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517 Ortho > Shoulder Lab > Flashcards

Shoulder Lab Flashcards

(65 cards)

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1
Q

GH joint mobilizations

A

anterior/posterior
distraction: distract humerus out of joint
inferior: press down towards feet

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2
Q

Scapula joint mobilizations

A

lateral/medial
inferior
distraction: hold under medial border, pull from ribcage

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3
Q

AC joint play

shoulder position

A

stand behind pt
shoulder in 20 degrees of abduction for loose pack
fix acromion with pincer grip
translate clavicle ant/post

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4
Q

SC joint play

A

superior and inferior glides
use dummy thumb for superior glide

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5
Q

tests for GH anterior instability

A

apprehension test
relocation test

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6
Q

apprehension test

A

purpose: identify anterior labral instability
supine
90 abd
move shoulder into full ER
positive: apprehension to movement, resistance to movement; more so than pain

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7
Q

relocation test

A

purpose: identify anterior labral instability
apprehension test position
go to just before point of apprehension
apply posterior translation to humeral head
positive: decreased apprehension/pain

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8
Q

tests for GH posterior/inferior instability

A

Jerk test
sulcus sign

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9
Q

jerk test

A

purpose: identify posteroinferior labral stability
position: pt seated, shoulder 90 abd, IR
movement: PT behind pt, hold elbow and scapula superiorly
push GH backwards and adduct arm
positive: sharp posterior shoulder pain, may have clunk

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10
Q

sulcus sign

A

purpose: GH posteroinferior instability
position: standing, 20-30 shoulder abd
movement: PT pulls humerus inferiorly
positive: depression between acromion and humeral head

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11
Q

SAPS testing cluster

A

Hawkins Kennedy
Neer
Painful Arc
Full/empty can
ER iso at 90

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12
Q

SAPS test psychometrics for diagnosis

A

3/5 + tests = 2.93 likelihood ratio
<3 + tests = -.34 likelihood ratio

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13
Q

Hawkins Kennedy test

A

purpose: SAPS, ACJ
position: 90 shldr flexion, 90 elbow flexion
PT places their arm under testing side and hand onto opposite shoulder
action: compress humerus into glenoid, passive humerus IR
positive: familiar pain

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14
Q

Neer impingement test

A

purpose: SAPS
position: seated
PT stands behind pt and stabilizes scap with downward force
action: passive IR, flex shoulder through entire PROM
positive: familiar pain

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15
Q

Painful Arc

A

purpose: SAPS
position: standing
action: pt AROM in abduction, report stop and start of pain
positive: 60-120 painful - GH involvement; >170 painful, ACJ involvement

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16
Q

Full can

A

purpose: SAPS, RCRPS
position: standing/seated, arm in scapular plane at shoulder height
action: apply downward force in scapular plane as pt resists
positive: familiar pain/weakness
*should be less provocative than empty can

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17
Q

Empty Can/Jobe

A

purpose: SAPS, supraspinatus tear, impingement, suprascapular n involvement, RCRPS
position: seated, shoulder at 90 degrees in scapular plane, shoulder IR
action: resist downward force
positive: familiar pain in supraspinatus, weakness

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18
Q

Resisted shoulder ER

A

purpose: SAPS, infraspinatus tear test
position: seated
action: test BL ER MMT
positive: weakness compared to unaffected side

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19
Q

RCRPS (rotator cuff related pain syndrome) test cluster

A

Jobe/Empty Can
Full Can
ER lag sign

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20
Q

Meaning of negative full can and positive empty can

A

pain is primarily related to a rotator cuff lesion

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21
Q

Unable to distinguish ________ or _________ with Empty Can test

A

rotator cuff dysfunction or impingement

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22
Q

ER lag sign

A

purpose: RCRPS - infraspinatus or supraspinatus pathology
position: passive 20 shldr abd in scapular plane, elbow flexed, full ER - ~5 degrees
action: pt holds as PT releases arm, supporting only elbow
positive: pt is not able to hold max ER in this position, will move into IR

