ascm clinical skills
DESCRIPTION
ASCM Clinical Skills. Shoulder. LOOK. Inspection. Swelling, bony prominence Bruising / lacerations Position of arm Asymmetry Atrophy Surgical scars. FEEL. Palpation. Expose both shoulders Palpate bony prominences Soft tissue palpation, least tender areas first - PowerPoint PPT PresentationTRANSCRIPT
ASCM Clinical SkillsASCM Clinical Skills
ShoulderShoulder
LOOKLOOK
InspectionInspection Swelling, bony prominenceSwelling, bony prominence Bruising / lacerations Bruising / lacerations Position of armPosition of arm AsymmetryAsymmetry AtrophyAtrophy Surgical scarsSurgical scars
FEELFEEL
PalpationPalpation
• Expose both shoulders
• Palpate bony prominences
• Soft tissue palpation, least tender areas first
• Compare to contralateral side
AC Joint
MOVEMOVE
ACTIVEACTIVEPASSIVEPASSIVE
ABNORMALABNORMAL
Compare both shouldersCompare both shoulders
Range of MotionRange of Motion
Forward Flexion:
180°
Range of MotionRange of Motion
Abduction: 180°
Range of MotionRange of Motion
External Rotation:
60-80°
Range of MotionRange of Motion
Internal Rotation:
T7
Range of MotionRange of Motion
Internal Rotation at
90° Forward Flexion: 90°
Rotator Cuff InjuryRotator Cuff Injury
• Tendonopathy or tear• Partial or complete• Acute or chronic
Rotator Cuff InjuryRotator Cuff Injury
Jobe Test:SupraspinatusMiddle deltoid
Rotator Cuff InjuryRotator Cuff Injury
External Rotation:
Teres minorInfraspinatus
Rotator Cuff InjuryRotator Cuff Injury
Internal Rotation:
SubscapularisPectoralis
majorLatissimus
dorsi
Rotator Cuff InjuryRotator Cuff Injury Drop Arm TestDrop Arm Test: :
Unable to resist Unable to resist pressure at pressure at 90°90° abductionabduction
Painful ArcPainful Arc: : Between Between 45 °45 ° and and 120°120° abduction abduction
ImpingementImpingement
• Usually subacromial space• Irritation between AC joint, RC
tendons and bursae
ImpingementImpingement
Neer’s Test
ImpingementImpingement
Hawkin’s Test
Biceps tendonitis/tearBiceps tendonitis/tear
• Usually long head• Related to overuse/activity• Anterior shoulder pain• Acute or chronic• Weakness with resisted
flexion/supination
Biceps Tendon
Biceps tendonitisBiceps tendonitis
Yergason’s Test
Biceps tendonitisBiceps tendonitis
Speed’s Test
AC Joint arthritisAC Joint arthritis
Crossed Adduction Test
GH Joint LaxityGH Joint Laxity
•Apprehension Test
•Relocation
GH Joint LaxityGH Joint Laxity
Sulcus Sign
GH Joint LaxityGH Joint Laxity
Load and Shift Test
Referred PainReferred Pain
NeckNeck ElbowElbow HeartHeart DiaphragmaticDiaphragmatic Pan coastPan coast
Neurological ExaminationNeurological Examination
Radial nerve – Thumbs upRadial nerve – Thumbs up Median nerve – Thumb to hypothenar Median nerve – Thumb to hypothenar
eminenceeminence Ulnar nerve – Abduct VUlnar nerve – Abduct V Axillary nerve - DeltoidAxillary nerve - Deltoid