midterm Oral practicle

Question 1

Palpate the hyoid bone

Answer 1

located across from the c3 vertebra

Question 2

palpate the thyroid cartilage

Answer 2

located at the level of the fourth and fifth cervicle vertebrea. This sturcture moves up and down when swallowing and side to side like the hyoid bone. Commonly called the adams apple

Question 3

palpate the caricoid cartilage

Answer 3

identify the cricoid cartilage which lies at the level of the sixth cervicle vertebrea. the coricoid cartilage demarcates the location where the pharynx joins the esophagus and the larynx joins the treachea

Question 4

palpate the sternocleidomastoid

Answer 4

cordlike scm along its length from its origin on the mastoid process and superior nuchal line to its insertion ont he sternum and clavicle. rotating the head causes the scm on the side opposite the movement to become more prominent.

Question 5

Palpate the Scalenes

Answer 5

posterior the the SCM muscle at about the C3 to C6 level

Question 6

palpate the lymph nodes

Answer 6

near the upper trapexius and beneath the mandible palpate the lymphones lying near the origin of the SCM. they become enlarged during illness or infection

Question 7

palpate the occiput and superior nuchal line

Answer 7

the occipital bone, the most posterior aspect of the skull is located at the apex of the cervicle spine.

Question 8

palpate the transverse process

Answer 8

located approximately one finger width inferior to the mastoid processes. the processes of C1 are the onl processes of the cervicle spine that are palable.

Question 9

palpate the spinous processes

Answer 9

are more easily palpated when the cervicle spine is slightly flexed.

Question 10

palpate the Trapezius

Answer 10

beginning at the occiput and superior nuchal line the upper portion of the trapezius is palpated inferiorly to its insertion on the lateral clavicle, acromion process and spine of the scapula. the thickness is easily palpated because it spans from cervical spine to the Acromion process

Question 11

Palpate the levator scapulae

Answer 11

although deep to the trapezius the levator may be discernible as the long vertically oriented muscle at its origin on the medial upper scapula

Question 12

goniometry: cervical flexion and extension

Answer 12

Patient seated with examiner at their side
the axis is positioned over the external audiory meatus (ear)
the movement arm is help paralles with the base of the nasal openings
the sationary are is help perpendicular to the floor

Question 13

Goniomentry: Cervical Rotation

Answer 13

patient seated with trunk suppored examiner positioned over top of the patient.

the axis is positioned over the center of patient’s head.

the sationary arm is aligned aligned with and imaginary line betweent he patients acromion processes.

the movement arm is positioned so that it bisects the patients’s nose.

Question 14

Goniomentry: Cervical later flexion:

Answer 14

seated with the turnk supported examiner positioned infront of patient

the axis is centere on the patients sternal notch.

the stationary arm is aligned parallel to an imaginary line between patient’s aromion processes.

the movement arm is positioned so that it bisects the patients nose.

Question 15

MMT: cervicle Flextion

Answer 15

supine the shoulders are abducted to 90 degrees with the elbows flexed to 90 degrees.

start with the cervicle spine in neutral

stabalize over the superior aspect of the sternum and resistance applied to the sternum

SCM, anterior scalene, longus capitis, anerior scalene

Question 16

MMT: cervicle extension

Answer 16

prone with the shoulders abducted to 90 degrees and the elbows flexed to 90 degrees. the cervicle spine and head are in th neutral position. stabalize on the superior aspect of the thoracic spine.

resist on the sull ove the occiput

Question 17

MMT: Lateral Flexion of cervicle spine

Answer 17

patient seated with the cervile spine and head in neutral position

stablize over the AC joint on the side toward the motion

resistance over the temporal and parietal bones on the side of motion

PM: SCM scalenes and paraspinal muscles on the side being tested

Question 18

MMT: Cervicle rotation and flexion

Answer 18

patient is positioned supine the head is rotated to the side opposit that being tested stabilization over the sternum and resist ove rthe temporal bone on the side toward the motion.

