Shoulder - Assessment

Question 1

Shoulder Assessment

Glenohumeral snapshot:

• Flexion = ?
• Abduction = ?
• Extension = ?
• External Rotation = ?
• Internal Rotation = ?
• Capsular Pattern = ?

Answer 1

• Flexion = 180 degrees
• Abduction = 180 degrees
• Extension = 60 degrees
• External Rotation = 90 degrees
• Internal Rotation = 70 degrees
• Capsular Pattern = External rotation > Abduction > Internal Rotation

Question 2

Shoulder Assessment

GH loose and closed packed positions = ?

Answer 2

• GH loose = 55 degrees abduction and 30 degrees horizontal adduction
• GH closed = Full abduction and external rotation

Question 3

Shoulder Assessment

AC loose and closed packed positions = ?

Answer 3

AC loose = Arm resting at side
AC closed = 90 degrees arm abduction

Question 4

Shoulder Assessment

SC loose and closed packed positions = ?

Answer 4

SC loose
Arm resting at side

SC closed
Maximum shoulder elevation

Question 5

Shoulder Assessment

Arthrokinematics:

• GH = ?
• AC = ?
• SC = ?

Answer 5

Arthrokinematics:

• GH = Convex on concave
• AC = Planar
• SC = Saddles

Question 6

Shoulder Assessment

Posterior Shoulder Palpation =

Answer 6

Spine of the Scapula

• Prominent Bony Ridge Along the Upper Lateral Back
• Approximately T3

Medial Border of the Scapula

• From the Medial Spine, Follow the Bony Ridge Inferiorly

Inferior Angle of Scapula

• The Terminal Aspect of the Medial Border
• Approximately T7

Posterior Angle of the Acromion

• The most Lateral Aspect of the Spine of the Scapula

Question 7

Shoulder Assessment

Anterior Bony Shoulder Palpation =

Answer 7

Sternal Notch

• Midline V-shape indentation above the sternum

Sternoclavicular Joint and Clavicle

• Sternoclavicular Joint is ~1cm inferior-lateral from the Sternal Notch
• Clavicle is the S-shaped bone that runs toward the shoulder

Lateral Edge of Acromion and V-notches

• The most Lateral Aspect of the Spine of the Scapula

Coracoid Process

• Inferior to the Clavicle in the Infraclavicular Fossa, Hold Arm in Ext

Lesser Tubercle

• Feel laterally from the Coracoid Process until you hit a bony ridge

Question 8

Shoulder Assessment

Anterior Muscular Shoulder Palpation

Answer 8

Subscapularis

• Between Coracoid and Lesser Tubercle

Biceps

• Lateral to the Lesser Tubercle in the Intertubercular Grove

Supraspinatus

• Superior to the line of the Biceps on the Greater Tubercle
• Easier to palpate in Extension and IR (Arm Behind the Back)

Question 9

Shoulder Assessment

Posterior-lateral Shoulder Palpation =

Answer 9

Infraspinatus

• Courses under the Spine and attaches to the Posterior Aspect of the Greater Tubercle

Teres Minor

• Running Mediolateral, 2cm inferior to the Spine of the Scapula

Question 10

Shoulder Assessment

Olecrannon-Manubrium Percussion Test

Fracture Screening

Answer 10

Question 11

Shoulder Assessment

Scapular Active ROM Observation

Answer 11

Neutral

In Elevation

• Upward Rotation
• External Rotation

Arms On Hips

• Posterior Tilt

Question 12

Shoulder Assessment

Shoulder Flexion ROM

Answer 12

Normal ROM = 0-180 degrees

video

Question 13

Shoulder Assessment

Shoulder Extension ROM

Answer 13

Normal ROM = 0-60 degrees

video

Question 14

Shoulder Assessment

Shoulder Abduction ROM

Answer 14

video

Question 15

Shoulder Assessment

Shoulder Internal Rotation ROM

Answer 15

video

Question 16

Shoulder Assessment

Shoulder External Rotation ROM

Answer 16

video

Question 17

Shoulder Assessment

Scapular Elevation MMT (3-5)

Answer 17

video

Question 18

Shoulder Assessment

Scapular Elevation MMT (0-2)

Answer 18

video

Question 19

Shoulder Assessment

Scapular Protraction MMT (0-5)

Answer 19

video

Question 20

Shoulder Assessment

Scapular Retraction MMT (0-5)

Answer 20

video

Question 21

Shoulder Assessment

Scapular Retraction Alternate Arm Positions

Answer 21

lower trap

rhomboids

Question 22

Shoulder Assessment

Shoulder Flexion MMT (3-5)

