Approach to Shoulder Complaint

Question 1

what is unique about the shoulder joint?

Answer 1

It is the only joint where tendons pass between bones

Question 2

what is the most sensitive indicator of joint disease?

Answer 2

range of motion

Question 3

where should you check the neurovascular status at?

Answer 3

distal to the site of the injury

Question 4

what is the painful arc test used to test?

Answer 4

subacromial impingement and rotator cuff tendon injury

Question 5

what is the cross arm test used to test?

Answer 5

acromioclavicular joint/ ligament injury

Question 6

what is unique about the painful arc test compared to all of the rotator cuff maneuvers?

Answer 6

it has the highest positive LR and the lowest negative LR

Question 7

what is a positive painful arc test?

Answer 7

shoulder pain from 60-120 degrees

Question 8

what is the triceps reflex testing?

Answer 8

C6-C7

Question 9

what is the biceps reflex testing?

Answer 9

C5-C6

Question 10

what is the brachioradialis reflex testing?

Answer 10

C5-C6

Question 11

what is the normal grade for a reflex?

Answer 11

2/4

Question 12

what is the normal grade for a pulse?

Answer 12

2/3

Question 13

where should you always check the pulse/ capillary refill?

Answer 13

distal to the site of the injury

Question 14

clavicle fractures most often occur in what demographic?

Answer 14

kids and young adults

Question 15

proximal humerus fractures most often occur in what demographic?

Answer 15

in the elderly

Question 16

what are scapular fractures associated with?

Answer 16

blunt trauma

Question 17

what is the most common type of glenohumeral dislocation?

Answer 17

anterior dislocation

Question 18

what do acromioclavicular joint injuries usually occur from?

Answer 18

direct trauma to the superior or lateral aspect of the shoulder with the arm adducted (direct blow or falling onto the shoulder)

Question 19

what type of painful ROM is associated with acromioclavicular joint injuries?

Answer 19

pain with abduction

Question 20

what tendons make up the rotator cuff?

Answer 20

supraspinatus, infraspinatus, teres minor, and subscapularis

Question 21

what tendon is most often injured in rotator cuff injuries?

Answer 21

supraspinatus tendon

Question 22

What are the symptoms of a rotator cuff injury?

Answer 22

shoulder pain over the lateral deltoid more prevalent with overhead activity and at night

Question 23

what diagnostic tests are of choice for a rotator cuff injury?

Answer 23

ultrasound and/or MRI

Question 24

what are the life threatening causes of shoulder pain?

Answer 24

septic arthritis, referred pain from an acute MI, intraperitoneal hemorrhage, and a lung pathology

Question 25

what does the scapula joint motion require?

Answer 25

clavicle motion

Question 26

what does the distal clavicle articulate with?

Answer 26

acromion

Question 27

what does the proximal clavicle articulate with?

Answer 27

the sternum

Question 28

what happens to the distal clavicle when the scapula depresses?

Answer 28

inferior glide (of the AC joint)

Question 29

what happens to the proximal clavicle when the scapula depresses?

Answer 29

superior glide (of the SC joint)

Question 30

what happens to the clavicle when the glenohumeral joint externally rotates?

Answer 30

the clavicle will externally rotate at the AC joint

Question 31

what happens to the clavicle when the glenohumeral joint internally rotates?

Answer 31

the clavicle will internally rotate at the AC joint

Question 32

what happens to the GH joint when the scapula depresses?

Answer 32

adduction

Question 33

what happens to the GH joint when the scapula elevates?

Answer 33

abduction

Question 34

what happens to the scapula when the GH joint flexes?

Answer 34

protraction

Question 35

what happens to the scapula when the GH joint extends?

Answer 35

retraction

Question 36

if you have a superior AC joint somatic dysfunction, where is the direct barrier?

Answer 36

inferior pressure to the distal clavicle

Question 37

if you have an internal rotation somatic dysfunction, where is the direct barrier?

Answer 37

GH external rotation

Question 38

if you have an inferior glide somatic dysfunction of the SC joint, where is the GH direct barrier?

Answer 38

GH adduction

Question 39

if you have a superior glide somatic dysfunction of the SC joint, where is the GH direct barrier?

Answer 39

GH abduction

Question 40

if you have an anterior glide somatic dysfunction of the SC joint, where is the GH direct barrier?

Answer 40

GH flexion

Question 41

if you have a posterior glide somatic dysfunction of the SC joint, where is the GH direct barrier?

Answer 41

GH extension