PM: SCM

Question 19

Cervicle Vertebral Joint Play

Answer 19

patient is placed supine the head is in a neutral position. with the examiner at the head of the patient

CPA: palpate the target spinous process using the tips of the thums and gradual anterior directed force until an end feel is determined. repeat at each level noting any differences

UPA palpate the target spinous process and move laterally approximately one thumb breadth to the raised area the articular pillar apply an anteriorly directed force. repeat at each level and the assess the opposte side.

Question 20

Mobility of the first Rib

Answer 20

Patient is prone standing at the head of the patient palpate the posterior aspect of the first rib just anterior to the upper traps just above the vertebral border of the scapula. provide an inferior gliding force to the

PT: hypomobility and or pain

IM: restriced mobility of the first constovertebral joint

Question 21

Upper quater Neurologic scree

Answer 21

Look at page 541

Question 22

Upper Limb Tension Test (ULTT)

Answer 22

patient supine the GH joint is adducted to the side the wrist and fingers are relaxed and forarm pronated and the elbow is flexed. examin on the side of patient.

Hold each position for six seconds

degress the shoulder girdle on the same side

abduct the GH joint to 110 degrees

subinate the forearm

externally rotate the GH joint

extend the elbow

add neck lateral flexion

PT: provocation of stated symptoms and restricted ROM

IM hyperirritability of the Peripheral Nerve due to adaptive shortening or impingement

Question 23

Babinski test for uper motor neuron lesions

Answer 23

supine with examiner at the foot of the patient. a b lunt devce such as the handle of a relex hammer or the handle of a pair of scissors is needed

run the device up the plantar aspet of the foot making an arc from clacaneus medially to the ball of the great toe. normal innervation the doews should curl

PT: the great toe extends and the other toes splay

IM: upper motor neuron lesion especially in the pyramidal tract, cased by brain or spinal cord trauma or pathology

Question 24

Cervical Compression Test

Answer 24

Patient sitting with the examiner standing behind the patient with hands interlocked over the top of the patients head.

the exminer presses down on the crown of the patients head.

PT: the patient experiences pain or reproduction of symptoms in the upper cervicle spine, upper extremity, or both.

IM: compression of the facet joints and marrowing of the intervertebral foramen resulting in pain

Question 25

Oppenheim test for Uppor motor Neuron Lesions

Answer 25

supine wit the examiner at the side of the patient with a blunt object.

the blunt object or the examiners fingernail is run along the crest of the anteromedial tibia.

PT: the great toe extends and the other toes splay or the patient reports hypersensitivity to the test.

IM: upper motor neuron lesion caused by prain or spinal cord trauma or pathology.

Question 26

Spurling test

Answer 26

seated with the examiner standing behind the patient with hands interlocked over head.

the patient laterally flexes the cervical spine. a compressive force is then placed along the cervicle spine.

PT: pain or reproduction of symptoms radiating down the patients arm

IM: nerve root impingemtn by narrowing of the neural foramina

Question 27

Cervical distraction test

Answer 27

supine to relax the cervicle spine postural muscles

a the head of the patient with one hand unter the occiput and the other on top f the forehead stabilizing the head.

the examine flexed the patients cervical spine to the position of comfort. a traction force is applied to the skull producing distraction of the cervicle spine.

PT: the patients symptome are relieved and or reduced.

IM: compression of the cervicle facet joints and or stenosis of the neurla foramina.

Question 28

Vertebra artery test

Answer 28

the patient is placed supine with the examiner at the head of the patient wit the hand placed under the occiput to stabilize the head.

the examiner passively extends the cervicle sipne the head is then rotated to one side and held for 30 sec. repeat the procedure for the opposite side. during this procedure the examiner must monitor the pulillary activity.

PT: dissiness, confusion, nystagmus, pupil changes

IM: occlusion of the cervicle vertebral arteries.

