ASCM Clinical Skills Shoulder. LOOK Inspection Swelling, bony prominence Swelling, bony prominence Bruising / lacerations Bruising / lacerations Position.

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Presentation transcript:

ASCM Clinical Skills Shoulder

LOOK

Inspection Swelling, bony prominence Swelling, bony prominence Bruising / lacerations Bruising / lacerations Position of arm Position of arm Asymmetry Asymmetry Atrophy Atrophy Surgical scars Surgical scars

FEEL

Palpation Expose both shoulders Palpate bony prominences Soft tissue palpation, least tender areas first Compare to contralateral side

AC Joint

MOVE

ACTIVE PASSIVE ABNORMAL Compare both shoulders

Range of Motion Forward Flexion: 180°

Range of Motion Abduction: 180°

Range of Motion External Rotation: 60-80°

Range of Motion Internal Rotation: T7

Range of Motion Internal Rotation at 90° Forward Flexion: 90°

Rotator Cuff Injury Tendonopathy or tear Partial or complete Acute or chronic

Rotator Cuff Injury Jobe Test: Supraspinatus Middle deltoid

Rotator Cuff Injury External Rotation: Teres minor Infraspinatus

Rotator Cuff Injury Internal Rotation: Subscapularis Pectoralis major Latissimus dorsi

Rotator Cuff Injury Drop Arm Test: Unable to resist pressure at 90° abduction Drop Arm Test: Unable to resist pressure at 90° abduction Painful Arc: Between 45 ° and 120° abduction Painful Arc: Between 45 ° and 120° abduction

Impingement Usually subacromial space Irritation between AC joint, RC tendons and bursae

Impingement Neer’s Test

Impingement Hawkin’s Test

Biceps tendonitis/tear Usually long head Related to overuse/activity Anterior shoulder pain Acute or chronic Weakness with resisted flexion/supination

Biceps Tendon

Biceps tendonitis Yergason’s Test

Biceps tendonitis Speed’s Test

AC Joint arthritis Crossed Adduction Test

GH Joint Laxity Apprehension Test Relocation

GH Joint Laxity Sulcus Sign

GH Joint Laxity Load and Shift Test

Referred Pain Neck Neck Elbow Elbow Heart Heart Diaphragmatic Diaphragmatic Pan coast Pan coast

Neurological Examination Radial nerve – Thumbs up Radial nerve – Thumbs up Median nerve – Thumb to hypothenar eminence Median nerve – Thumb to hypothenar eminence Ulnar nerve – Abduct V Ulnar nerve – Abduct V Axillary nerve - Deltoid Axillary nerve - Deltoid