UE - Normal and Abnormal

sandyle909's version from 2016-09-10 21:22


Question Answer
Palpation Palpate known areas of tenderness last
Neurologic: Muscle Strength Muscle function
0no muscle contraction
1visible contraction, no joint movement
2joint motion, not against gravity
3movement agains gravity only
4movement with some resistance
5full strength, full resistance
Wing Scapulaparalysis of serratus anterior
long thoracic nerve
Glenohumeral Dislocation95% anterior, 5% posterior
*Sulcus Sign - arm held in position of protection/ (pulling downward on elbow or wrist) (+) inferior glenohumeral instability
Suprascapularis m. abduction
Subscapularis m. internally rotate
Infraspinatous m. / Teres Minorexternally rotate
80% infraspinatous, 20% teres minor
Apley's Scratch Testpatient touches superior and inferior aspects of opposite scapula
(+) loss of range of motion: rotator cuff problem
Empty Can Test Resistance against forward flexion in hyperpronation (thumbs down), elbow extension, and abduction
(+) Supraspinatous injury/tear
Lift Off TestPlace hand on back with shoulder internally rotated
push against resistance
(+) Subscapularis injury/tear
Drop Arm TestProvider passively abducts arm to 120 degrees, ask patient to lower it
(+) Inability to complete this seconardy to weakness and/or pain
Rotator cuff tear
Impingement SyndromeMechanical phenomenon, not enough space, results in painful arc ROM (70-120 degrees)
Hawkin's TestPassive flexion to 90 degrees and forceful internal rotate the shoulder
(+) Pain, impingement, rotator cuff concerns
Supraspinatous tendon impingement
Neer's Impingement Sign (Neer, near the ear)Arm in full flexion
Passive flexion with arm pronated and scapula is stabilized
(+) Pain, subacromial impingement, rotator cuff concerns
Yergason Test (arm wrestle and feel over pronation/supination)Biceps Tendon Assessment
Elbow flex at 90 degrees with forearm pronated
Supinate forearm and externally rotate humerus against resistance
(+) Biceps tendon instability, tendonitis
Speed's Maneuver Arm extended in full supination with shoulder flexed. Elevate arm against resistance
(+) Biceps tendon instability, tendonitis
"Popeye" deformity of upper arm, bicep tendon rupture
Sulcus Sign Arm in neutral relaxed position, provider will pull on the arm downward
Depression or "sulcus" in the shoulder near the acromion
Elevates for inferior instability
Apprehension Test and Relocation TestGlenohumeral Instability
Elbow flexed at 90 degrees, arm abducted at 90 degrees
Apply external rotation at the shoulder and not apprehension
(+) Pain and apprehension with ROM, pain relieved with relaxation/relocation
Cross-body Adduction Test Adduct pt arm across body toward other arm
(+) Pain elicited and localized to the AC joint
Acromioclavicular (AC) joint
Frozen Shoulder Adhesive Capsulitis
Diffuse, dull, aching pain
NO localized tenderness
Progressive restriction of ROM
Usually unilateral - "post sling wear"