Question 29

Shoulder abduction test:

Answer 29

seated or standing with the examiner in front of the paitent the patient activity abducts the arm so that the hand is resting on top of the head and maintains this position for 30 seconds.

PT: decrease in the patients symptoms secondary to decreased tension on the involved nerve root.

IM: herniated disk or nerve root compression

Question 30

Brachial plexus tracion test

Answer 30

seated or standing with exminer standing behind the patient.

one hand is placed on the side of the patients head the other hand is placed over the AC join stabilizing the turnk. the cervicle spine is laterally bent and oppposite shoulder depressed.

PT: reproduction of pain and or paresthesia symptoms throughout the involved upper extremity.

IM: prachial plexus neurapaxia

Question 31

Adson’s test for THOS:

Answer 31

patient sitting the hould abducted to 30 degrees the elbow extended with the thumb poiting upward the humerus externally rotated and the examiner behind patient one hand positioned so that the radial puls is palpable.

while still maintaing a feel for radial pulse externally rotate and extend the patients houlder while the face is rotated toward the involved side and extends the neck the patint inhales deeply and hold the breath.

PT: the radial pulse disappears or markedly diminishes as compared to the opposite side.

IM: sublavian artery is being occluded between the anterior and middle scalene muscles and pectoralis minor

Question 32

Allen Test for THOS:

Answer 32

Sitting the head faceing forward with examiner behind patine papating the radial pulse.

the elbow is flexed to 90 degrees the hsoulder is then passively horizonally abducted and placed into external rotation. the patient then rotates the hear toard the opposite shoulder.

PT: the radial pulse diappears or reproduction of neurologis symptoms.

IM: the pectoralis minor muscle is compressing the neurovascular bundle.

Question 33

Military brace position for THOS:

Answer 33

standing the shoulder in a relaxed posture the head looking forward. with the examiner behind patient palpating radial pulse.

the patint retracts and depreses the shoulders as if coming to military atention. the humberus is extended and abducted to 30 degrees the neck and headd are hyperextedned.

PT: the radial pulse disappears.

IM: subclavian artery is bieng blocked by the costoclavicular structures of the shoulder.

Question 34

Roos test for THOS:

Answer 34

standing with examiner in front of patient the sholder are abducted to 90 and the elbows to 90

the patient rapidly opens and closes both hands for 3 min

PT: inability to maintain the test position replication of sensory and or motor sympoms in the extremity.

IM: thoracic outlet syndrome of neurologic and or origin

Question 35

Abdominal quadrant reference system

Answer 35

Look at page 570 figure 15-11

Question 36

Palpate sternum

Answer 36

the three parts are the manubrium, xiphoid process , and the body

Question 37

palpate costal cartilage and rib

Answer 37

located on the rib when palpating these you are looking for pain or tenderness

Question 38

Palpate Spleen

Answer 38

under the left rib cage. ave the patient raise the arms above the head will make the spleen more prominent and easily palpated

Question 39

palpate the kidneys

Answer 39

under the posterolateral portion fo the rib cage. the left kidney is relaively well protected with in the rib cage the right kidney rest more inferiorly.

Question 40

Palpate and locate Mcburney’s point

Answer 40

located one third of the way between the right anterior superior iliac spin and the navel

Question 41

Abdominal Percussion

Answer 41

the patient is in the hook line position with the examiner at the side lightly place one hand palm down over the area to be assessed. the index nd middle fingers of the opposite hand tap the DIP joins of the hand placed over the patients abdomen.

Evaluation Procedure: the finertips of the top hand quickly strike the midle phalanges of the bottom hand in a tapping motion the sound of the echo within the abdomen is notied. areas over solid organs have a dull thump associated with them. hollow organs make the crisper, more resonant sound.

PT: a hard solid sounding echo over areas that should normally sound hollow

IM: internal bleeding filling the abdominal cavity.

