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Shoulder Exam
Aka: Shoulder Exam
- See Also
- Shoulder Anatomy
- Shoulder History
- Shoulder Pain
- Exam: Inspection (from all angles and with Shoulder fully exposed)
- Swelling and Bruising in recent Trauma
- Scars suggesting old Trauma
- Observable deformity
- Sternoclavicular Joint
- Clavicle
- Acromioclavicular joint
- Glenohumeral joint (in acute dislocations)
- Asymmetry
- Disuse atrophy of the supraspinatus muscle
- Chronic Rotator Cuff Tear or Shoulder Impingement
- Efficacy of atrophy as test for Rotator Cuff Syndrome
- Test Sensitivity: 56%
- Test Specificity: 73%
- Shoulder sag
- Cranial Nerve 11 disorder
- Sulcus at glenohumeral joint
- Seen with acute Shoulder Dislocation
- Exam: Palpation
- Grading of pain
- No pain: 0
- Mild pain: 1
- Moderate: 2
- Severe: 3
- Technique
- Both Shoulders exposed
- Palpate for atrophy or swelling
- Assess contour of Shoulder
- Palpate for tenderness in both Shoulders
- Deformity and focal tenderness: Palpate landmarks in order (anterior, medial to lateral, then to Scapular and spine)
- Sternoclavicular Joint
- Clavicle
- Acromioclavicular joint
- Acromioclavicular Joint Osteoarthritis or
- AC Seperation
- Coracoid Process
- Humeral Head
- Glenohumeral joint (in acute dislocations)
- Greater Tuberosity
- Lesser Tuberosity
- Bicipital Groove and Biceps tendon
- Bicipital Tendonitis
- Scapular Spine
- Cervical Spine
- Palpate fibromyalgia Tender Points at occiput and medial trapezius muscle
- Assess for comorbid myofascial pain
- Exam: Specific Shoulder Tests (see categories below for full descriptions)
- Shoulder Range of Motion
- See Shoulder Range of Motion (forward flexion, abduction)
- Apley Scratch Test (internal and external Shoulder rotation)
- Evaluate passive and active range of motion
- Shoulder Strength Exam
- French Horn Shoulder Test
- Lift-Off Subscapularis Test
- Empty Cans Test or Full Cans Test (Supraspinatus)
- Drop Arm Test (Supraspinatus)
- Speeds Test (Bicipital tendon)
- Yergason Test (Bicipital tendon)
- Rotator Cuff Triad Test (Rotator Cuff Tear)
- Shoulder Instability Exam
- Shoulder Apprehension Test (and Relocation)
- Shoulder Crossover Maneuver (AC Joint disease)
- Shoulder Impingement Signs
- Neer Test (Shoulder Internal Rotation and forward flexion)
- Hawkins Test (Internal and external rotation)
- Empty Cans Test (Supraspinatus)
- Cervical Spine Test (cervical radicular pain radiating to Shoulder)
- Spurling Test
- Exam: Neurovascular exam
- Radial Pulses and distal Capillary Refill
- Sensory Exam
- C6: Thumb, Index Finger, lateral Forearm (Radial Nerve)
- Dorsal first web space sensation
- C7: Index, Middle and Ring Fingers, triceps (Median Nerve)
- Thenar eminence sensation
- C8: Middle, Ring and Little Finger (pinky), medial Forearm (Ulnar Nerve)
- Hypothenar eminence sensation
- Motor Exam
- Radial Nerve (C5-C6, C7-C8): Wrist Drop
- Dorsiflexion wrist, fingers against resistance (extensor carpi radialis, extensor digitorum)
- Median Nerve (C7, C8, T1): Cannot make 'OK' Sign
- Opposition of thumb and index finger against resistance
- Ulnar Nerve (C8-T1): Claw Hand
- Finger abduction against resistance
- References
- Kiel and Koneru (2019) Crit Dec Emerg Med 33(9): 17-27