week 5 - shoulder

Question 1

What are some subjective questions for the shoulder?

Answer 1

Age
Previous capsulitis
previous dislocation/instability
clicking
neck pain
altered sensation
functional activities
hand dominance

Question 2

What are some shoulder specific red flags?

Answer 2

cardiac issues - left shoulder/arm pain
Loss of E.R could indicate tumour

Question 3

What clinical tests attempt to diagnose rotator cuff related shoulder pain?

Answer 3

Hawkins-Kennedy test
empty can test

Question 4

What special tests look for rotator cuff tear?

Answer 4

drop arm sign
lift off sign

Question 5

What special test is for shoulder instability?

Answer 5

apprehension test

Question 6

Name some common signs of rotator cuff related pain

Answer 6

pain and impairment of shoulder movement and function, usually during shoulder elevation and lateral rotation
painful to lie on affected side
commonly affects 30-50 age range
painful AROM commonly into abduction
reduced pain on passive movement

Question 7

What are some common signs and symptoms of frozen shoulder?

Answer 7

Age
gender
history of smoking
diabetes
global shoulder pain
difficulty moving arm in various positions due to pain/stiffness
reduced AROM
reduced passive range of movement

Question 8

What should you look for when observing the shoulder?

Answer 8

scapular position
scapular orientation
head of humerus
cervical position
thoracic spine
muscle tone

Question 9

What movements occur at the shoulder girdle?

Answer 9

elevation
depression
protraction
retraction

Question 10

What movements occur at the glenohumeral joint?

Answer 10

flexion
extension
abduction
lateral rotation
medial rotation
horizontal flexion
horizontal extension

Question 11

What accessory movements are there at the glenohumeral joint?

Answer 11

AP
PA
distraction
longitudinal caudad

Question 12

What accessory movements are there at the acromioclavicular joint?

Answer 12

AP

Question 13

What accessory movements are there at the scapular clavicular joint?

Answer 13

AP

Question 14

What is a positive for Hawkins-Kennedy test?

Answer 14

passive flexion to 90 degrees

Question 15

How do you carry out Hawkins-Kennedy test?

Answer 15

passive flexion to 90 degrees
fix scapula
passively medially rotate humerus

Question 16

How do you carry out full can/empty can test?

Answer 16

90 degrees in scapular plane
full MR
maintain position whilst therapist pushes down

Question 17

What is a positive for the empty/full can test?

Answer 17

weakness/pain or both
weakness is more accurate for tears

Question 18

How do you carry out apprehension/Jobes relocation test?

Answer 18

supine lying
abduct arm to 90 degrees
externally rotate arm
Repeat test with AP glide to head of humerus

Question 19

What is a positive for the Apprehension/Jobes relocation test?

Answer 19

apprehension -> fear, muscle spasm, conscious limitation of movement (NOT PAIN)
after relocation -> increased ROM/reduction in apprehension

Question 20

How do you carry out the lift off test?

Answer 20

standing position]patient lifts hand off back
must maintain this position

Question 21

What is a positive for the lift off test?

Answer 21

problems if lack of movement or pain will reduce contraction

Question 22

How do you carry out drop arm sign?

Answer 22

stand behind the seated patient and passively abduct the patients arm to 90 degrees and full external rotation, while supporting the arm at the elbow
release the elbow support and ask patient to slowly lower the arm back to neutral

Question 23

What is a positive drop arm sign?

Answer 23

it is a positive test if there is a sudden drop of the arm or weakness in maintaining arm position