Final Frontier: Special Test Shoulder

Final Frontier: Special Test Shoulder Flashcards | Quizlet pics

Yargasons Test -
▶ PURPOSE- Integrity of transverse ligament
▶ DESCRIPTION- Patient sitting with elbow flexed to 90° and
stabilized against the thorax and with the forearm
pronated. Resist the supination of forearm and external
rotation of shoulder
▶ RESULT- Tendon of long head of biceps will pop out of the
groove. Tenderness in the bicipital groove alone without the
dislocation may indicate bicipital paratenonitis/tendinosis

Speeds Test -
PURPOSE- Identify bicipital tendinosis/ tendinopathy
▶ DESCRIPTION- Upper limb in full extension and forearm
supinated, resist shoulder flexion. Alternate - place
shoulder in 90 degree flexion and push upper limb into
extension
▶ RESULT- Pain in long head of biceps tendon/ increased
tenderness in the bicipital groove

Neers Impingement Test -

▶ PURPOSE- For impingement of supraspinatus and
biceps tendon
▶ DESCRIPTION- The patient's arm is passively and
forcibly fully elevated in the scapular plane with the arm
medially rotated by the examiner. This passive stress
causes the greater tuberosity to jam against the
anteroinferior border of the acromion
▶ RESULT- Reproduces symptoms of pain in the shoulder
region

Empty Can/Jobe Test -

▶ PURPOSE- Identify tear/ impingement of supraspinatus
tendon or suprascapular nerve neuropathy
▶ DESCRIPTION- The patient's arm is abducted to 90°
with neutral (no) rotation, and the examiner provides
resistance to abduction. The shoulder is then medially
rotated and angled forward 30° ("empty can" position)
so that the patient's thumbs point toward the floor in the
plane of the scapula. Differentiate if pain is present
between two positions
▶ RESULT- Reproduces pain in supraspinatus tendon
or weakness in empty can position

Drop Arm Test -

▶ PURPOSE- Also known as Codman's test. Identify tear/
full rupture of rotator cuff
▶ DESCRIPTION- The examiner abducts the patient's
shoulder to 90° and then asks the patient to slowly
lower the arm to the side in the same arc of movement
▶ RESULT- A positive test is indicated if the patient
is unable to return the arm to the side slowly or
has severe pain when attempting to do so

Posterior Internal Impingement Test -

▶ PURPOSE- To identify impingement between rotator
cuff and greater tuberosity or posterior glenoid and labrum
▶ DESCRIPTION- The patient is placed in the supine
lying position. The examiner passively abducts the
shoulder to 90° to 110°, with 15° to 20° extension and
maximum lateral rotation
▶ RESULT- Reproduction of pain in posterior shoulder
during test

Hawkins-Kennedy Impingement Test -

PURPOSE: Identify sub-acromial impingement
▶ DESCRIPTION: The arm of the patient is passively flexed up to 90 degrees in the
plane of the scapula. The arm is stabilized and the forearm is forced into IR
▶ RESULT: Pain indicates a positive test for supraspinatus paratenonitis/tendinosis
or
secondary impingement
▶ The Yocum test is a modification of this test in which the
patient's hand is placed on the opposite shoulder and the
examiner elevates the elbow. Pain indicates a positive test

O'Brien's Test (Active Compression Test) -

PUPOSE: To detect SLAP (Type II) or Suprerior Labral Lesion
DESCRIPTION: Two-part test. The patient stands with his or her involved shoulder
at
90 degrees of flexion, 10 degrees of horizontal adduction, and maximum IR with the
elbow in extension. In this position, the patient then resists a downward force applied
by the clinician to the distal arm. The test is then repeated in the same manner
except that the arm is positioned in maximum ER.
▶ RESULT: If pain on the joint line or painful clicking is produced inside the shoulder
(not over the acromioclavicular joint) in the first part of the test and eliminated or
decreased in the second part, the test is considered
positive for labral abnormalities.

Pain Provocation Test -

PURPOSE: To identify SLAP lesion
DESCRIPTION: The patient is seated and the arm is abducted to between 90° and
100°, and the examiner laterally rotates the arm by holding the wrist. The forearm is
taken into maximum supination and then maximum pronation.
▶ RESULT: If pain is provoked only in the pronated position
or if the pain is more severe in the pronated position,
the test is considered positive for a superior (SLAP) tear.
lateral rotation LAG sign -
PURPOSE: To test the teres minor and infraspinatus. Aka SPRING BACK test
DESCRIPTION: The patient is seated or in standing position with the arm by the side
and the elbow flexed to 90°. The examiner passively abducts the arm to 90° in the
scapular plane, laterally rotates the shoulder to end range and asks the patient to
hold it
▶ RESULT: For a positive test, the patient cannot hold the position and the hand
springs back anteriorly toward midline, indicating infraspinatus and teres minor
cannot hold the position due to weakness or
pain

Abdominal Compression Test -

PURPOSE: Checks the subscapularis muscle. Also k/a Belly-Press or Napoleon
Test
▶ DESCRIPTION: The patient is standing, examiner places a hand on the abdomen
below the xiphoid process so that the examiner can feel how much pressure the
patient is applying to the abdomen. The patient places his hand of the shoulder
being
tested on the examiner's hand and pushes the ahnd as hard as he can into the
stomach (medial rotatio). WHile pushing the hadn into the abdomen, the patient
attempts to bring the elbow forward to the scapular plane, causing greater medial
shoulder rotation.
RESULT: if the patient is unable to maintain the pressure on the examiners ahnd
while moving the elbow forward, or posteriorly flexes the wrist or extends teh
shoulder, the test is positive for a tear of the subscapularis muscle.

