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NPTE > Shoulder Special Tests > Flashcards

Shoulder Special Tests Flashcards

(84 cards)

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1
Q

Yergason’s Test - purpose

A

integrity of transverse ligament - may indicate bicipital paratenonitis/tendinosis

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2
Q

Yeargason’s Test - description

A

elbow flexed to 90d and stabilized against the thorax and with forearm pronation. resist supination of forearm and ER of shoulder

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3
Q

Yeargason’s Test - result

A

tendon of long head of biceps will pop out of the groove. tenderness in bicipital groove alone without the dislocation may indicate bicipital paratenonitis/tendinosis

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4
Q

Speed’s Test - purpose

A

identify bicipital tendinosis/tendinopathy

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5
Q

Speed’s Test - description

A

UE full extension and forearm spination, resist shoulder flexion. ALT - place shoulder in 90d flexion and puss into extension

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6
Q

Speed’s Test - result

A

pain in long head of biceps tendon/increased tenderness in the bicipital groove

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7
Q

special test for bicipital tendinosis/tendinopathy

A

yergason’s and speed’s

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8
Q

Neer’s Impingment Test - purpose

A

impingement of supraspinatus and biceps tendon

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9
Q

Neer’s Impingment Test - description

A

patient’s arm in passively and forcibly fully elevated in scapular plane with the arm MR by examiner. passive stress causes greater tuberosity to jam against the anteroinferior border of the acromion

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10
Q

Neer’s Impingment Test - result

A

reproduces symptoms of pain in the shoulder region

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11
Q

Empty Can / Jobe Test - purpose

A

indentify tear/impingement of Supraspinatus tendon or supra scapular nerve neuropathy

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12
Q

Empty Can / Jobe Test - description

A

pt’s arm is abducted to 90d and neutral, and examiner provides resistance to abd. shoulder then MR and angled in scapular position (30d)

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13
Q

Empty Can / Jobe Test - result

A

reproduces pain in supraspinatus tendon or weakness in empty can position

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14
Q

Drop Arm Test (Codman’s Test) - purpose

A

identify tear/fulll rupture of rotator cuff

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15
Q

Drop Arm Test (Codman’s Test) - description

A

examiner abducts pt’s shoulder to 90d and then ask the pt to slowly lower the arm to the side in the same arc of movement

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16
Q

Drop Arm Test (Codman’s Test) - result

A

(+) pt is unable to return arm to the side slowly or has severe pain when attempting to do so

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17
Q

Posterior Internal Impingement Test - purpose

A

to identify impingement between rotator cuff and greater tuberosity or posterior glenoid and labrum

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18
Q

Posterior Internal Impingement Test - description

A

pt is placed in the supine lying position. examiner passively abducts the shoulder to 90 - 110d, with 15-20d extension and max LR

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19
Q

Posterior Internal Impingement Test - result

A

reproduction of pain in posterior shoulder during test

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20
Q

Hawkins-Kennedy Impingement Test - purpose

A

identify subacromial impingement

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21
Q

Hawkins-Kennedy Impingement Test - description

A

pt’s arm is passively flexed up to 90d in the plane of the scapula. arm is stabilized and forearm is forced into IR

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22
Q

Hawkins-Kennedy Impingement Test - result

A

pain = (+) for supraspinatus paratenonitis/tendinosis or secondary impingement

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23
Q

Yocum Test - all

A

modification of Hawkins-Kennedy.

pt’s hand placed on opposite shoulder and examiner elevates elbow.

