off
Bear hug
Supraspinatus Tests
Empty can
Drop test
Should Instability/Dislocation Tests
Apprehension
Sulcus
Jobe’s relocation
Shoulder Labral Lesion Tests
Speed’s
Yergason’s
AC Joint Separation Test
Cross arm test
Describe Neer’s Test for Impingement
Pronation of the arm
Hold scapula in blace
Passively flex the patient’s arm at the shoulder
Describe Hawkin’s Test for Impingement
Forward flexion of arm at 90 degrees
Elbow flexion at 90 degrees
Internal rotation of arm
Describe the Bear Hug Test
Place patient’s hand on opposite shoulder
Try to lift the patient’s hand off of their shoulder
Describe the Belly Press Test
Place patient’s hand on stomach
Try to pull patient’s hand away from stomach
Describe the Lift-Off Test
Place patient’s hand in small of back
Have patient push away examiner’s hand
Describe Drop Arm Test
Passively abduct patient’s arm to 90 degrees
Have patient smoothly bring arm back to side
Describe Positive Drop Arm Test
Rachel like movement of arm down
Pain in the upper shoulder
Describe Empty Can Test
Flexion of arm in scapular plane
Internal rotation of arm & pronation of hand
Try to push patient’s arm down
Describe Apprehension Test
Patient in supine position
90 degree abduction of arm
90 degree flexion of elbow
Externally rotate arm
Describe Jobe’s Relocation Test
Same as apprehension test with pressure on the humeral head at the glenohumeral joint
Try to remove hand from joint and patient will feel like shoulder will pop out
Describe Posterior Apprehension Test
Forward flexion of arm to 90 degrees
Flexion of elbow at 90 degrees
Stabilize scapula with on hand
Push down on elbow/forearm with other hand
Describe Speed’s Test
Patient in anatomic position
Have patient perform forward flexion
Resist patient’s flexion
Do same test with patient’s arm pronated
Describe Yergason’s Test
Elbow flexion to 90 degrees
Grasp hand
Patient supinates against resistance
Describe the Cross Arm Test
Forward flexion of arm to 90 degrees
Cross arm across body
Instability Elbow Tests
Varus
Valgus
Peripheral Nerve Compression Elbow Tests
Tinel's Modified Phalen's Bent elbow Wartenberg Froment's
Distal Biceps Elbow Test
Hook Test
Describe Varus & Valgus Test
Flexion of arm at 45 degrees
Flexion of elbow at 90 degrees
Valgus: elbow pushed in, wrist pushed out
Varus: elbow pushed out, wrist pushed in
Describe Tinel’s Sign
Gently tap on area of nerve
Describe Modified Phalen’s Test
Help patient into wrist flexion and hold for 1 minute
Painful = positive test
Describe Wartenberg’s Sign
Have patient abduct fingers
Then have patient adduct fingers
Pinky doesn’t return = positive
Froment’s Sign
Have patient grasp paper
Try pulling paper away from patient
Positive = flexion of thumb
Describe Distal Biceps Hook Test
Elbow flexion at 90 degrees
Hook finger underneat tendon
Describe Finkle’s Sign or De Quervains
Tuck thumb into flexed fingers
Radial flexion normal
Ulnar flexion painful
What is usually wrong with extra snuff box tenderness?
Scaphoid fracture
