shoulder exam

Question 1

what to look for in anterior inspection in a shoulder exam

Answer 1

scars, brusing, asymmetry of the shoulder girdle, swelling, abnormal bony prominance and deltoid wasting

Question 2

what can asymmetry of the shoulder girdle be caused by

Answer 2

scoliosis, arthritis, fractures or dislocation

Question 3

what can cause swelling in the shoulder joints

Answer 3

effusion, inflammatory arthropathy, or dislocation

Question 4

what can an abnormal bony prominence on the shoulder indicate

Answer 4

a clavicular fracture or anterior dislocation of the glenohumeral joint

Question 5

what can deltoid wasting indicate

Answer 5

disuse atrphy or axillary nerve injury

Question 6

what to look for on lateral inspection in a shoulder exam

Answer 6

scars and deltoid wasting

Question 7

what to look for on posterior insepction in a shoulder exam

Answer 7

scars, trapezous muscle asymmetry, supraspinatus and infraspinatoid asymmetry, scoliosis, winged scapula

Question 8

what is trapezius muscle asymmetry suggestive of

Answer 8

muscle wasting secondary to disuse atrophy spinal accessory nerve lesion

Question 9

what is supraspinatoud and infraspinatous asymmetry suggestive of

Answer 9

muscle wasting secondary to chronic rotator cuff tear of a suprascapular nerve lesion

Question 10

what is a winged scapula indicative of

Answer 10

ipsialtral serratus anterior muscle weakness secondary to long thoracic nerve injury

Question 11

what to do in a shoulder exam after looking

Answer 11

feel the temperature of the shoulder joint

Question 12

what to do after assessing joint temperature in a shoulder exam

Answer 12

palpate the sernoclavicular joint, the clavicle, the acromioclavicular joint, acromion, coracoid process, head of the humerus, greater tubercle of the humerus and the spine of the scapula

Question 13

what to do after palpating in a shoulder exam

Answer 13

ask patient to place hands behind their head

Question 14

what does asking the patients to place their hands behind their head asses

Answer 14

external rotation and abduction of the shoulder joint

Question 15

what to do in a shoulder exam after asking patients to place their hands behind their head

Answer 15

ask the patient to place each hand nehind their back and reach as far up their spine as they can

Question 16

what does asking the patient to put their hand behind their back asses in a shoulder exam

Answer 16

internal rotatoin and adduction of the shoulder joint

Question 17

what to do after asking the patient to put their hand behind their back in a shoulder exam

Answer 17

ask the patient to raise their hands forwards until theyre pointing towards the ceiling (shoulder flexion)

Question 18

what to do after asking the patient to put their hands forwards to the sky in a shoulder exam

Answer 18

ask the patient to stretch their arms out behind them (shoulder extension)

Question 19

what to do after asking the patient to put their arms out behind them in a shoulder exam

Answer 19

ask the patient to raise their arms out to the sides in an arc like motion until their hands touch above their head (abduction)

Question 20

what to do after the arc movemnet in a shoulder exam

Answer 20

ask the patient to keep their arms straight and move them across the front of their body to the opposite side (adduction)

Question 21

what to do after adduction in a shoulder exam

Answer 21

ask the pateint to keep their elbows by their sides flexed at 90 degrees they move their forearms out (external rotation)

Question 22

what to do after asking a patient to keep their elbows by their side flexed at 90 degrees and moce their forearms out in a shoulder exam

Answer 22

ask the patient to place each hand behind their back and reach up as far as they are able to (internal rotation)

Question 23

how far up their own spine should a patient to able to reach

Answer 23

T4-T8

Question 24

what to do in a shoulder exam after asking the patient to place each hand behind their back and reach up as far as they are able

Answer 24

wing scapular test (wall)

Question 25

what does jobes test assess

Answer 25

the function of the supraspinatous muscle

Question 26

how to perform jobes test

Answer 26

abduct the patients arm to 90 degrees and then angle the arm forwards by 30 degrees so the shoulder is the plane of the scapula, internally rotate the arm so the thumb points to the floor, now push down the arm whilst the patient resists

Question 27

how to interpret jobes test

Answer 27

weakness - tear in supraspinatous pain - impingement

Question 28

what to do after jobes test

Answer 28

painful arc test

Question 29

what does pain between 60-120 degrees suggest

Answer 29

impingemnet or supraspinatour tendonitis

Question 30

what to do after the painful arc test

Answer 30

assess the function of infraspinatour and teres minor muscles

Question 31

how to assess the function of infraspinatous and teres minor muslces

Answer 31

position the patients arm with the elbow flexed at 90 degrees on slight abduction then passively externally rotate the arm to its maximum

Question 32

pain on resisted external rotation suggets

Answer 32

infraspinatois tendonitis

Question 33

if the arm falls back to internal roation or their is loss of power in the external rotation against resistance test what does this indicate

Answer 33

a tear in the infraspinatus or teres minor tendon, muscle wasting or lower motor neurone lesion

Question 34

how test test the function of the teres minor muscle

Answer 34

external rotation in abduction

Question 35

how to peform external rotation in abduction

Answer 35

position the arm in 90 degree of abduction and bend the elbow to 90 degrees, passively externally rotate the shoulder to its maximum degree

Question 36

what is hornblowers sign

Answer 36

inability to keep the arm in a 90 degrees whilst passively rotating the shoulder

Question 37

what can hornblowers sign suggest

Answer 37

teres minor pathology or an axillary nerve lesion

Question 38

what test assesses internal rotation against resistance

Answer 38

gerbers lift off test

Question 39

how to perform gerbers lift off test

Answer 39

ask the patient to place the dorsu of their hand on their lower back and apply light resistance to the heand and ask the patient to move their hand off the bacl

Question 40

how to interprate gerbers lift off test

Answer 40

if the patient is unable to move their hand of their back it indicates pathology of the subscapularis muscle or subscapular nerve lesion

Question 41

what does the scarf test assess

Answer 41

the function of the acromioclavicular joint

Question 42

how to perform the scarf test

Answer 42

passively flex the shoulder to to degrees and ask the patient to place the hand on the side you are examining to the contrateral shoulder and apply resistance to the elbow in the direction of the contralateral shoulder

Question 43

interpratation of the scraf test

Answer 43

id the patient experiences pain in the test there is acromioclavicular joint pathology