Question 42

Determination the heart rate using the carotid pulse

Answer 42

Seaated or supine with the indes and middle fingers to locate the thyroid cartilage move the fingers laterally in either direction to find the common carotid artery between the thyroid carticlage and the SCM.

Procedure: count the number of pulses in a 15 s interval and then multiply the number by 4 to determine the number of beats per minute

IM: Normal 60 - 100 bpm , well trained athletes 40-60 bpm, tachycardia greater than 100 bpm, bradycardia less than 60 bpm

Question 43

Blood Pressure Assessment

Answer 43

patient should be seated and the support of the arm so that the middlesection of the upper are is at heart level . the examiner is in front or beside of the patient to read the gauge on the BP cuff.

the cuff around the upper arm with the lower edge of the bladder approximately 1 inch above the antecubital fossa. the stethescope placed over the brachial artery. the cuff inflated to 180 to 200 mmhg the air is released from the fcuff at a rate of 2 mm per second until the initial beaat is heard then listened for last pulse is heard.

PT: hypertension: systolic pressure greater than 140/90

prehypertension: 120-139/80-89, normal is 90-119/60-79, hypotension less than 90/60

IM: low BP indicate shock or internal hemorrhage

Question 44

heart Auscultation

Answer 44

Sitting and or standing with the examiner facing the patient’s right side.

Procedure: listen at four locations: right sternal border between ribs 2 and 3, left sternal border ribs 2-3, left sternal border between ribs 5 and 6, left mid clavicle line between ribs 5-6

PT: any deviation from the typical sound
IM: a range of cardiac conditions

Question 45

Lung Ascultations

Answer 45

done from ether the front or the back more common on the back

Procedure: above the spine of scapula, at the level of the scapula spine, midscapula, distal scapula, below the inferior angle. go from one side to the other to compare sounds.

PT: absens of sound, hyper resonance, crackles, wheese, rhonchi

Question 46

Peak flow meter

Answer 46

standing with the examiner in front of patient.
the patient takes a deep breath as possible then blows out as hard and as fast as possible into the device.

PT: diagnostic: decreases greater or equal to the 15% decrease in beak expiratory flow rate from reexerside to post exercise

IM: exercise induced asthma

Question 47

abdomen auscultation

Answer 47

patient lieing hookline with the examiner at the side of the patient. examine them with empty bladder if possible. Listen in the lower right quadrent for 30 seconds

PT: bowel sounds that are high pitched or tinkle indicate possible partial obstruction or complete bowel obstruction.

IM: bowel obstruction, peritonities, internal injury

Question 48

compression test for rib fractures

Answer 48

seated or standing with the examiner infront of the patient with the hand on opposite sides of the rib cage.

Procedure: the examiner compresses the rib cage in an anterior posterior direction and quickly releases the pressure the rib cage is then compressed from the patients side and the pressure is quickkly released.

PT: in the rib cage isolated to the fracture site.

IM: damage to the rib cage, including the possibility of a frature contusion or costochondral separation

Question 49

palpate the jugular notch

Answer 49

begin by palpating process by locating the jugular notch on the manubrium.

Question 50

palpate sternoclavicular joint

Answer 50

proceed laterally to identify the sc joint checking for point tenderness over the articualtion. this is the only spot for attachment of the shoulder to the axial skeleton

Question 51

palpate clavicular shaft

Answer 51

from the sc joint continue to palpate laterally alnog the shft of the clavicle noting deformity, crepitus or pain.

Question 52

acromion process and the ac joint palpate

Answer 52

as the clavicle extends laterally expect that it may become less palpable in patients who have well-developed deltoid muscles. the acromion may be eaisier to palpate if palpate the scapular spine.

Question 53

coracoid process palpation

Answer 53

from the most concave portion of the clavicle move approximatey one inch inferior to its to locate the coracoid process. feel for the coracoid proecess just above and behind the dendon of the pectoralis major

Question 54

palpate the greater tuberosity

Answer 54

locate the greater tuberosity in the anatomical position approximately one finger breadth inferioor to the lateral edge of the anterior porition of the acromion process

Question 55

lesser tuberosity palpation

Answer 55

with the humerus externally rotated to ease palpation, locate the medial border of the bicipital groove formed by the lesser tuberosity.

