shoulder examination

Question 1

subsections of the shoulder examination and essentially any ortho examination

Answer 1

introduction
inspection
palpation 
movement 
special tests

Question 2

introduction

Answer 2

wash hands, full intro, check pt name, full explanation and consent

2. Asks patient to undress from waist upward
   - ask about shoulder pain, stiffness and effect on ADL

Question 3

inspection

Answer 3

front back and sides
dwarfs
-deformity, wasting, asymmetry, rash, fasciculations, scars.

Question 4

palpation

Answer 4

• temperature of joints
• tenderness over sternoclav, acromioclav, glenohum and spine of scapula
• tenderness of biceps tendon in inter tubercular groove.

Question 5

movement

Answer 5

active and passive

abduction and adduction (straight arm across body)
flexion and extension with elbow bent
internal (hand into small of back) and external rotation (open the gate with elbows fixed at sides)

Flexion – “raise your arms forward above your head” – 150°-170°
Extension – “straighten your arms backwards as far as possible” - 40°
Abduction – “move your arms away up from the side until they point at the ceiling” - 160°-180°
Adduction – “move your arm across your body as far as you can” – 30°-40°
External rotation – “hold elbows to your body flexed at 90, then move apart in an arc motion” – 70°
Internal rotation – “move your arms back across your body, keeping your elbows at your side” – 70°

abduction, adduction and external rotation initiation should all be tested against resistance to test power of rotator cuff muscles. supraspinatus, subscapularis, and infraspinatus with teres minor, respectively.

during passive movement comment on crepitus and PT tenderness. do this separately from/after active.

Question 6

special tests

Answer 6

push against wall for winging of scapula.

functional tests - arms behind head and in small of back (already done)