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NMS I Exam 2 > Tests for the Shoulder > Flashcards

Flashcards in Tests for the Shoulder Deck (37)
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Procedure for Apley's Test

The patient is seated and is instructed to place the affected hand behind the head and touch the opposite superior angle of the scapula. The patient is then instructed to place the hand behind the back and attempt to touch the opposite inferior angle of the scapula. Exacerbation of the patient's pain indicates degenerative tendinitis of one of the tendons of the rotator cuff, usually the supraspinatus tendon


Purpose of Apley's Test

To evaluate range of motion of the shoulder joint


Clinical indications for Apley's Test

This result indicates tendinitis of the supraspinatus tendon. Note the location of pain-it will help identify the etiology


Procedure for the Apprehension Test

The examiner abducts and externally rotates the patient's shoulder. A positive test is indicated when the patient shows apprehension or alarm and resists further motion. The patient also may state that such rotation elicits a feeling that resembles the pain felt when the shoulder was previously dislocated. This test must be performed slowly. If the test is done too quickly, there is a chance that the humerus will dislocate. A positive test indicates anterior shoulder dislocation trauma. In determining the trauma resulting from posterior shoulder dislocation, the examiner flexes and internally rotates the patient's shoulder. The examiner then applies a posterior force on the patient's elbow. A positive result is indicated if the patient exhibits a look of alarm or feeling of apprehension and resists further motion. A positive test indicates a posterior dislocation of the humerus


Purpose of the Apprehension Test

To evaluate for the laxity of the shoulder joint


Clinical indications for the Apprehension Test

A positive result is indicated if the patient exhibits a look of alarm or feeling of apprehension and resists further motion


Procedure for Codman's Sign

The patients arm is passively abducted. The examiner suddenly removes support at some point above 90 degrees, which makes the deltoid contract suddenly


Codman's Sign is also known as what

Drop Arm Test


Purpose of Codman's Sign

To evaluate for possible supraspinatus tendon injury (rotator cuff injury)


Clinical indications for Codman's Sign

If shoulder pain occurs and there is a hunching of the shoulder due to the absence of rotator cuff function, the sign is present for rotator cuff tear or, more specifically, rupture of the supraspinatus tendon. The test is positive if the patient is unable to return the arm to the side slowly or has severe pain. A positive test indicates a tear in the rotator cuff complex. Note the location of pain


Procedure for Dawbarn's Sign

With the patient's arm comfortably at the side. deep palpation of the shoulder by the examiner elicits a well-localized, tender area. With the examiner's finger still on the painful spot, the patient's arm is passively abducted by the examiner's other hand. The sign is present if as the arm is abducted, the painful spot under the examiner's nonmoving finger disappears. The sign is significant for subacromial bursitis


Purpose of Dawbarn's Sign

Evaluate for subacromial bursitis


Clinical indications for Dawbarn's Sign

This result indicates subacromial bursitis


Procedure for Dugas' Test

The patient places the hand of the affected shoulder on the opposite shoulder and attempts to touch the chest with the elbow. The test is positive if the patient cannot touch the chest wall with the elbow. The test is positive in shoulder dislocation


Purpose of Dugas' Test

Checking for laxity of the shoulder joint for propensity for dislocation


Clinical indications for Dugas' Test

This result indicates propensity for shoulder dislocation


Procedure for Impingement Sign

The patient's arm is slightly abducted and moved fully through flexion by the doctor, this causes a jamming of the greater tuberosity against the anteroinferior acromial surface. Pain in the shoulder is a positive test result. Note the location of the pain


Purpose of Impingement Sign

Examination for possible supraspinatus and/or bicepital irritation as well as degenerative joint disease


Clinical indications for Impingement Sign

The test indicates an overuse injury to the supraspinatus and sometimes to the biceps tendon. Note the location of pain-helps identify etiology


Procedure for Speed's Test

The doctor provides resistance to flexion of the shoulder by the patient


Purpose of Speed's Test

Evaluate for possible bicepital tendonitis


Clinical indications for Speed's Test

A positive test (pain in the bicipital groove) indicates Bicipital tendinitis


Procedure for Supraspinatus Press Test

The patient's shoulder is abducted to 90 degrees, and the doctor provides resistance to this abduction. The shoulder is then medially rotated and angled 30 degrees forward so the patient's thumbs point to the floor. The doctor then provides resistance to abduction while observing for weakness or pain. If the patient exhibits weakness or experiences pain, the test is positive, which indicates a tear of the supraspinatus tendon or muscle


Purpose of Supraspinatus Press Test

Evaluate for possible supraspinatus tear and/or rupture


Clinical indications for Supraspinatus Press Test

If the patient exhibits weakness or experiences pain, the test is positive, which indicates a tear of the supraspinatus tendon or muscle


Procedure for Yergason's Test

The patient flexes the elbow while seated. The doctor resists the patient's attempt to supinate the hand. Then the patient resists the examiner's efforts to extend the affected upper extremity. The test is positive if pain over the intertubercular groove develops or is aggravated.A positive sign indicates tenosynovitis or a "pop" over the transvers humeral ligament. This test is not conclusive because motion does not occur between the tendon and the bicipital groove during the test. Biceps tendon pain tends to occur during motion rather than during tension.


Purpose of Yergason's Test

Evaluate for possible transverse humeral ligamnet rupture and/or bicepital tendonitis


Clinical indications for Yergason's Test

A positive sign indicates tenosynovitis or involvement of the transverse humeral ligament. Pain indicates bicipital denonitis. Hearing a "click" indicates torn transverse humeral ligament


Procedure for Load and Shift Test

With the doctor stabizing the scapula with one hand and grasping the humeral head with the other, the doctor loads the shoulder by pushing in towards the glenoid, then pushes forward to test anterior stability and finally pulls backwards to test posterior stability. The examiner then pulls down on the arm to test inferior stability


Purpose/Function of Load and Shift Test

Test for instability or loosening of the shoulder. This test is reserved for those patients with past history of dislocation or medical subluxation and those individuals who are suspected of having generalized joint laxity. Function: this stresses the supporting ligaments of the shoulder joint