(+) pain

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24
Q

Horn Blower’s Sign (Patte Test) - purpose

A

detect rotator cuff tears involving teres minor

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25
Horn Blower's Sign (Patte Test) - description
sitting or standing. pt's arm supported at 90d of abduction in scapular plane, with elbow flexed to 90d. pt asked to rotate the forearm externally against the resistance of clinician's hand
26
Horn Blower's Sign (Patte Test) - result
if pt is unable to ER shoulder in position
27
Active Compression Test of O'Brien - purpose
detect SLAP type 2 or superior labral lesions
28
Active Compression Test of O'Brien - description
pt standing with shoulder at 90d flexion, 10d horizontal add, and max IR with elbow in extension. pt resists downward force applied to distal arm. repeat test with arm in max ER
29
Active Compression Test of O'Brien - result
pain on joint line or painful clicking produced inside shoulder during max IR and eliminated or decreased during max ER. (+) = labral abnormalities
30
Biceps Load Test - purpose
check the integrity of the superior labrum - SLAP lesions
31
Biceps Load Test - description
patient supine or seated with shoulder abducted to 120d and ER with elbow flexed to 90d and forearm supinated. examiner performs an apprehension test on the pt by taking arm into full ER. if apprehension appears, examiner stops ER and holds the position. pt is then asked to flex the elbow against the examiner's resistance at the wrist
32
Biceps Load Test - result
(-) if apprehension decreases or pt feels more comfortable (+) if apprehension remains the same or the shoulder becomes more painful
33
Lateral Rotation Lag Sign (Spring Back test) - purpose
test teres minor and infraspinatus
34
Lateral Rotation Lag Sign (Spring Back test) - description
pt seated or standing with arm by side and elbow flexed to 90s. examiner passively abducts arm to 90s in scapular plan, ER shoulder to end range and asks pt to hold it
35
Lateral Rotation Lag Sign (Spring Back test) - result
(+) pt cannot hold position and hand springs back anteriorly toward midline - infraspinatus and teres minor cannot hold position due to weakness or pain
36
Abdominal Compression Test (Belly-Press/Napoleon Test) - purpose
checks the subscapularis muscle
37
Abdominal Compression Test (Belly-Press/Napoleon Test) - description
pt standing, examiner places a hand on the abdomen below the diploid process so the examiner can feel how much pressure the pt is applying tot he abdomen. pt places his hand of the shoulder being tested on the examiner's hand and pushes the hand as hard as into he stomach (shoulder MR). while pushing the hand into the abdomen, the pt attempts to bring the elbow forward tot he scapular plane, causing greater shoulder MR
38
Abdominal Compression Test (Belly-Press/Napoleon Test) - result
(+) if pt unable to maintain pressure on examiner's hand while moving the elbow forward, or posteriorly flexes the wrist or extends the shoulder = tear of subscapularis muscle
39
Lift Off Sign (Gerber's Test) - purpose
to detect a lesion of the subscapularis muscle
40
Lift Off Sign (Gerber's Test) - description
pt places the dorm of the hand on his back pocket or against the mid-lumbar spine. pt lifts the hand away from the back
41
Lift Off Sign (Gerber's Test) - result
(+) inability to do so indicates a lesion of the subscapularis muscle
42
Jerk Test - purpose
to test recurrent posterior instability
43
Jerk Test - description
pt sits with the arm medially rotated and forward flexed to 90d. examiner grasps pt's elbow and axially load the humerus in a proximal direction. while maintaining the axial loading, the examiner moves the arm horizontally across the body
44
Jerk Test - result
(+) production of sudden jerk or clunk as the humeral head slides off (sublimes) the back of the glenoid. when the arm its returned to the original 90d abduction position, a second jerk may be felt as the head reduces
45
Sulcus Sign - purpose
test for inferior shoulder instability
46
Sulcus Sign - description
pt stands with the arm by the side and shoulder muscles relaxed. examiner grasps the pt's forearm below the elbow and pulls the arm distally
47
Sulcus Sign - result
presence may indicate inferior instability or glenohumeral laxity but should only be considered (+) for instability if the pt is symptomatic
48
Pectoralis Major Contracture Tests - purpose
to identify tightness of pest major muscle
49
Pectoralis Major Contracture Tests - description
pt lies supine and clasps the hands together behind the head. arms are then lowered until elbow touch the examining table
50
Pectoralis Major Contracture Tests - result
(+) if elbow do not reach the table and indicates a tight pest major muscle
51
Halstead Maneuver - purpose
identify pathology of structures that pass through thoracic inlet
52
Halstead Maneuver - description
