Special Physical Exam Test Flashcards
Drop arm test
Rotator Cuff
Purpose: To test for injury, weakness or tears in the rotator cuff, primarily supraspinatus muscle
Method: patient abducts arm and then slowly lowers it. May be able to lower arm slowly to 90 degrees. Arm will then drop to side if notator cuff is injured.
Positive test: patient unable to lower arm further with control. If able to hold at 90 degrees pressure on wrist will cause arm to fall.
Neer’s Sign
Rotator cuff-Impingement
Patient seated with arm at side, palm down (pronated)
Examiner stabilizes scapula and raises the arm (between flexion and abduction)
Positive test=pain
Neer’s impingement sign is elicited when the patient’s rotator cuff tendons are pinched under the coracromial arch.
Hawkin’s Test
Rotator cuff-impingement
Patient standing
Examiner forward flexes shoulder to 90 degrees, then forcibly internally rotates the arm.
Positive test=pain in area of superior glenohumoral or AC joint
Pain with this maneuver suggest subacromial impingement or rotator cuff tendonitis. One study found Hawkin’s test more sensitive for impingement than Neer’s test
Speed’s Test
Biceps tendon
Forward flex shoulder against resistance while maintaining elbow in extension and forearm in supination.
Positive test= tender bicipital groove (bicipital tendonitis)
O’Brien’s Active Compression Test
Labral Tear (SLAP lesion)
Patient standing
Arm forward flexed at 90 degrees, adducted 15 to 20 degrees with elbow straight
Full internal rotation so thumb pointing down
Examiner applies downward force on arm-patient resists
Patient externally rotates so thumb pointing up
Examiner applies downward force on arm-patient resists
Positive test= Pain or painful clicking elicited with thumb down and decreased or eliminated with thumb up
Crank Test
Labral tear (SLAP lesion)
Shoulder elevated to 160 degrees in the scapular plane
A gentle axial load is applied through the glenohumoral joint with one hand, while other hand does internal and external rotation
Positive test= pain, catching, or clicking in the shoulder
Apprehension Test-sitting
Glenohumoral Joint Stability
90 degrees of abduction
Examiner applies slight anterior pressure to humerus and externally rotates arm
Positive test= patient expresses apprehension (concern that the glenohumoral joint may dislocate)
May indicate a loose capsule and/or ligaments
Apprehension Test-supine
Patient in supine position with affected shoulder at edge of table, are abducted 90 degrees
Examiner externally rotates by pushing forearm posteriorly
Positive test=patient expresses apprehension
Relocation Test
Glenohumeral Joint Stability
Performed after positive result on anterior apprehension test
Patient supine
Examiner applies posterior force on proximal humerus while externally rotating a patients arm
Positive test= patient expresses relief