Answer 22

video

Question 23

Shoulder Assessment

Shoulder Flexion MMT (0-2)

Answer 23

video

Question 24

Shoulder Assessment

Shoulder Extension MMT (3-5)

Answer 24

video

Question 25

# Shoulder Assessment Shoulder Extension MMT (0-2)

Answer 25

## Footnote [video](https://app.clinicalpattern.com/rom_mmt/2598/2597/2454/p7233/)

Question 26

# Shoulder Assessment Shoulder Abduction MMT (3-5)

Answer 26

Question 27

# Shoulder Assessment Shoulder Abduction MMT (0-2)

Answer 27

## Footnote [video](https://app.clinicalpattern.com/rom_mmt/2598/2597/2455/p7235/)

Question 28

# Shoulder Assessment Shoulder Horizontal Abduction MMT (3-5)

Answer 28

## Footnote [video](https://app.clinicalpattern.com/rom_mmt/2598/2597/2455/p7234/)

Question 29

# Shoulder Assessment Shoulder Horizontal Abduction MMT (0-2)

Answer 29

## Footnote [video](https://app.clinicalpattern.com/rom_mmt/2598/2597/2456/p7238/)

Question 30

# Shoulder Assessment Shoulder Horizontal Adduction MMT (3-5)

Answer 30

Question 31

# Shoulder Assessment Shoulder Horizontal Adduction MMT (0-2)

Answer 31

[video](https://app.clinicalpattern.com/rom_mmt/2598/2597/2457/p7240/)

Question 32

# Shoulder Assessment Shoulder Internal Rotation MMT (3-5)

Answer 32

## Footnote [video](https://app.clinicalpattern.com/rom_mmt/2598/2597/2458/p7241/)

Question 33

# Shoulder Assessment Shoulder Internal Rotation MMT (0-2)

Answer 33

## Footnote [video](https://app.clinicalpattern.com/rom_mmt/2598/2597/2458/p7242/)

Question 34

# Shoulder Assessment Shoulder External Rotation MMT (3-5)

Answer 34

[video](https://app.clinicalpattern.com/rom_mmt/2598/2597/2459/p7243/)

Question 35

# Shoulder Assessment Shoulder External Rotation MMT (0-2)

Answer 35

## Footnote [video](https://app.clinicalpattern.com/rom_mmt/2598/2597/2458/p7242/)

Question 36

# Shoulder Assessment Sulcus Sign ## Footnote Joint Play

Answer 36

## Footnote General Laxity

Question 37

# Shoulder Assessment Scapulothoracic Joint Glides ## Footnote Scapulothoracic Joint Play Testing

Answer 37

## Footnote [video](https://app.clinicalpattern.com/ortho/p1508/#main)

Question 38

# Shoulder Assessment GH Joint Anterior Glide ## Footnote Anterior Capsule Mobility

Answer 38

[video](https://app.clinicalpattern.com/ortho/p1555/#main)

Question 39

# Shoulder Assessment GH Joint Posterior Glide ## Footnote Posterior Capsule Mobility

Answer 39

## Footnote [video](https://app.clinicalpattern.com/ortho/p1542/#main)

Question 40

# Shoulder Assessment GH Joint Inferior Glide ## Footnote Inferior Capsule Mobility

Answer 40

Question 41

# Shoulder Assessment Sternoclavicular Joint Anterior Glide ## Footnote Sternoclavicular A-P Joint Play Testing

Answer 41

Question 42

# Shoulder Assessment Sternoclavicular Joint Inferior Glide ## Footnote SC Sup-Inf Joint Play Testing

Answer 42

Question 43

# Shoulder Assessment Acromioclavicular Joint Posterior Glide ## Footnote Acromioclavicular A-P Joint Play Testing

Answer 43

Question 44

# Shoulder Assessment Anterior Apprehension Test ## Footnote Special Test

Answer 44

## Footnote Anterior Instability

Question 45

# Shoulder Assessment Shoulder Shrug Sign and Coracoid Pain Test ## Footnote Special Test

Answer 45

## Footnote Adhesive Capsulitis

Question 46

# Shoulder Assessment Lateral Jobe Test ## Footnote Special Test

Answer 46

## Footnote Supraspinatus Tear Screening

Question 47

# Shoulder Assessment Hornblower's Sign ## Footnote Special Test

Answer 47

## Footnote Infraspinatus/TM Tear Screening

Question 48

# Shoulder Assessment Internal Rotation Lag Test ## Footnote Special Test

Answer 48

## Footnote Subscapularis Tear Screening