Shoulder Pain/Exam Flashcards
(27 cards)
Name the 4 muscles involved in the rotator cuff. Which one is most commonly injured?
Supraspinatus M. (most common), Infraspinatus M., Teres Minor M., and Subscapularis M.
What are the 4 top causes of chronic shoulder pain?
rotator cuff disorder, adhesive capsulitis, shoulder instability, and shoulder arthritis
Which rotator cuff muscle is not palpable?
Subscapularis M.
Arm Flexion
180 - anterior deltoid and coracobrachialis
Arm Extension
60 - latissimus dorsi and teres major
Arm Abduction
180 - deltoid and supraspinatus
Arm horizontal adduction
130-140 - pectoralis major and latissimus dorsi
arm horizontal abduction
40-55 - supraspinatus and teres minor
arm external rotation
90 - infraspinatus and teres minor
arm internal rotation
90 - supscapularis and pectoralis minor
Biceps reflex
C5
Brachioradialis reflex
C6
Triceps reflex
C7
Apprehension Test
shoulder abducted to 90 and elbow flexed to 90; stabilize shoulder w/ 1 hand and force arm into external rotation with other
(+) = pt apprehensive of repeat dislocation
Indicates: glenohumeral instability
Sulcus Sign
stabilize shoulder, grasp pt’s elbow and pull down
(+) = indentation appears beneath acromion
Indicates: glenohumeral instability
Yergason’s Test
pt’s arm at side w/ elbow flexed to 90; palpate bicipital groove with one hand and grasp pt’s wrist w/ other; have pt supinate and externally rotate against resistance
(+) = pain and/or tendon subluxation out of groove
Indicates: unstable bicipital
Speed’s Test
pt’s arm flexed (50-90) at shoulder w/ arm supinated; slightly flex pt’s elbow and resist at forearm while pt flexes shoulder; monitor bicipital groove
(+) = pain in bicipital groove
Indicates: bicipital tendonitis of long head of biceps
Empty Can Test
pt’s shoulder flexed to 90 and arms horizontally abducted to 45; internally rotate both arm and press down on forearms while pt resists
(+) = pain or weakness
Indicates: rotator cuff pathology (specifically supraspinatus)
Drop Arm Test
Pt abducts arm then slowly drops arm
(+) arm will drop abruptly or gentle tap on wrist will cause arm to drop
Indicates: full thickness tear of supraspinatus
painful arc test
pt abducts arm starting at their side
(+) pain elicited within 60 and 120 degrees
Indicates: subacromial impingement and/or rotator cuff injury
Neer Impingement
stabilize pt’s shoulder and with forearm pronated, passively flex shoulder into fully flexed position
(+) = pain
Indicates: subacromial bursa or rotator cuff impingement
Hawkins Test
flex shoulder and elbow to 90 and passively rotate humerus into internal rotation
(+) = pain
Indicates: rotator cuff or subacromial bursa impingement
Lift Off Test
place pt’s arm into internal rotation and extension (behind their back); pt pushes arm further into internal rotation as physician resists
(+) = weakness
Indicates: subscapularis weakness
Cross Arm Test
physician passively adducts pt’s arm across their chest and rests it on opposite shoulder
(+) = pain in AC joint with end range adduction
Indicates: AC joint pathology