Question 56

palpate the bicipital groove

Answer 56

externally rotate the humerus to make the bicipital groove mor palpael. the groove is felt as an indentation in the bone just medial to the greater tuberosity.

Question 57

goniometyr for shoulder flexion

Answer 57

fulcrum alinged lateral to the acromion process with the patient lying supine the stationary arm aligned parallel to the thorax. the movement arm is centered over the midline of the lateral humerus.

Question 58

goniomentry for shoulder extension

Answer 58

the fulcrum aligned lateral to the acromioon process. the stationary arm is aligned parallel to the thorax. the movement arm is centered over the midline of the lateral humerus.

Question 59

goniomentry shoulder abduction

Answer 59

patient lying supine with the fulcrum anterior to the acromion process the stationary arm is aligned parallel to the long axis of the torso. the movement arm is centered over the midline of the anterior humerus.

Question 60

goniomentry for shoulder internal and external rotation

Answer 60

centered later to the olecranon process the stationary arm is alinged perpendicular to the floor or parallel to the table top. the movement arm is centered over the long axis of the ulna

Question 61

goinometry for shoulder horizontal abduction and adduction

Answer 61

seated with the arm abducted to 90 and the elpbow is flexed and to forearm is pronated. the fulcrum superior acromioclavicular join. the proximal arm is perpendicular to the trunk and the moveable arm is parallel to the longitudinal axis of the humerus.

Question 62

Drop arm test for rotator cuff tendinopathy

Answer 62

standing or sitting the humerus fully abducted and externally rotated and the forarm supinated with the examiner standing lateral to the patient.

the patient slowly lowers the arm to the side.

PT: the arm fall uncontrollably from a position of approximately 90 abduction to the side severe pain may also be described

IM: The inability to lower the arm in a controlled manner is indicative of lesions to the rotator cuff especially the supraspinatus.

Question 63

apleys scratch test

Answer 63

the patient touches the oppostite shoulder by crossing the chest.

the patient reaches behind the head and touches the opposte shoulder from behind

the patient reaches behind the back and touches the opposite scapula

Question 64

shoulder flexion and extension mmt

Answer 64

seated the humerus in the neutral position the superior aspect of the hsould is stabalized. palpation is done on the anterior lateral aspect of clavicle resistance is applied distal anterior humerus just proximal to the cubital fossa.

With extension you just apply resistance on the back of the upper arm

Question 65

shoulder abduction and adduction

Answer 65

the patient is seated with the humerus abducted ot 30 degrees. the scapula is stabilized resistance on the distal humerus just proximal to the lateral epicondyle.

the adduction resistance is applied to the distan humerso just proximal to the medial epicondyle.

Question 66

shoulder internal and external rotation

Answer 66

seated or prone stabilization is improved with the patient prone.

the numbers and elbow are flexed to the 90 and 90 position. stabilization of the distal humerus is stabilized just proximal to the elbow. resistance is applied on the anterior distal forearm.

for external rotation the resistance is applied to the posterior distal forearm.

Question 67

Horizontal adduction and abduction

Answer 67

supine with the shoulder abducted to 90 the scapula is stabilized the palpation anterior axilla. resistance is applied to the anterior portion the distal humerus

with abduction resistance is applied to the posterior portion of the distal humerus.

Question 68

gerber lift-off test for subscapularis pathology

Answer 68

the patient is standing with the humerus internally rotated the dorsal surface of the hand placed against the midlumbar spine with the examiner standing behind the patient.

the patient attempts to actively lift the hand off the spine while the humerus stays in extension.

PT: inability to lift the hand off the back.

IM: are associated with tears or weaknes of the subscapularis muscle.

