- Skin
- Color: erythema, ecchymosis, white, black
- Trophic changes (altered hair growth, sweat production)
- Scars
- Swelling
- Muscle tone: atrophy, hypertrophy
- Rotator cuff atrophy
- Deformity: asymmetry, rotation, amputation
- Areas of emphasis for shoulder exam
- Scapular winging?
Shoulder/Upper Arm
GENERAL EXAM
INSPECTION
PALPATATION
- Palpate for
- Effusion
- Clicking
- Snapping
- Crepitus
- Tenderness
- Temperature
- Masses
- Areas of Emphasis
- Acromioclavicular Joint
- Sternoclavicular Joint
- Coracoid Process and proximal Biceps Brachii
- Insertion of Rotator Cuff (greater tuberosity)
- Trapezius
RANGE OF MOTION
- Shoulder
- Abduction: 180 degrees
- Adduction: 50 degrees
- Forward flexion: 180 degrees
- Extension: 50 degrees
- External Rotation: 90 degrees
- Internal rotation: 90 degrees
- Elbow
- Flexion: 150-160
- Extension: 0
STRENGTH
- Strength
- Abduction:
- 0-90: Deltoid, Superspinatus, Coracobrachialis
- 90-180: Trapezius, Serratus Anterior
- Adduction: Pectoralis Major, Latissimus Dorsi, Teres Major, Subscapularis
- Flexion: Pectoralis Major, Deltoid, Coracobrachialis
- Extension: Latissimus Dorsi
- External Rotation: Deltoid. Infraspinatus, Teres Minor
- Internal rotation: Deltoid, Teres Major, Subscapularis, Pectoralis Major, Latissimus Dorsi
- Abduction:
- Motor Nerves:
- Axillary Nerve: Abduction, External rotation, Shoulder flexion and extension
- Musculocutaneous Nerve: Shoulder flexion
NEUROVASCULAR
- Sensory Nerves
- Needs to be updated
- Dermatomes: C5-T1
- Deltoid (C5)
- Thumb (C6, median n)
- Posterior 1st web space (C6, radial n)
- Middle finger (C7, median n)
- Little finger (C8, ulnar n)
- Proximal medial forearm (T1)
- Deep Tendon Reflexes (C5-C7)
- Biceps (C5, C6)
- Brachioradialis (C6)
- Triceps (C7)
- Myotomes: C5-T1
- C5: shoulder abduction
- C6: Elbow flexion Wrist extension
- C7: Elbow extension
- C8: Finger flexion
- T1: Finger abduction
- Vascular
- Radial pulse
- Ulnar pulse
SPECIAL TESTS / VIDEOS
- Subacromial Impingement Syndrome
- Rotator Cuff Disease: Subscapularis
- Rotator Cuff Disease: Supraspinatus
- Rotator Cuff Disease: Infraspinatus/ Teres Minor
- Proximal Biceps Tendon Injuries
- AC Joint Disease (Sprain, Arthritis, etc)
- Glenoid Labrum (see: Shoulder instability, Biceps)
- Shoulder Instability (general)
- Anterior Instability
- Posterior-Inferior Instability/ Laxity
- Inferior Instability/ Laxity
- Multidirectional Instability
- Thoracic Outlet Syndrome
- Wrights Test: WikiSM |
- Glenohumeral Arthritis
- Passive Compression Test: WikiSM |
- Scapular Dyskinesis
- Suprascapular Nerve Injury
- Winged Scapula
- Scapular Assistance Test: WikiSM |
OTHER
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CITATIONS
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