Shoulder Exam Flashcards
(6 cards)
Shoulder Exam - General Inspection
Stand Further away so its not a focused inspection
* Looks well
* Mobility
* Gait
* Cast or sling
* No obvious asymmtery or deformities
* Normal Posture and Stance
* Normal Body Habitus
Shoulder Exam - Focused Insecption
- Lift up arm - check for scaring
- preservation of normal muscle bulk
- No wasting, erythema, rashes
-
Scapula Winging Test:
- walk up to door, lean slightly against it and push up agasint door
- Positive (which is bad) is if the shoulder blade becomes prominent
Shoulder Exam - Feel
Temp, Swelling, Tenderness, Bony Prominences
1. Start at the sternal notch and move acorss the clavicle to find the AC joint
2. Go postierly to spine of the scapula and trace along it to the medial border, inferior, lateral.
3. You will lose the lateral border so get them to make a chicken wing shape
4. go back to the front and feel for the biceps tendon
5. Go up to the AC joint (bony promience that is superior
6. Use three fingers to feel dowanrds slightly for soft tendon in divot
7. General lateral portion of the arm to check for burstitis or tenderness
Shoulder Exam - Move
Active First
1. Flexion and Extension (180, 70)
2. Abduction (180)
3. Adduction (90)
4. external rotation tuck elbow in and move out to side
5. Internal touch stomach
Passive:
- only do passive if active is not normal
- put hand on shoulder to feel for creptiation
- during abduction put hand on scapula to see when it moves (50-70% of movement should come from glenohumoral joint)
Shoulder exam special tests
Power:
1. empty can/jobes:
* pop arm straight out ahead slightly to left turn thumb to floor
* keeping arm straight i’m gonna pop some pressure try to resist
* did you feel and pain (will be in shoulder) —> ticks of impingement
2. external rotation:
* tuck hand to side and push out and try to resist me
* normal stretch of the infrapsinatus
3. Lift off:
* tuck hand behind back and can you try to lift hand off back and try to resist me
* subscapularis
4. Hornblower test:
* copy means then push out and resist my movement
* for teres minor
Impingement :
1. empty can
2. meers/painful arc:
* in a second i’m gonna ask you to move your arm up and down slowly l if you have any pain
* copy me
did you notice any pain (if no then say negative)
* Hawkins:
3. internal rotation
* can you copy my movement put stabilise arm on patient under there arm on shoulder
* than passively internally rotate arm
* don’t have to support actually easier
* have to ask if they are having any pain
hyper mobility :
put hand out inferior and pull fingers back as far as you can —> see if they can get fingers parralel to arm
keep arm out touch wrist to see if it can be parallel to arm
ask them to pop their arms out (hyper extension of elbow)
look for knee hyper extension must look from side
then like touch toes and see if patient can put pal on floor
laxity
1. inferior:
gently pull down the arm from below the shoulder joint to see if any sulcus develops around joint
2. anteriorly:
lie down of bed and make L shape with arm
put fingers under arm push up see if it wants to pop out
Shoulder exam finishing
id complete by doing a neurovascular assessment and testing the joint above and below