Question 69

Scapular retraction and downward rotation

Answer 69

patient is lying prone the arm being tested is behind th patients back with the humerus internally rotated

the trunk is stabilized with palpation on the lateral to vertebral border of scapula.

resistance is applied to the lateral scapula as the patient attempts to lift the hand off the back in an upward and lateral direction

Question 70

scapular retraction mmt

Answer 70

prone the elbow is extended and the humerus is flexed to 90 degrees.

the trunk is stabilized while palpatingthe spine and scapula and spinous process

resistance on the scapula

the PM are the middle traps and rhomboids

Question 71

scapular protraction and upward rotation

Answer 71

supine wit the test are flexed to 90 degrees with the trunk stabilized

resistance applied on the distal humerus proximal to the elbow instruct the patient to fund the ceiling

PM: serratus anterior

Question 72

scapular depression and retraction MMT

Answer 72

prone with the arm being tested is abducted to 135 degrees with the forarm supinated and the patients head rotated to the side oppostie that being tested

stabilize the trunk palpate the medial to inferior angle of the scapula resistance on the scapula and instruct the patient to raise your arm.

PM: lower trapezius

Question 73

scapular elevation mmt

Answer 73

seated this the trunk stabilized palpate the superomedial to scapula resistance is on the superior aspect of the shoulder. the patient assumes a shoulder shrug position which the examiner pushes down.

PM: upper trapezius

Question 74

Sternoclavicular joint play joint play

Answer 74

patient is supine or seaded with the examiner standing next to the patient grasping the proximal clavicle. evaluative procedure apply the gliding pressure that forces the medial clavicle downward upward anteriorly and posteriorly relative to the sternum noting pain or laxity elicited

PT: pain, hyper mobility or hypomobility

IM: hypermobility laxity and or sprain, hypomobility joint adhesions

Question 75

acromioclavicular joint play

Answer 75

seated or supine with the examine standing on the lateral side of the patient graspig the distal portion of the clavicle just proximal to the ac joint. the opposite hand is stabilzer the acromian process.

Evaluative Procedure: apply the gliding pressure that forces the distal clavicle downward upward anteriorly and posteriorly relative to the scapula noting pain or laxity elicited.

Question 76

Glenohumeral Joint Play

Answer 76

patient seated place the patients arm is placed in the resting position the examiner maintains the patients arm in the position to assure relaxation.

position of examiner inferior glide: one hand supports the arm to maintain the resting position. the oppostie hand cups the superior aspect of the humerus.

Anterior glide: one hand stabilizes the scapula anteriorly by applying pressure to the coracoid process, reaching under the axilla to the scapular body. the opposite hand applies force at the posteror aspect of the humerus.

Posteror glide: one hand stabilizes the scapula at the acromion process. the opposte hand applies force at the anterior aspect of the humeral head.

Procedure: a gentle yet firm force is applied that distracts the joint and then moves the humeral head inferiorly anteriorly or posteriorly.

PT: pain increased mobility or decreased mobility compared with the same direction on the opposite shoulder.

IM: hypermobility or hypomobility of the static stabilizers of the GH joint.

Question 77

Acromial clavicular traction test

Answer 77

sitting for standing the arm hangin naturally from the side. the examiner standing lateral to the involved side the clinician grasps the patients humerus proximal to the elbow the oppostie hand gently palpates the AC joint.

evaluative procedure: the examiner applies a downward traction on the humerus.

PT: the humerus and scapula move inferior to the clavicle causing a step deformity pain or both.

IM: sprain of the ac or costoclavicular ligaments.

Question 78

Acromioclavicular compression test:

Answer 78

sitting or standing with the arm hanging naturally at the side with the examiner standing on the involved side with the hands cupped over the anterior and posterior joint structures. the examiner squeezes the hands together compressing the AC joint

PT: pain at the AC joint or excursion o the clavicle over the acromion process

IM: damage to the ac ligament and possibly the coracolcavicular ligament.

