shoulder

Question 1

shoulder GH ROM

Answer 1

flexion 180
abduction 180
IR 90
ER 90
extension 60

Question 2

GH joint open pack

Answer 2

55 deg abduction
30 deg horizontal adduction
neutral rotation

Question 3

GH joint closed pack

Answer 3

max abduction, ER

Question 4

scapulohumeral rhythm

Answer 4

first 30-60deg elevation GH

then 2:1 = 120 GH:60 scapulothoracic

Question 5

scapular upward rotation muscles

Answer 5

upper and lower trap

serratus anterior

Question 6

scapular downward rotation muscles

Answer 6

rhomboids
levator scapulae
pectoralis minor

Question 7

joint mobilization for ER

Answer 7

anterior glide

adhesive capsulitis - posterior glide

Question 8

shoulder labrum special tests

Answer 8

o’briens - slap lesion
speeds - Superior labral tear or tendinitis
yergason’s - Torn transverse humeral ligament, bicipital tendonitis or tendinosis
crank - labral instability
clunk - glenoid labrum tear

Question 9

instability tests

Answer 9

anterior instability

posterior instability

Question 10

shoulder GH capsular pattern

Answer 10

ER, Abduction, IR

Question 11

shoulder SC and AC capsular pattern

Answer 11

pain at extremes of ROM

Question 12

shoulder SC and AC open and closed pack

Answer 12

open: arm resting by side
SC closed: max shoulder elevation
AC closed: arm abducted 90deg

Question 13

painful arc in 60-120 degrees of shoulder flexion

what special test next? suspect?

Answer 13

impingement:
Neers
Hawkins Kennedy
Infraspinatus MMT
Empty Can (Jobe)
- Supraspinatus tendonitis, impingement, partial tear

Question 14

treatment program for adhesive capsulitis

Answer 14

primary treatment: gentle progressive stretching exercises with the focus on increased active range of motion.

Question 15

O’Brien’s test for?

Answer 15

SLAP tears, Superior labral tear

Question 16

interventions:

• subacromial bursitis
• difficulty with overhead activities

Answer 16

Shoulder rotation, esp ER, strengthening the rotator cuff, which will be the MOST helpful at treating subacromial bursitis.

Question 17

what pathology?
pain with extreme flexion and internal rotation,
passive range of motion WNL

Answer 17

Subacromial bursitis

Question 18

what pathology?

pain with cross-body movements

Answer 18

Acromioclavicular joint lesion

Question 19

most common cause Hill-Sach’s lesion

Answer 19

most likely to occur with anterior shoulder dislocation which creates a divot in the cortex of the humeral head.

Question 20

primary or secondary impingement?

• Worsening pain with overhead activity
• rotator cuff weakness

Answer 20

secondary

Question 21

primary or secondary impingement?
mechanically narrow the subacromial space such as 
- osteophytes, 
- hooked acromion, 
- malposition after fracture, 
- increased subacromial soft tissue

Answer 21

primary

Question 22

adhesive capsulitis end feel

Answer 22

firm

capsule shrinks and sticks

Question 23

what test(s)?
Rotator cuff pathology

Answer 23

external rotation lag sign

resisted external/internal rotation/supraspinatus.

Question 24

what test(s)?
crossover test

Answer 24

Acromioclavicular joint pathology

Question 25

``` what test(s)? bicep tendon pathology ```

Answer 25

Speed's Test yergasons biceps load ludington

Question 26

what pathology? - Gross symptomatic instability in more than one direction - caused by hyperlaxity in ligaments and GH joint capsule, symptomatic instability

Answer 26

glenohumeral multidirectional instability

Question 27

pivot shift test which way is leg rotated? what does it test for?

Answer 27

medial rotation of the leg | ACL

Question 28

reverse pivot shift test which way is leg rotated? what does it test for?

Answer 28

lateral rotation | PCL

Question 29

what test? + indicates what pathology? | arm in 90 degrees of abduction and 30 degrees of horizontal adduction with the thumb pointing downward.

Answer 29

supraspinatus test | + supraspinatus tendon tear, impingement, suprascapular nerve pathology

Question 30

what test? + indicates what pathology? | arm in 90 degrees of abduction and external rotation with the elbow also flexed to 90 degrees

Answer 30

Roos test | + thoracic outlet syndrome

Question 31

what test? + indicates what pathology? | arm in 90 degrees of flexion before being medially rotated

Answer 31

Hawkins-Kennedy impingement test | + shoulder impingement specifically involving the supraspinatus tendon

Question 32

what test? + indicates what pathology? | positioned with the arm in a resting position at their side with the elbow flexed to 90 degrees and the forearm pronated

Answer 32

Yergason’s test | + bicipital tendonitis

Question 33

what test? + indicates what pathology? - Patient’s arm is placed in 90 degrees of flexion in the scapular plane and 90 degrees of elbow flexion. - Therapist then laterally rotates the shoulder to end range and asks the patient to hold the position. - Positive: inability to hold the test position (i.e., hand springing back toward midline)

Answer 33

lateral rotation lag sign infraspinatus or teres minor lesion - both ER

Question 34

what test? + indicates what pathology? - patient to medially rotate the arm behind the back with the dorsum of the hand resting in the mid-lumbar region. - Therapist then instructs the patient to attempt to lift the hand off the back. - Positive: unable to lift hand off back

Answer 34

lift-off sign lesion of the subscapularis muscle - shoulder IR, innervated by the subscapular nerve (C5-C6).

Question 35

what pathology? - drop arm test was positive, - magnetic resonance imaging confirmed that the rotator cuff was not torn.

Answer 35

Axillary nerve palsy | deltoid acts as a primary abductor of the shoulder, innervated by the axillary nerve (C5-C6)

Question 36

what pathology? | generalized weakness, sensory disturbances and pain in the shoulder, arm, and hand.

Answer 36

thoracic outlet syndrome

Question 37

shoulder arthrokinematics | Flexion and medial rotation

Answer 37

humeral head rolls anterior, slides posterior

Question 38

shoulder arthrokinematics | Extension and lateral rotation

Answer 38

humeral head rolls posterior, slides anterior | if adhesive capsulitis glide posterior for ER

Question 39

shoulder arthrokinematics | Abduction

Answer 39

humeral head roll superiorly, slides inferiorly

Question 40

shoulder arthrokinematics | Adduction

Answer 40

humeral head rolls inferiorly, slides superiorly