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23
Q

Full thickness infraspinatus tear testing

A

ER lag sign

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24
Q

Full thickness subscapularis testing

A

lift off test
belly press
bear hug

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25
lift off test
purpose: subscapularis lesion position: standing, hand in small of back action: pt lifts hand off back positive: pt is unable or aberrant scapular movement
26
Belly press test
purpose: subscapularis tear position: standing/seated?, PT has hand on pt belly with pt's hand pressing in action: pt presses into belly/PT hand as PT resists their IR positive: weakness or pain *quantify weakness w pressure cuff instead of hand
27
bear hug test
purpose: subscapularis lesion position: seated action: pt places hand on opposite shoulder w arm at 90 degrees, pt presses their hand down into the shoulder positive: pain
28
rotator cuff tendinopathy/partial tear testing | rule out w what tests?
painful arc Hawkins Kennedy these 2 being negative used to rule out diagnosis | If these tests are negative it is unlikely pt has RC tendinopathy
29
IR lag sign
purpose: rule out full thickness subscapularis tear position: standing/seated, PT passively moves pts hand behind back and lifts hand off lumbar spine action: pt maintains forearm position as PT releases them while supporting the elbow positive: unable to maintain position, falls back towards back
30
Additional tests for full thickness RC tear
drop arm hornblower's sign
31
Drop arm test
purpose: full thickness RC tear/supraspinatus specifically position: seated, shldr abducted to 120 passively action: pt slowly lowers arm to side as PT guards positive: unable to control lowering of arm to side
32
Hornblower's sign
purpose: full thickness RC tear, teres minor or infra position: seated, passive abd to 90 scapular plane, elbow flexed action: PT pushes pt into IR and pt resists, pushing into ER positive: inability of pt to ER in this position, or forearm drops/elbow up
33
ACJ testing cluster
Paxinos sign active compression test Hawkin's Kennedy 2/3 indicates ACJ involvement? + horizontal adduction test for AC joint OA, laxity, separation
34
Order of ACJ cluster testing
Paxino first if positive: perform active compression test if negative: perform Hawkins Kennedy
35
Paxinos sign
purpose: ACJ involvement position: seated, arm relaxed at side action: PT places thumb posterolateral acromion and fingers on clavicle; apply pressure ant/superior direction with hand, fingers apply in inferior direction positive: local ACJ pain
36
Active compression/O'Brien test
purpose: ACJ cluster if positive paxinos, SLAP (felt inside shoulder) position: seated, shoulder flexed to 90, 10 degrees h. add. (hands together) action: apply downward pressure with shoulder IR, then ER positive: IR provoking pain/click, ER relieving * pain location at AC joint or inside GH
37
SLAP (superior labrum anterior to posterior) testing
Active compression/O'Brien's: with symptoms inside shoulder Passive distraction
38
Passive distraction test
purpose: SLAP lesion position: supine, 150 abd, forearm supinated action: PT stabilizes arm and pronate forearm positive: pain deep in ant or post GH joint
39
SLAP lesion testing with weak clinical value
bicep load I test bicep load II test Crank test Anterior Slide test Yergason Speed's
40
Bicep load I test
purpose: SLAP position: position of apprehension test, 90 abd full ER in supine action: apply resistance to elbow flexion positive: apprehension same or worse + pain
41
Bicep load II test
purpose: SLAP position: supine, shldr abd 120, 90 elbow flexion, forearm supination action: flex elbow against resistance positive: pain
42
Crank test
purpose: SLAP position: supine, shldr abd 120 action: provide axial compression to GH from humerus or elbow while repeating IR then go into ER positive: pain, click, catching *similar to McMurrays for knee
43
Anterior slide test
purpose: SLAP position: seated, hands on waist, thumbs posterior action: apply anterior superior pressure at elbow as patient resists, stabilize scapula with other hand positive: pain, click deep in shoulder
44
Yergason's test
purpose: integrity of transverse ligament (bicep tendon) bicipital tendinosis, SLAP position: seated, 90 elbow flexion, forearm pronated action: palpate bicipital groove, pt resists supination of forearm positive: pain/tender without popping indicates tendinopathy or SLAP, popping indicates torn transverse humeral ligament
45
Speed's test
purpose: SLAP, bicipital tendinosis position: elbow extended, forearm supinated action: pt performs AROM flexion to 90, then resist shldr flexion positive: pain/tender in bicipital groove
46
ULTT 1
purpose: identifies peripheral nerve dysfunction, median bias position: supine, depressed shoulder girdle action: abd 110, ER, forearm supination, then extend elbow, wrist, and fingers positive: reproduction of symptoms, side to side diff of 10 degrees, CL SB increases symptoms and IL SB decreases symptoms
47
thoracic outlet syndrome tests
adson's test roos test
48
Adson's test
purpose: thoracic outlet, vascular component position: seated, arms 15 deg abd, inhale deeply and hold breath, tilt head back and rotate towards testing side action: PT checks pulses before and during positive: change in pulse, paresthesia
49
Roos test
purpose: thoracic outlet position: seated, arms 90 abd, 90 elbow flexion action: pt does slow finger clenching for 3 min positive: unable to maintain position, pain, heaviness, N/T, disappearance of pulse
50
Frozen shoulder testing
ROM limitations in capsular pattern (PROM), compare to unaffected side 1. ER (loss of 50% or <30 degrees) 2. Abd 25% loss of motion 3. Flexion 25% loss of motion
51
Scapulothoracic special tests
lateral scapular slide test dynamic scapular dyskinesias
52
lateral scapular slide test
distance of inferior angle from spinous process with arms at side, hands on hips, arms at 90 positive: 1.5+ cm difference between sides
53
dynamic scapular dyskinesia testing
active flexion/abduction with small weight positive: medial border winging, inferior angle winging, dysrhythmia including premature shoulder elevation, non symmetrical upward rotation, rapid descent
54
subscapularis stretch
retract scap with fingers under medial border pin humerus back with towel/body pull scapula away from body perform if limited ER with arms at side ther ex: active ER, abduction w ER
55
levator stretch
1 hand superior scap, 1 inferior rotate scapula upwards and pull inferior angle away from body ther ex: levator stretch w arm behind head
56
shoulder close pack
90 abd full ER or full abd and ER
57
shoulder open pack
55 abd, 30 h. add
58
shoulder capsular pattern
ER>abd>IR
59
name of types of scapular dysfunction
Kibler types
60
Kibler type 1
inferior medial border is more prominent
61
causes of kibler type 1
results from anterior tilt of scapula tight pec minor/biceps SH LT, lat, serratus weakness
62
kibler type 2
medial border off of ribs worse w hands on hips glenoid fossa pointed anterior straining anterior capsule
63
cause of kibler type 2
serratus and LT weakness
64
kibler type 3
superior border of scapula elevated
65
causes of kibler type 3
tight UT weak LT

517 Ortho (11 decks)

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