Question 79

Apprehension test for anterior glenohumeral laxity

Answer 79

patient position supine standing or sitting the GH joint is abducted to 90 and the elbow is flexed to 90. positioned in front of or beside the patient on the involved side the examiner supporting the humerus at midshaft while the forearm is grasped proximal to the wrist.

evaluative proceure: while supporting the humerus at 90 abduction the examiner passibly externally rotates the GH joint by slowly applying pressure to the anterior forearm.

PT: the patient displays apprehension that the shoulder may dislocate and resists further movement pain is centered in the anterior capsule of the GH joint.

IM: the anterior capsule inferior GH ligament or glenoid labrum have been compromised allowing the humeral head to dislocate or supluxate anteriorly on the glenoid fossa. apprehension coupled with pain is often associated with instability secondary to rotator cuff pathology. pain in the deep posterior shoulder may be associated with internal impingement d

Question 80

Relocation and anterior relase tests for anterior glenohumeral laxity

Answer 80

supine the GH is abducted to 90 and the elbow to 90. position of examiner standing beside the patient inferiro to the humerus on the involved side. the forearm is grasped proximal to the wrist to provide leverage during external rotation of the humerus. the opposite hand is held over the humeral head.

Evaluation Procedure: the relocation test with teh patients arm in the original position the examiner applies the posterior force to the head of the humerus and maintains that force while externally rotating the humerus.

Anterior release Test ( Surprise Test): with the GH in external rotation during the relocation test the examiner removes the hand applying the posteror pressure.

PT: decreased pain or increased ROM compared with the anterior apprehension test. Anterior release test: apprehension and or pain when the anterior stabilizing pressure from the relocation test is removed.

IM: relocation test anterior pain may be the result of increased laxity in the anterior ligamentous and capsular structures or tear of the labrum. posterior pain may be from internal impingement of the posterior capsule or labrum.

Anterior release test: Apprehension or pain when the anterior stabilizing pressure from the relocation test is removed.

Question 81

posteror apprehension test for glenohumeral laxity

Answer 81

sitting or supine the hould is flexed to 90 and the elbow is flexed the GH joint being tested is off to the side of the table. standing on the involved side one hand grasps the forearm the opposite hand stabilizes the posteriro scapula.

Procedure: the examiner applies a longitudinal force to the humeral shaft, encouraging the humal head to moe posteriorly on the glenoid fossa. the examiner may choose to alter the amount of flexion or rotation of the humerus.

PT: the patient displays apprehension and produces muscle guarding to preent the shoulder from supluzation posteriorly.

IM: laxity in the posteriorly GH capsule torn posterior labrum.

Question 82

jerk test for labral tears

Answer 82

supine or eated the supine position provides better scapula stabilization.

the behind the patient one hand stabilzed the scapula the opposite hand holds the affected arm at 90 of flexion and internal rotation.

procedure: the affected arm is passively horizontally adducted while the examiner applies a simultaneous axial load to the humerus.

PT: clunk that mayor may not be painful.

IM: posteroinferior instability with or without posteroinferior labral tear.

Question 83

Sulcus sign for inferior glenohumeral laxity

Answer 83

patient position sitting examiner on the lateral side of the involved side.

Procedure: the patients arm is gripped distal to the elbow a downward traction force is applied to the humerus while the scapula is stabilized.

PT: an indentation appears beneath the acromion process. to defferentiate the results of this test from those of teh AC traction test for AC joint instability the movement of the humeral head is away from the scapula and the clavicle in this test.

IM: the humeral head slides inferiorly on the GH ligament.

Question 84

the neer shoulder impingement test

Answer 84

standing the shoulder elbw and wrist begin in the anatomical position. one hand stabilizes the patient’s scapula. the oppostie hand grasps the patients arm distal to the elbow joint.

the elbow exted the humerus is placed in internal rotation and the forarm is pronated. the GH joint is then forecefully moved through forward flexion as the scapula is stabilized.

