shoulder OSCE

Question 1

what are the 3 true synovial joints in the shoulder

Answer 1

glenohumeral
sternoclavicular
acromioclavicular

Question 2

2 functional joints

Answer 2

suprahumeral

scapulathoracic

Question 3

2 accessory joints

Answer 3

costosternal

costovertebral

Question 4

T levels for spine of scapula and inf. border of scapula

Answer 4

spine of scapula - level of T3

inf. border of scapula - level of T7

Question 5

rotator cuff muscles

Answer 5

supraspinatus
infraspinatus
teres minor
subscapularis (not palpable)

Question 6

joints involved in early shoulder abduction

Answer 6

glenohumeral

suprahumeral

Question 7

joints involved in late shoulder abduction

Answer 7

scapulothoracic
sternoclavicular
acromioclavicular

Question 8

GH joint ROM

Answer 8

flexion - 180 sagittal plane
extension - 60 sagitall plane
abduction 180 coronal plane
adduction 40-50 coronal and transverse plane
int. ext. rotation 90 
horziontal abduction 130-145
horizontal aDduction 40-50

Question 9

to check for SD we load into GH joint and translate it

Answer 9

ant/ inferior

pos/ superior

Question 10

normal AC joint is

Answer 10

10 degrees both ways

IR of GH = IR of AC and vice versa

Question 11

to maximize AC joint motion you bring GH joint into

Answer 11

60 coronal abduction and

60 horizontal adduction

Question 12

SD more common for SC joint

Answer 12

• horizontal extension SD (restriction in horizontal flexion) more common
• adduction SD (restriction in abduction) more common

Question 13

upward rotation of the scapula is

Answer 13

forward tilt - turning on A-P axis so posterior surface faces upward and inferior angle protrudes

Question 14

downward rotation of the scapula is

Answer 14

backward tilt - turning on AP axis so posterior surface faces downward and inferior angle comes anterior

Question 15

checking scapula your cephalad hand is.. and caudad hand is…

Answer 15

cephalad at acromion process

caudad at inferior scapular angle

Question 16

muscles involved in elevating/ depressing scapula

Answer 16

elevate - trapezius and levator scapulae

depress - trapezius and lower rhomboids (R. major)

Question 17

protracting/ abducting scapula

retracting/ adducting scapula

Answer 17

pro / ab - serratus anterior

ret/ add - rhomboids and middle trapezius

Question 18

upward/ downward rotation of scapula

Answer 18

upward - serratus anterior and upper trapezius

downward - levator scapulae, rhomboid major and minor, lat. dorsi

Question 19

flexion/ extension at shoulder girdle muscles

Answer 19

flexion - ant. deltoid and coracobrachialis

extension - lat. dorsi and teres major

Question 20

abduction/ adduction at shoulder joint

Answer 20

abduction - supraspinatus (first 10-15) and mid-deltoid (remainder of 180)
adduction - pec. major and lat. dorsi

Question 21

int. rotation/ external rotation at shoulder joint muscles

Answer 21

int. rotation - subscapularis and pec. major (lift off test)
ext. rotation - infraspinatus and teres minor

Question 22

shoulder shrug muscles

Answer 22

trapezius and levator scapulae

Question 23

scapular retraction muscles and test

Answer 23

rhomboid major and minor

- grasp upper arm/ shoulder and resist position of “attention”

Question 24

scapular protraction muscles and test

Answer 24

serratus anterior
stabilize spine, grasp flexed elbow and resist forward motion
or have patient do a wall push-up