Shoulder

Question 1

what is the cross arm test?

Answer 1

1. Passively adduct patient’s arm across chest wall with humerus parallel
   to the ground so free hand of the examined elbow rests on the opposite
   shoulder
2. Patient pushes elbow superiorly against the clinician’s resistance

Positive => pain with end-range adduction or with pushing arm up

Question 2

what are the findings for cross arm test?

Answer 2

acromioclavicular joint pathology

Question 3

what is the active compression test

Answer 3

1. Patient flexes arm to 90 and adducts 10-15 with internal rotation
   (thumb down)
2. Patient resists examiners downward force – maneuver repeated with
   arms supinated

Positive => pain in AC joint or shoulder during the first maneuver that
improves for resolves with the second maneuver

Question 4

what are the findings for the active compression test?

Answer 4

If pain in AC joint -
acromioclavicular joint pathology

If pain in internal shoulder –labral
(slap lesion) pathology

Question 5

what is the scapular wining

Answer 5

1. Have patient do a push-up off the wall

Positive => scapula wings

Question 6

what are the findings for scapular winging?

Answer 6

weakness of serratus anterior or long thoracic nerve

Question 7

what is the Yergason’s test

Answer 7

1. Patient seated with elbow at side and forearm flexed to 90 degrees
2. Examiner palpates long head of biceps with one hand while holding the
   wrist with other
3. Patient simultaneously flexes their elbow and supinates their forearm
   against resistance

Positive => tendon will pop out of groove and cause significant pain

Question 8

what is the findings for Yergason’s test

Answer 8

unstable bicipital tendon and subluxation

Question 9

what is the speed’s test

Answer 9

1. Shoulder in 90 of forward flexion, elbow extended, and hand
   supinated, with resistance applied downward

Positive => pain in bicipital groove

Question 10

what is the finding for speed’s test?

Answer 10

bicipital tendon pathology - usually tendinitis

Question 11

what is the empty can or Jobe’s test

Answer 11

1. Patient abducts both arms to 90 degrees and forward flexes 45 degrees with thumbs
   pointing down to ground
2. Patient resists downward pressure

Positive => weakness, pain, or dropping of the arm

Question 12

what are the finding for empty can/Jobe’s test

Answer 12

Dropping – significant tear of
supraspinatus muscle with even gentle tap
Supraspinatus tendon tear

Question 13

what is the full can test

Answer 13

1. Same as empty can but thumbs point to ceiling
2. Patient resists downward pressure

Positive => weakness, pain, or dropping of arm

Question 14

what are the findings for full can test?

Answer 14

Dropping – significant tear of
supraspinatus muscle with even gentle tap
Supraspinatus tendon tear

Question 15

what is the neer impingement sign

Answer 15

1. Examiner stabilizes patients’ shoulder on top with off hand
2. Forward flex humerus in scapular plane to 180 with the arm medially
   rotated

Positive => pain in shoulder

Question 16

what are the findings of neer impingement sign

Answer 16

Impingement pathology – usually supraspinatus or biceps tendon

Question 17

what is the painful arc test

Answer 17

1. Patient abducts arm overhead as far as they can go

Positive => pain with shoulder abduction between 70-100

Question 18

what is the findings for painful arc test

Answer 18

Rotator cuff impingement pathology

Pain after 100 degrees of abduction
suggests AC joint pathology

Pain immediately with abduction may indicate frozen shoulder

Question 19

what is the drop-arm test

Answer 19

1. Examiner abducts patient’s shoulder to 90 degrees and asks patient to slowly
   lower arm to side in same arc movement

Positive => patient unable to return arm to side slowly or has severe pain
when attempting

Question 20

what is the findings of the drop-arm test

Answer 20

Tear in rotator cuff complex – likely supraspinatus

Question 21

what is the Napoleon sign

Answer 21

1. Place patient’s hand on his or her stomach and have patient push palms
   into stomach

Positive => elbow will drop backward

Question 22

what is the findings for Napoleon sign

Answer 22

subscapularis weakness or injury

Question 23

what is the Gerber’s test

Answer 23

1. Patient puts hand behind lumbar spine and attempts to lift the hand
   away from the back

Positive => if patient cannot accomplish lift off

Question 24

what is the findings for Gerber’s test

Answer 24

subscapularis injury or weakness

Question 25

what is the anterior apprehension sign

Answer 25

1. Patient sitting or supine, arm is abducted to 90 degrees, elbow flexed to 90 degrees 2. Forearm forced into external rotation past 90 degrees Positive => patient will be apprehensive and ask to stop for fear of repeat dislocation

Question 26

what is the finding for anterior apprehension sign

Answer 26

anterior glenohumeral instability, previous dislocation

Question 27

what is the posterior apprehension sign

Answer 27

1. Patient lying or sitting 2. Examiner moves patient’s arm into internal rotation, adduction, and flexion 3. Examiner gently but firmly pushes posteriorly on elbow Positive => pain, clunk, apprehension

Question 28

what is the findings of the posterior apprehension sign

Answer 28

posterior instability due to labral pathology

Question 29

what is the clunk test

Answer 29

1. Patient is supine 2. Examiner places hand behind the humeral head, opposite hand holds the distal humerus and fully abducts the humerus over the patient’s head 3. Examiner pushes anteriorly (towards ceiling) on the humeral head 4. Hand on distal humerus then externally rotates shoulder Positive => clunk or grinding in shoulder

Question 30

what is the finding of the clunk test

Answer 30

labral pathology

Question 31

what is the special tests for AC joint sprain

Answer 31

- cross arm test - active compression test - painful arc test

Question 32

what are the special test for supraspinatus injury

Answer 32

- Full can - Empty can (Jobe’s) - Neer’s test (impingement sign) - Painful arc (pain around 70- 100)

Question 33

what are the special tests for subscapularis tendonitis/tear?

Answer 33

Gerber’s Lift Off Test – (+) indicates inflammation injury Napoleon sign – (+) indicates weakness of subscapularis

Question 34

what are the special tests for bicipital tendinopathy

Answer 34

- speed's test - Yergason's

Question 35

what are the special test for glenohumeral instability

Answer 35

- crank test - anterior apprehension sign - posterior apprehension sign - clunk test

Question 36

what are the special tests for adhesive capsulitis (frozen shoulder)

Answer 36

all the rotator cuff tests