PT: pin in the anteriro or lateral shoulder in the range of 90 degress of full elevation.

IM: patholgoy is present in the rotator cuff group. of the long head of the biceps brachii tendon. the motion of the test impinges these structures.

Question 85

hawkin shoulder impingement test

Answer 85

sitting ro standing the shoulder elbow and wrist are in the anatomical position. with the examiner on the side of the patient. with the elbow flexed the GH joint is elevated to 90 degrees in the scapular plane at htis poin the humerus is passily internally rotated until painful or scapular rotation is felt or obsered.

PT: pain with motion especially near the end or ROM

IM: pathology in the rotator cuff group. or the long head of the biceps brachii tendon.

Question 86

empty can test for supraspinatus pathology

Answer 86

sitting or standing the Gh is abducted to the 90 degrees in the scapular plane the elbow extended and the humers internally rotated and the forarm pronated so that the thumb points downward.

Position of examiner sanding facing the patient one hand is placed on the superior portion of the midforearm to resist the motion of abduction in the scapular plane.

Evaluative procedure: the evaluator resists abduction

PT: weakness or pain acompanying the movement

IM: the supraspinatus tendon is being impinged between the humeral head and coracoacromial arch is inflamed or contains a lesion.

Question 87

Yergason’s Test

Answer 87

sitting with the GH joint in the anatomica position the elbow is flexed to 90 the forarm is positioned so that the lateral borer of the radius faces upward. with the eaminer lateral to the patient on the involved side lightly palpating the bicipital groove the olecranon stabilized. the forarm is stabilized proximal to the wrist.

procedure: the patient provides resistance while the examiner concurrently moves the GH joint into external rotation while resisting supination.

PT: pain or snapping in the bicipital groove pain at the superior glenohumeral joint (SLAP LESION).

IM: primary snapping or popping in the bicipital groove indicates a tear in humeral ligament.

Question 88

Speed Test

Answer 88

sitting the elbow extended the GH joint is in neutral position or slightly extended with examiner standing lateral to involved limb.

Procedure the clinician provides resistance while flexion of the GH joint and elbow while palpating for tenderness over the bicipita groove. allow the patient to moe through flexion ROM.

PT: pain on biceps tendon especialy in the biciptal groove or at the superior shoulder

IM: inflammation of the long head or the biceps tendon as it passes through the bicipital groove. possible tear of the transverse humeral ligament with concurrent instability of long head of biceps tendon as it passes through the biciptal groove (slap lesion)

Question 89

Active compression test (Obrien test)

Answer 89

standing the gh joint is lexed to 90 and horizontally adducted 15 degrees the humerus is in full internal rotation elbow extended and the forearm pronated. with the examiner in front of patient on hand over superior distal arm.

Procedure: the patient isometrically resists the examiners downward force. the test is repeated with the humerus externally rotated and the forarm supinated.

PT: pain that is experience with the arm internally rotated but is decreased during external rotation. pain or clicking withing the GH joint indicate a labral tear. pain at the AC joint may indicate AC joint pathology positie SLAP lesion test are confirmed with pain relief when the ahnd is supinated pain with cross armed horizontl adduction is used to confirm ac patholgy

IM: SLAP Lesion or AC pathology

Question 90

Anterior Slide Test

Answer 90

eated or standing hands on hips with humbs pointing posteriorly. examiner behind the patient one hand on shoulder the other behind the elbow on the test side.

Procedure: an anterior and slightly superior force is applied longituinally trough the humerus. the patient resists or pushes back against this force

PT: shoulder pain or pop or click under the index finger. Patient report of reproduction of symptoms.

IM: slap lesion

Question 91

Compression Rotation Grind Test

Answer 91

supine the shoulder is abducted to 90 and the elbow is flexed to 90. with examiner at patient side. the examiner mainains and axial load on the humerus while internally and externally rotating it.

Pt: SLAP lesion and reproduction or symptoms.