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Shoulder
Shoulder evaluation
| Question | Answer |
|---|---|
| Supraspinatus palpation | UE in max txtension & IR; palpate from supraspinatus fossa to tendon anterior to AC joint |
| Infraspinatus palpation | In prone, palpate posterior-lateral of acromion (just inferior to inferior angle of acromion) |
| Subscapularis palpation | Side-lying, maneuver relaxed UE to allow you to slide your thumb under the axillary/lateral border of scapula |
| Teres Minor palpation | in prone, palpate just inferior to infraspinatus |
| Apley scratch test | evaluates rotational lack; hand to opposite shoulder, behind back to opposite scapula, and behind back to lower angle of opposite scapula |
| Elevation | trapezius, rhomboid, serratus anterior |
| Upward rotation | upper/lower trapezius & serratus anterior |
| Abduction | Supraspinatus, subscapularis, & deltoid |
| Downward rotation | Lower trapezius, latissimus, & pectoralis minor |
| Stabilization of humeral head | RC & long head of biceps |
| SICK scapula | malposition, inferior medial winging, coracoid tenderness, scapular dyskinesia, |
| C3-4 | spinal accessory, trapezius |
| C5 | dorsal scapular, levator scapula, rhomboids |
| C5-6 | Lateral pectoral, pectoralis major and minor |
| C5-6 | Subscapular, subscapular teres major |
| C5-6 | Long thoracic, serratus anterior |
| C5-6 | Suprascapular, supraspinatus, infraspinatus, sensation to top of shoulder |
| C5-6 | Axillary, deltoid teres minor, sensation to deltoid anterior shoulder |
| C5-7 | Musculocutaneous, coracobrachialis, biceps, & brachialis, sensation to lateral forearm, biceps reflex |
| C5-T1 | Radial, triceps wrist ext/finger flexion, sensation to dorsum of hand, triceps reflex |
| C6-7 | Thoracodorsal, Latissimus dorsi |
| Radial nerve, C5-8, T1 muscles | anconeus, brachioradialis, ECRL, ECRB, extensor digitorum, APL, ECU, extensor indices, extensor digiti minimi |
| Radial nerve, C5-8, T1 function | weak supination, wrist extensors, finger flexors, & thumb abductors; weak grip, secondary to loss of wrist stabilization |
| Median nerve, C6-8, T1 muscles | pronator teres, FCR, palmaris longus, FDS, FPL, pronator quadratus, thenar eminence, lateral 2 lumbricales |
| Median nerve, C6-8, T1 function | weak pronation, wrist flexion, RD, thumb flexion, abduction, grip, & pinch; ape hand |
| Ulnar nerve, C7-8, T1 muscles | FCU, palmaris brevis, hypothenar eminence, adductor policis, medial 2 lumbricales, interossei |
| Ulnar nerve, C7-8, T1 function | weak wrist flexion, UD, 5th finger flexion, & finger abduction/adduction; benediction sign |
| FCU | flexor carpi ulnaris |
| FPL | flexor pollicis longus |
| FDS | flexor digitorum superficialis |
| FCR | flexor carpi radialis |
| Rent sign | Assess RC tears, UE in full extension, clinician hand under flexed elbow with other hand fingertips in anterior margin of acromion; perform passive UE IR/ER & palpate for defect, compare bilaterally |
| Empty can test | Assess supraspinatus; seated or standing with UE elevated to 30-45 degrees in plan of scapula with IR; resist elevation; + test reproduce pain &/or weakness |
| Full can test | Assess supraspinatus, seated with UE elevated to 30-45 degrees in plan of the scapula with ER; resist elevation, + test reproduces pain/weakenss |
| Drop arm (Codman) test | Assess supraspinatus, seated with shoulder passively positioned at 90 degrees abduction with palm down; have client lower arm to side; + test is inability to lower arm in a smooth manner |
| Whipple test | assess supraspinatus; sitting with shoulder elevated to 90 degrees then perform horizontal adduction with hand on the other shoulder, resist elevation at the elbow |
| Lateral jobs test | assess supraspinatus; shoulder at 90 degrees abduction and max IR; resist abduction |
| ER rotation lag sign | assess supraspinatus & infraspinatus; shoulder in 20 degrees of scaption & 5 degrees less than max ER; ask patient to hold position; + test lag in ER |
| Drop sign | assess supraspinatus and infraspinatus; shoulder at 90 degrees abduction; ask to hold position; + test supraspinatus 5-10 degrees lab in position; + test supraspinatus greater than 15 degrees lag |
| Dropping sign | assess infraspinatus; shoulder at side with 45 degree IR & 90 degree elbow flexion; resist ER |
| Hornblower (Patte) test | assess teres minor, shoulder in 90 degrees abd & elbow flexed so that hand comes to mouth; asked to hold position; + test = pain or inability to maintain UE in IR |
| Lift-off (Gerber) sign | assess subscapularis; hand in the curve of lumber spine; move hand off lower back and resist IR |
| Belly press (Napoleion) sign | assess subscapularis; seated with hand on belly; press hand into belly |
| Belly-off test | assess subscapularis; seated or standing on belly; clinician applies force to pull hand off belly |
| Bear-hug test | assess subscapularis; seated with palm of hand on opposite shoulder; resist IR by attempting to pull hand off shoulder |
| Hawkins-Kennedy test | assess for impingement RC tear and/or subacromial bursitis; seated with shoulder in 90 degree flexion; sight horizontal adduction; clinician weaves arm under patient forearm and onto pts ipsilateral shoulder; use forearm to take to max IR |
| Jerk test | assess posterior instability; sitting w/ UE in IR and flex to 90; grasp flexed elbow and load humerus proximal while passively moving UE into horizontal adduction; + test sudden jerk/clunk as humeral head subluxes posteriorly |
| Yergason test | Assess THL and labrum via biceps attachment; shoulder neutral, elbow flexed 90, and forearm supinated; resist elbow flexion with palpating the THL; + test pain w/tenosynovitis; click/snapping= torn THL |
| THL | transverse humeral ligament |
| Speed test | allow for biceps tendonitis or labrum problem; shoulder elevated 75-90 degrees in sagittal plane, elbow extended, forearm supinated; resist elevation |
| Biceps load test | assess labrum via very high selectivity of long head of biceps; supine in 90 degrees shoulder abduction & 90 degrees elbow flexion; load biceps by resisting elbow flexion and supination |
| Pain provocation test | assess labrum; supine in 90 degree shoulder abduction, 90 degree elbow flexion; traction biceps by passively taking forearm in max pronation |
Created by:
jessupj17