Jerk Test -
PURPOSE: To test recurrent posterior instability
▶ DESCRIPTION: The patient sits with the arm medially rotated and forward flexed
to
90°. The examiner grasps the patient's elbow and axially loads the humerus in a
proximal direction. While maintaining the axial loading, the examiner moves the arm
horizontally across the body.

RESULT: A positive test is the production of a sudden jerk or clunk as the humeral
head slides off the back of the glenoid.

Sulcus Sign -
PURPOSE: To test for inferior shoulder instability
▶ DESCRIPTION: The patient stands with the arm by the side and shoulder muscles
relaxed. The examiner grasps the patient's forearm below the elbow and pulls the
arm distally
▶ RESULT: The presence of a sulcus sign may indicate inferior instability or
glenohumeral laxity but should only be considered positive for instability if the patient
is symptomatic

Pectoralis Major Contracture Test -

PURPOSE: To identify tightness of pectoralis major muscle
▶ DESCRIPTION: The patient lies supine and clasps the hands together behind the
head. The arms are then lowered until the elbows touch the examining table
▶ RESULT: A positive test occurs if the elbows do not reach the table and indicates
a
tight pectoralis major muscle.

Halstead Maneuver -
PURPOSE: Identify pathology of structures that pass through thoracic inlet
▶ DESCRIPTION: The examiner finds the radial pulse and applies a downward
traction
on the test extremity while the patient's neck is hyperextended and the head is
rotated to the opposite side
▶ RESULT: Absence or disappearance of a pulse indicates
a positive test for thoracic outlet syndrome.

Clunk Test -
PURPOSE- Identifies glenoid labrum tear
▶ DESCRIPTION- Patient is supine, with shoulder in full abduction. Push humeral
head
anteriorly, while rotating humerus externally
▶ RESULT- Audible clunk is heard while performing test

Anterior Apprehension/Crank Test -

PURPOSE- Identify past anterior dislocation of shoulder
▶ DESCRIPTION- Patient supine, the examiner abducts the arm to 90° and laterally
rotates the patient's shoulder slowly. By placing a hand under the glenohumeral joint
to act as a fulcrum, the apprehension test becomes the fulcrum test
▶ RESULT- Patient does not allow or does not like to move shoulder into that
direction
to simulate anterior dislocation

Acromioclavicular Shear Test -

PURPOSE- Identifies dysfunction of AC joint
such as arthritis, separation
▶ DESCRIPTION- With the patient in the sitting
position, the examiner cups his or her hands
over the deltoid muscle with one hand on the
clavicle and one hand on the spine of the
scapula. The examiner then squeezes the heels
of the hands together
▶ RESULT- Reproduces pain in AC joint

Adson's Test -
▶ PURPOSE- Identify pathology of structures that
pass through thoracic inlet
▶ DESCRIPTION-The examiner locates the radial
pulse. The patient's head is rotated to face the
test shoulder. The patient then extends the head
while the examiner laterally rotates and extends
the patient's shoulder. The patient is instructed to
take a deep breath and hold it.
▶ RESULT- A disappearance of the pulse
indicates a positive test.

Costoclavicular Syndrome (military Brace) Test -

▶ PURPOSE- Identify pathology of structures that
pass through thoracic inlet
▶ DESCRIPTION-The examiner palpates the radial
pulse and then draws the patient's shoulder down
and back
▶ RESULT- A positive test is indicated by an absence
of the pulse and implies possible thoracic outlet
syndrome (costoclavicular syndrome). This test is
particularly effective in patients who complain of
symptoms while wearing a backpack or heavy coat.

Roos Test -
▶ PURPOSE- Identify pathology of structures that
pass through thoracic inlet
▶ DESCRIPTION- The patient stands and abducts
the arms to 90°, laterally rotates the shoulder, and
flexes the elbows to 90° so that the elbows are
slightly behind the frontal plane. The patient then
opens and closes the hands slowly for 3 minutes
▶ RESULT- If the patient is unable to keep the arms
in the starting position for 3 minutes or suffers
ischemic pain, heaviness or profound weakness of the
arm, or numbness and tingling of the hand during the
minutes, the test is considered positive for thoracic outlet
syndrome on the affected side.

Median Nerve Tension Test -

shoulder depression
slight shoulder abduction
elbow extension
shoulder ER
forearm supination
wrist/finger/thumb extension
increase shoulder abduction
sidebend neck away

Axillary Nerve Tension Test -

Shoulder depression, elbow extension, forearm supination, wrist extension, finger
and thumb extension, contralateral cervical side bend

Radial Nerve Tension Test -

shoulder depression
slight abd
elbow ext
shoulder IR
forearm pronation
wrist finger and thumb flexion
ulnar deviation
sidebend neck away

Ulnar Nerve Tension Test -

wrist extension
forearm sup
full elbow flexion
shoulder depression
shoulder ER
Shoulder abd
sidebend neck away