examiner finds radial pulse and applies a downward traction on the test extremity while the pt's neck is hyperextended and head is rotated to opp side
53
Halstead Maneuver - result
(+) absence or disappearance of a pulse = thoracic outlet syndrome
54
Clunk Test - purpose
identifies glenoid labrum tear
55
Clunk Test - description
pt supine, with shoulder in full abduction. push humeral head anteriorly, while rotating humerus externally
56
Clunk Test - result
audible clunk heard while performing test
57
Anterior Apprehension/Crank Test - purpose
identify past anterior dislocation of shoulder
58
Anterior Apprehension/Crank Test - description
pt supine, examiner abducts the arm to 90d and ER pt's shoulder slowly. by placing a hand under the GH joint to act as a fulcrum, apprehension test becomes the fulcrum test
59
Anterior Apprehension/Crank Test - result
pt does not allow or does not like to move shoulder into ER to simulate anterior dislocation
60
Posterior Apprehension Sign - purpose
to identify past history of posterior shoulder dislocation
61
Posterior Apprehension Sign - description
pt supine/sitting. examiner elevates pt's shoulder in scapular plane to 90d while stabilizing the scapula with the other hand, then applies a posterior force on the pt's elbow. while applying the axial load, the examiner horizontally adducts and MR the arm
62
Posterior Apprehension Sign - result
pt does not allow or does not like to move shoulder into that direction to simulate posterior dislocation
63
Acromioclavicular Shear Test - purpose
identifies dysfunction of AC joint (arthritis, separation)
64
Acromioclavicular Shear Test - description
pt sitting; examiner cups his or her hands over the deltoid muscle with one hand on the clavicle and one hand on the spine of the scapula. examiner then squeezes the heels of the hands together
65
Acromioclavicular Shear Test - result
reproduction of pain in the AC joint
66
Adson's Test - purpose
identify pathology of structures that pass through thoracic inlet
67
Adson's Test - description
examiner locates the radial pulse. pt's head is rotated to face test shoulder. pt then extends the head while examiner LR and extends the pt's shoulder. pt is instructed to take a deep breath and hold it
68
Adson's Test - result
(+) a disappearance of the pulse
69
Costoclavicular Syndrome (Military Brace) Test - purpose
identifies pathology of structures that pass thought the thoracic inlet
70
Costoclavicular Syndrome (Military Brace) Test - result
(+) absence of pulse and implies possible thoracic outlet syndrome (costoclavicular syndrome). test is particularly effective in pts who complain of symptoms while wearing a backpack or heavy coat
71
Wright (Hyperabduction) Test - purpose
identify pathology of structures that pass through thoracic inlet
72
Wright (Hyperabduction) Test - description
pt sitting, locates radial pulse of extremity being tested. move shoulder into max abduction and ER. taking deep breath and rotating head opposite to test site may accentuate symptoms
73
Wright (Hyperabduction) Test - result
neurological/vascular symptoms (disappearance of pulse) will be reproduced
74
Roos Test (Elevated Arm Stress Test) - purpose
identify pathology of structures that pass through thoracic inlet
75
Roos Test (Elevated Arm Stress Test) - description
pt stands and abducts the arm to 90d, LR shoulder, and flexes the elbows to 90d so that the elbows are slightly behind the frontal plane. pt then opens and closes hands slowly for 3 min
76
Roos Test (Elevated Arm Stress Test) - result
if pt is unable to keep arms in starting position for 3 min or suffers ischemic pain, heaviness, or profound weakness of the arm, or numbness and tingling of the hand = (+) for affected side
77
Upper Limb Tension Test - position
shoulder depression and abduction (110d); elbow extension; forearm supination; wrist extension; fingers + thumb extension; C-spine contralto side flexion
78
Upper Limb Tension Test 1 - purpose
test median nerve, anterior interosseous nerve, C5-7
79
Upper Limb Tension Test 2 - postition
shoulder depression and abduction (10d) and lateral rotation ; elbow extension; forearm supination; wrist extension; fingers + thumb extension; c-spine contralat side flexion
80
Upper Limb Tension Test 2 - purpose
test median nerve, musculocutaneous nerve, and axillary nerve
81
Upper Limb Tension Test 3 - position
shoulder depression, MR, abduction (40d), and extension (25d); elbow extension; forearm pronation; wrist flexion and ulnar deviation; fingers + thumb flexion; c-spine contralto side flexion
82
Upper Limb Tension Test 3 - purpose
test radial nerve
83
Upper Limb Tension Test 4 - position
shoulder depression, abduction (10d - 90d), LR, and hand to ear; elbow flexion; forearm supination/pronation; wrist extension and radial deviation; finger + thumb extension; c-spine contralto side flexion
84
Upper Limb Tension Test 4 - purpose
ulnar nerve; C8-T1 nerve roots

NPTE (17 decks)

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